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Scot: Hey, this is Scot from "Who Cares About Men's Health?" What we're trying right here is a brand new concept we're calling the "Who Cares About Men's Health Sideshow." So as the podcast is developing, we've come up with some different themes. One is our "Core Four Plus One More," which is activity, nutrition, sleep, emotional health, and then also knowing your genetics have a big impact on your current health and your health in the future and also can help prevent disease in the future as well. So we do episodes that focus around those areas and how to improve in those areas and just education in those areas.

Another concept that we have are "Who Cares About Men's Health Men's Health Essentials." These are diseases and conditions that impact men, stuff you need to know in order to remain healthy. And now, this particular concept, if you see a show called the "Sideshow," we're going to be a little bit more loose. Could talk about some of the Core Four stuff, probably going to involve a few more personal stories, and might be some articles that Troy has, or just some other interesting things we think you might find interesting. But if you're here because you want to focus on your "Core Four Plus One More," check out those episodes. That'd be a good place for you to go. If you're interested in specific men's health conditions, check out our "Men's Health Essentials." If you're interested in a little bit more free form, then that's what you're going to get right here. So pick and choose what you like and enjoy.

I need to talk about nutrition because I was a freak at one point. Like before this podcast started, I was logging and weighing all my food, and I scheduled my times to eat, and I stressed about what I ate, and I didn't want to eat any bread, and I hesitated on fruits because I was trying to keep low carbs. And I didn't want to, you know, eat too much fat and . . . I should talk about that, because I changed a lot with my nutrition. I think I feel pretty much okay.

Troy: Well, that gets to that orthorexia and . . .

Scot: What's orthorexia?

Troy: Well, do you remember . . .

Scot: Oh, that eating disorder.

Troy: Dr. [Pohl], Susan Pohl, she talked about it very briefly, buy it's not anorexia. I mean, it kind of obviously has that same root.

Scot: [inaudible 00:02:02]

Troy: But it's orthorexia where you get like a very strict diet and to the point that it becomes like a compulsion where it's just like, "Oh, I can't do that, I can't do that, I can't do that. I have to do that exactly this way," where it is classified as an eating disorder. It's a newer thing that's come out in the last 5 to 10 years I think. But that might be interesting to talk about your experience and say, "Hey, do I meet the criteria for orthorexia?" And I can dive on mine too. Like, sometimes I wonder, "Am I orthorexic?"

Scot: You know what changed all of that was, first of all, realizing that I didn't need as much protein as I thought, because I was building my life around protein. Second of all . . . Actually, the first thing was when Thunder said, "If you just alter the time that you eat. Like, if you do 8 on, or 16 off, or even 12 on, 12 off, you can eat what you want and you're going to maintain." I'm not going to go crazy with junk, but at least I'm like, "Well, I don't have to weigh my food anymore." So that was kind of good. And I kind of have an idea of how much I'm eating now anyway. That's so freeing and it's freeing to know that I can have bread. I just had some great sourdough bread. It wasn't made by Mitch this time, but . . .

Troy: It's all good.

Scot: . . . Bob and Randy Harmon made it and they did a pretty good job of it.

Troy: Nice.

Scot: Yeah. Troy, what do you got there? Looks like you got some sort of medical journal there. You want to tell us a story from that book of medicine?

Troy: Well, I have several options today, Scot. Would you like to know about the effectiveness of honey for symptomatic relief of upper respiratory infections?

Scot: Okay.

Troy: The efficacy of ginger for the treatment of migraines?

Scot: Okay.

Troy: The effect of vitamin D supplementation, omega-3 fatty acids, or strength training for older adults?

Scot: All right.

Troy: A man with a gnawing sensation under his scalp?

Scot: Eww, that sounds creepy. I bet you Mitch is going to vote for that one.

Troy: Maybe he will.

Scot: Yeah, so which one of those are you going to vote for, Mitch? What do you like?

Mitch: Oh, I don't know.

Troy: Or let me give you the last one. A pilot trial of topical capsaicin treatment for cannabinoid hyperemesis syndrome. Basically, how do you treat retching when you smoke marijuana?

Mitch: They all sound so good. I can't choose.

Troy: I know. Every one of these I could use in some form.

Mitch: All of them, please.

Scot: I don't know. Which one, Mitch?

Mitch: We can we talk about the cannabinoid one? I am interested.

Troy: Yeah, absolutely. And this is something I use in the ER.

Scot: Really?

Troy: Yeah.

Scot: Oh, this technique, if somebody . . .

Troy: Yeah.

Scot: . . . comes in with this problem. All right.

Mitch: I'm in.

Troy: I put it on myself before I go to work. It's how I get through the shift.

Scot: All right. I'm into this. So essentially, it's about people that smoke marijuana, and then they start retching, what to do about that?

Troy: Yeah. How do you treat it, yeah.

Scot: Okay. So what journal is this from?

Troy: This is from the journal "Academic Emergency Medicine."

Scot: All right. Troy reads them and finds a good story so you don't have to. So . . .

Troy: That's right.

Scot: . . . go ahead and go.

Troy: So Scot, so this is an interesting article. I love articles that just show you a fairly simple treatment, and maybe it's not a huge study, maybe it's not the best done study, but it shows it's effective. And then you try it at work and you treat someone with it, or maybe you try it yourself and it works. So as you know, the use of marijuana is becoming more and more prevalent. Maybe they have a prescription for it. You know, there's several states where you can use it recreationally legally. So we are seeing more and more cases in the emergency department of what's called cannabinoid hyperemesis syndrome. And what this means is that people who use marijuana frequently can sometimes just develop just retching vomiting. They just cannot stop vomiting and they feel miserable. Sometimes they treat it by taking a hot shower. For some people, that seems to work. But there was a study that was done, and this appeared in the journal "Academic Emergency Medicine." So not a big study, they had 30 patients, and 17 patients, so about half of them, they treated with capsaicin cream. Are you familiar with capsaicin cream?

Scot: No, what is that? Mitch, do you know what capsaicin cream is?

Mitch: It's like the granola version of IcyHot. What's that brand called?

Troy: Yeah. Well, actually the brand is called Capzasin, C-A-P-Z-A-S-I-N, so you may have heard of it. But yeah, something you can use to treat muscle soreness. I mean, capsaicin is a pepper. So it's actually like this pepper in this cream, and people put it on sore muscles, sore joints, things like that. Kind of like IcyHot, it relieves the pain because it just stimulates these nerves in a certain way that the nerves are then more focused on that or it just, you know, overstimulates them in a sense where then you're not so focused on the pain there. But the bottom line is that's what it's used for. It's over the counter, super easy to find this stuff in any pharmacy, any place you want to shop.

But basically, they treated 17 patients with the capsaicin cream and they treated 13 patients with the placebo, just another cream that was not a capsaicin cream. They found, in just about everything they measured, in the patient's nausea, in just their vomiting, you know, like the 30 minutes, at 60 minutes, they found that the large majority of the patients who had the capsaicin cream did better. And patients who had the capsaicin cream, 29% had complete resolution of the nausea versus none of the patients who had the placebo treatment.

Scot: Wow.

Troy: So, yeah, pretty significant improvement, and that's complete relief. But then just looking at, okay, how much did you improve? Maybe not completely. People who got the cream did a lot better. So it's something I use in the ER, because we see this surprisingly frequently, people who come in who just are having this retching vomiting and feel miserable. And I'll just order up some capsaicin cream. I'll have them apply it to their abdomen and the large majority of the time, with an hour, they feel better. And I say, "Just take this home. If this happens again, use this cream."

Mitch: You take the cream and you rub it on your belly?

Troy: Yeah, you just rub it on your belly.

Mitch: Oh wow.

Troy: It's very simple. You're not rubbing it on joints or anything like that. You're just rubbing it on your belly. Don't drink it, don't eat it, just rub it on your belly. Just use it externally. It's just a cream. You know, I don't know if this will work for any other types of nausea, I've never tried it there. Certainly there are other meds that can help with those sorts of things. But a lot of times with these patients who come in with this type of vomiting, it's like you give them other stuff and nothing seems to help, like a lot of the standard medications we use. You use some capsaicin cream, makes a difference, they feel better, I just tell them, "Use it at home."

Scot: And you have to put it on your abdomen? If you put in your arm, then it doesn't help?

Troy: Yeah, don't put it anywhere else. Just rub it right over your belly. Right over that spot that's cramping up, that's miserable.

Scot: Do we know why it works?

Troy: I don't know why. And I don't know [inaudible 00:08:48]. It's probably the same thing as the hot shower. It's one of those things, I remember seeing case reports about this, you know, a few years ago where people are like, "Hey, we tried this and it worked." And I don't know if it was the same thing as the hot shower, where some dude is just like, "Hey, I've got some of my grandmother's arthritis, while I'm in here I'm going to rub this on my belly," and then he told someone else, and then someone reported it in a medical journal, and then here's this really small study that said, "Hey, it really seemed to help." So I don't know the origin or the rationality behind it.

Scot: It's a bizarre thing to try.

Troy: It is.

Scot: You know, like any time you look at anything, sometimes I look at like foods and I'm like, "Who decided to try that first?" You know? And it's like who decided to try this first?

Troy: Who decided to do this first?

Scot: Like what was the connection that they made that they're like, "That could work."

Troy: Yeah, I don't know. And again . . .

Scot: Why ask why sometimes, right?

Troy: Why ask why? I'm sure there's someone who's come up with some sort of physiologic explanation for why it worked. But I guarantee that's not the reason someone used it in the first place. It's not like someone thought, "Well theoretically, this could make a difference." Again, the only reason this study happened, it's because of some of these case reports that were out there that I saw, you know, appearing in journals several years ago. And so someone tried it at some point, it seemed to work, and now here's a study, very small study, but says, "Yeah, it does seem to work." And my experience is that it does seem to work.

Scot: Hey, thanks for checking out "Who Cares About Men's Health The Sideshow." If you liked what you heard, we'll have more Sideshow episodes coming up. I also ask you to check out our "Men's Health Essentials" and our "Core Four" episodes to help you lead a healthier life today and in the future. Feel better now and later.

By the way, check out our migraines episode that we just recently did. It's really, really good if you know somebody that suffers from migraines. And if you know anybody that might enjoy what you just heard, do us a favor and just share this podcast with that one person. If you share that podcast with this one person, it will help us get to more people that we can help and more men who want to care about their health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Dr. Galli: Most of us take for granted the things that we see as normal and expected. So hopefully, we've at least parked the thought of, "Oh, hey, maybe that's not how I have to be. It's how I think I should be," and where is that coming from?

Scot: All right. Welcome to the podcast "Who Cares About Men's Health." What we've got here are some guys who care about their health, and they're not afraid to talk about it either. We get this bad rap. Guys don't care or want to talk about their health. That's not true, proving it right now.

My name is Scot Singpiel. I am the manager of thescoperadio.com, and I care about men's health.

Troy: And I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah, and I'm glad that for the first time in the history of this podcast I actually sound better than Scot on this, and I care about men's health.

Dr. Galli: And I am Dr. Nick Galli. I'm an associate professor at The U in the Department of Health and Kinesiology, and I care about men's health.

Scot: So today, we're going to talk about a force. It's a force that controls us as men, and a lot of us don't even know it, but it's this invisible force that impacts how we think about our health, our body, and it could be responsible for a lot of bad health decisions. It's reinforced in magazines, TV shows, movies, social media, and communities. We cannot get away from it. As a matter of fact, the World Health Organization thinks it's the reason why men tend to live six to eight years less than women, this invisible force. What is it?

Troy: Dark matter.

Scot: Kind of. It's the notion of what makes a man a man, the forces called masculinity. Nick is an expert in this topic. I actually did for my master's program a research paper on masculinity and men's health, and what I found was fascinating. I don't know about you guys, but I hate the thought that anybody or any force is controlling what I'm doing.

Troy: Especially if it's shortening our life by six to eight years. I had no idea. Wow.

Scot: Yeah. Isn't that crazy?

Troy: That's crazy.

Scot: So, before we get going, Nick, maybe you can give us a definition of what masculinity is, because it's not a real thing. It's what's called socially constructed. It's just something that we as people made up.

Dr. Galli: Yeah. Let's say it's sort of the set of attitudes, beliefs, behaviors that dictate how men should behave, what they should think, what they should value. And as you said, Scot, it's pervasive. We're primarily talking about Western cultures and even more primarily the U.S. It cuts across everything that we do.

Scot: So an example of this and how it might impact our health is somebody offers you a steak or a salad and you take the salad, what happens? What happens if you've got your guy friends around?

Dr. Galli: Well, of course, it depends, but yeah, you're going to get . . . I mean, when I think back to when I was sort of in the prime of . . . Because it changes, right? So, for me, when I was in my late teens and in my 20s and spending a lot of time with my guy friends, now you're immersed in that. And so, for sure, you'd get some looks.

I mean, even on that specific topic, I remember going out to lunch and dinner with my guy friends and it was almost, "How much fatty food can you eat?" Like, it was a challenge. Everything is a challenge in the world of masculinity. Everything is a competition, including how much you can eat.

Troy: Nick, I wonder how much of this is learned, how much of this is just the fact that as a man you've got testosterone and testosterone tends to lead men often maybe to be more risk-taking or maybe more competitive. I don't know. I mean, are there certain elements there versus . . .

Dr. Galli: I think there's a biological component, but that becomes accentuated for sure by messages that begin very early on.

Troy: And by masculinity then, are we talking about . . . again, is it the way we're interacting with others? Is it the expectation I have for myself? Is it just this idea that I can't show emotion? What is it about this that's kind of the core element of it? And getting to that, what is it about it that's so detrimental that's really shortening our lifespan?

Dr. Galli: Well, I think too, before we go much further on it, true experts and scholars in gender studies and masculinity would probably argue that there are multiple forms of masculinity. And the kind that we're talking about here today and that tends to be especially problematic is sort of that dominant, what we call a very . . . this is a very scholarly term . . . hegemonic masculinity. Hegemonic is just a fancy way to say dominant.

I think one of the tasks and one of the goals is to try to diversify. There's nothing inherently wrong with masculinity, femininity, but building in some flexibility into those concepts that there's not just one way to be masculine or one way to be feminine.

What's problematic about this dominant form that, as Scot alluded, seems detrimental to our health is that, yeah, we box ourselves in as men into a certain way of being, and that's fueled by things that we see and expectations that we hold of ourselves and that others hold of us. And really, what needs to happen, and this is maybe skipping ahead to more practical, is there needs to be a much more flexible conception of what it means to be a man in society.

Scot: And that's difficult, right? Because I bet you we could all tell our stories . . . I don't know. I can only speak for myself I guess, but I grew up in a ranch environment in western South Dakota and there was a certain kind of way that guys were supposed to be there, which is all just created in our own brains. There's nothing inherent about a lot of it. And I didn't fit in, right? I was a little bit more sensitive. I was a little bit more delicate. I wasn't a big muscular guy, right? I didn't like to ride bucking broncs and bulls and I didn't like to fight. So that made me less than.

Dr. Galli: Absolutely.

Scot: And I spent a lot of my life, and I still think about it to some extent, but not as much, trying to come to terms with, "Oh, I'm not a man. I don't look for a chance to . . ." Like, if somebody gets in my face, I don't get right back in their face. That's not how I choose to handle it. Maybe I choose to talk it out. That's not manly, right? That doesn't fit that masculine definition. So, for a long time I've . . . and especially then comparing myself to my dad who was all those things.

Dr. Galli: Well, thanks for sharing that, and I think that speaks to one of the earlier manifestations of how this can become problematic, is when we see young boys in school who maybe prefer different types of activities that aren't perceived as masculine or act in ways that aren't perceived as masculine, and then they can become the subject of bullying. We know well the consequences of bullying on mental emotional health.

Scot: And also just my own emotional health not living up to this ideal.

Dr. Galli: That you're not good enough. That you don't . . .

Scot: Exactly.

Dr. Galli: . . . meet that standard. I relate. I mean, where I grew up in a mid-sized city in central California, at my high school, for the boys, there were sort of two ways to be popular: one if you were a tough guy and/or two, if you were good at sports, and physical sports particularly, so football or the mainstream sports. If you couldn't check either of those boxes, you were sort of on the fringes of popularity or of acceptance.

Troy: Scot, it's interesting to hear you talk about that because I think I too . . . I mean, I didn't grow up in a ranching community. I grew up in a coal mining community, a small town. And as a skinny nerdy kid, middle school was miserable. I got beaten up. Not just bullied, but physically beaten up by kids in school and it was awful.

Scot: Wow.

Troy: And that kind of stuff sticks with you. I think probably over my entire life that element or that definition of masculinity, that's probably affected me.

And it's funny. I think back to two years ago, Scot, when you approached me and said, "I want to do a men's health podcast. Will you co-host with me?" It was like this sense of this imposter syndrome, like, "Who am I to talk about men's health? I am not a manly man."

And obviously, as we do this podcast, you realize that masculinity or that sense of the manly man, that's not who most men are. I don't think that's really who most men are. I think, like you said, Nick, that's the image that's out there and that's what we feel we should be. But you look at the men you know in your life and the men work with, most men are not that way.

Dr. Galli: If we were to all Google "men's health" right now, what would come up is probably very different than the things that we're discussing today. I mean, there's even a magazine called "Men's Health," and what do you get in that magazine? You get chiseled muscular bodies, very much an aesthetic and physical version of what health is.

Scot: Yeah. And not only that, but you get these attitudes of a man in "Men's Health" is great in the bed and takes care of his woman, and just all of these images and these thoughts that . . .

Troy: Well, not just takes care of his woman, takes care of multiple women. If you read "Men's Health" magazine, it's like . . . yeah, that's been my image of men's health is "Men's Health magazine. How often do you see a thin guy on the cover of "Men's Health" magazine? It's usually dudes who are just totally ripped and built and just these massive dudes.

And all the articles there, it's about that. It's about living a lifestyle. Not all of them, but a lot of them have to do with maximizing that lifestyle, live hard/play hard, work hard/play hard lifestyle, and a certain element of sexual prowess or whatever else some of these articles . . . and so it's a . . .

Dr. Galli: This makes the battle even harder, right? Because now we have sort of the big media hijacking the concept of men's health. Not just masculinity, but men's health, and selling it to the masses.

Scot: Yeah, it's that either/or, right? So it doesn't leave you any in between. It's either you're working out and you're doing high intensity exercise and you're eating just perfectly, or if you can't live up to that ideal, which sometimes I think I can't do that. So then it's just like, "Well, why even bother if that's not what I'm going to get?" So I think it's a little dangerous that way as well.

Troy: For sure.

Scot: Hey, Nick, I want to share another little aspect and then I want to kind of steer the transition of the conversation into how maybe each one of us can claim our own form of masculinity, because I think ultimately that's what we should be able to do.

So I can't speak for Troy, but I wasn't very confident and I lacked confidence for a long time in my life because I didn't fulfill this ideal of masculinity. And that can lead to mental health issues. That can lead to feelings of inadequacy. But I have noticed, too, that there are some men that are very confident in themselves and they might not fulfill that norm of hegemonic masculinity, but yet they create their own, right? To some extent, showing control and restraint in not doing all those dangerous behaviors can be a form of masculinity.

How exactly does that work and what are your thoughts on developing your own version of it? And then how are you confident in that version as you interact with the rest of the world?

Dr. Galli: That's a big question.

Scot: Hey, listen, I gave you a little bit of warm-up to get to this point. So I figure you should have all the answers by now.

Dr. Galli: Okay. There's not going to be a simple answer to this, but there are forces at play. I think two of them come to mind, as I think about folks who are sort of able to transcend what we've been talking about here.

One is just time and maturity. The young adult males are the ones who are kind of most at risk I would say for really trying to live this ideal that can be dangerous. As we get older, we care less about what other people think, we have different priorities, and so it becomes easier as we get into more middle adulthood to just sort of be our own person and not give a crap about what people say I should be. Now, that said, there are definitely some people who struggle with that. So I think time and normal development is an asset.

And then I think another asset that some folks have are support of influence and people in their family who are just unconditionally okay with a boy being how they want to be, and for that matter, a girl being how they want to be. Of course, there are forces outside the family, but that primary family tends to be the most powerful force for a lot of kids. And I think that goes a long way.

And as a young boy, if you want to play with Barbie dolls, that's fine. If you want to watch "My Little Pony," that's fine, or whatever. That's what it was when I was a kid growing up.

I think it seems very subtle, but when you are surrounded by folks who are just okay with you being you and not making snide comments or forcing you to be something that you don't want to be, then I think that allows for the possibility of just, as you said Scot, being comfortable in your own skin, even if that doesn't align with what you're seeing of other boys and men.

Troy: And I guess though, Nick, as we talk about this . . . I mean, certainly there are some elements of masculinity that are valuable, but at what point do you feel like that truly becomes toxic? We talk about masculinity or toxic masculinity. When does that sort of thing become toxic? And are we talking toxic to others, toxic to ourselves? How does that play into it?

Dr. Galli: Yeah, I think both. I mean, any time that somebody has fully internalized . . . I think of heavy drinking, womanizing, or having multiple partners and not exhibiting safe and thoughtful sex behaviors, over-imbibing in alcohol, drug use, steroid use, not going to see the doctor on at least a yearly basis because "I'm invincible." I mean, I think it's all about the behaviors, and underlying that is the thought that, "I am impervious to a lot of these issues, and also I don't need to talk about what's bothering me because that would suggest weakness."

And going back to something you said there, Troy, too about some of the advantages, I do think there are advantages, and in many ways I think our society is set up to favor and advantage men who do exhibit these dominant traits. So it's reinforcing, right?

Look at who we see as CEOs and in leadership positions. And that's starting to change, but it tends to be men. And there are some positive characteristics for sure. There are also positive characteristics of . . . and I keep pointing to femininity as sort of the other side of the coin here. Things that we associate with femininity that are also very positive, such as compassion and having a nurturing side, sort of those stereotypical feminine qualities, that many men feel like, "Well, that's not what I'm supposed to do." So they deny themselves the opportunity to explore that side of who they can be.

But in many ways our society is set up to really favor folks who exhibit these dominant alpha male qualities.

Troy: And it seems that in terms of just where masculinity truly becomes detrimental, it may be that it's that masculinity at the point where we really try and push away any sort of feminine qualities within ourselves, any sense of nurturing, any sense of emotion, those kind of things and . . .

Dr. Galli: Except for anger. Anger is okay. Anger is okay for a man.

Troy: It's okay for a man.

Scot: I think that's the only emotion, isn't it?

Dr. Galli: When a woman is angry, oh, there's something wrong. It's so true, right?

Troy: Yeah, but it seems though that that often . . . as I'm hearing you talk about this and talk about these different elements, it seems that when masculinity really becomes an issue and a problem, it is when we, like you said, take that masculinity to the extreme in terms of risk-taking, detrimental behaviors, in terms of how we treat others and interact with others, and then we push aside anything that would be associated with that feminine element, again the nurturing, the caretaking, all those sorts of things.

Scot, as you talked about, the years lost on our life, I would imagine that those are the things that really caused those years to drop off when we are pushing aside our ability to feel emotion and ability to care, and nurture, and those sorts of things, and then add on to that the risk-taking behavior and everything else there. That seems like that combination is what is truly toxic and what really hurts us.

Scot: As we wrap this up, here are a couple of my takeaways, Nick, and I'd love to hear yours as well. So I think the goal of this particular episode is just for those that weren't aware that this is an invisible force in one's life that is actually impacting your decisions or how you feel about yourself, just to become aware that it's out there and it's a thing. I think, obviously, awareness is the first thing.

And then I think developing your own definition of what you are as a person. Maybe just abandon the notion of men and women. What are you as a person? And I'm guessing that the super toxic masculinity individuals have dropped off this episode way before this point. So we're not talking to them necessarily.

Dr. Galli: But we could be talking to parents of children who have a role in shaping them.

Scot: Yeah. I mean, the way you shape them could either empower them to go out and accomplish great things, and feel good about themselves, and be mentally well off, or it can burden them if we're forcing those types of things, I suppose, on kids.

So I think becoming aware and I think realizing that it's okay to be you. I tend to be more sensitive, I tend to be more thoughtful, I don't react and come to anger as quickly as maybe some men, I don't believe in fighting. That's okay. That's my outlook on life, and that's fine.

Troy: Have you ever been in a fight, Scot? I'm just curious.

Scot: Actually, I never have, believe it or not.

Troy: Like a physical fistfight? Not even in elementary school?

Scot: No. I was a "doorman" at a bar for a couple years, and I never got in a fight.

Troy: You were a bouncer.

Scot: I know, right?

Dr. Galli: A bouncer. Yeah.

Troy: Scot is like the world's worst bouncer.

Scot: Actually, I wasn't.

Troy: He's like, "It's all right, guys. Let's talk this out."

Dr. Galli: He's actually willing to talk and . . .

Troy: I know. I was just joking. Yeah, you're totally breaking the mold of the bouncer. You're like the negotiator. I love it. That's great.

Scot: Nick, any final thoughts or takeaways from this episode? What do you hope that it accomplished today?

Dr. Galli: Oh, yeah. Raising awareness primarily. I talk about internalizing, and I think most of us take for granted the things that we see as normal and expected. So hopefully, we've at least sparked a thought of, "Oh, hey, maybe that's not how I have to be. It's how I think I should be," and where is that coming from? Maybe more men or women willing to have conversations, like we just did right now, about these topics.

Troy: Obviously, we say, "Be yourself." Sometimes that's hard because it's like, "Well, yeah, but there are different elements of myself." I think it's be your best self. There are elements of masculinity that are, I think, good.

Scot: Yeah, but it's also tough to sometimes be yourself if you're not in the environment. There's no way as a young man I would have been able to buck the trend, I don't think, of what was expected of me. I don't know. Maybe there could have been had I been more confident.

Troy: Still.

Scot: You've just got to try the best you can.

Troy: Yeah, embrace the best of these things and don't . . . I think that's it, too. Again, getting to that thing about, "Well, these things are associated with femininity in terms of emotion and caretaking and all that," but if that's part of you, embrace it. Embrace that and just . . .

I think one takeaway too, like I said, Scot, is just that most men are not that stereotypical man. I think that's been one thing that's come to me in terms of this podcast as we talk to so many experts. It's just opened my eyes and I look at the people I work with, and the patients I see, and all these things. Most men are not the stereotypical manly man that we sometimes think we should be, and that's not the norm. Maybe what's held out there is what we should become, but that's not what most men are.

Scot: And there's a certain strength . . . I guess if I was to give advice to young Scot, like how you could still be yourself and be in an environment where there's a different definition of masculinity, I think . . . and I could be completely full of crap and might get the crap kicked out of me. I think there's a certain strength in knowing who you are and owning that and making no apologies for it.

I think you can stand up to people, most people. I mean, there are going to be outliers, like anything, but I think there's a certain strength in that. And I think if you do it enough and you're resolved enough, that can help.

Nick, what do you think? Am I completely crazy?

Nick: I think for the most vulnerable people, which is kids and adolescents, they need support from parents, from teachers, from church leaders, because . . . I mean, when you're 8, 10, 12, 14 years old, we could be delivering this message to them all day, "Love who we are, own it, be okay with it," but they need to see more than that. And they need role models who they can look up to, who are confident, but also caring, but also strong, but also compassionate. They need to see that, I think, to really buy in.

Troy: Yeah. And it's a lot easier as an adult I think to do that than as a kid with the perils of just the peer groups and all that. That's a tough place to be.

Scot: Yeah. As an adult, you to some extent can choose where you go. As a kid, you can't. You have to go to this place called school and everybody's thrown in there, and it's just a big old free-for-all. But I can avoid the type of people I want to avoid in my work life.

Troy: Yeah. It's a lot easier, but for those listening who you're an adult, you can embrace that. And if you're in a work . . . because there are certain work environments where I think it's difficult. I think certain work environments it may be difficult to truly be who you are, and maybe certain co-workers, but you can always find a new job or even switch professions, or all those sorts of things.

I think it's a lot easier as an adult, but I think that's probably the point, is to really embrace that, embrace who you are, and not feel like you have to fit a certain mold that's held out there.

Scot: Yep. Realize that masculinity is a thing. It's not a real thing. It's just created by all of us in society that have come to these assumptions, and these assumptions can be challenged, and you can define your own way.

One of the things I love that you said, Nick, is question why we call things normal. I think that can even go beyond this notion of masculinity. Why is this considered normal? Do I subscribe to this thought that this is normal? What are my thoughts on it? When you start asking those questions, I think you can start really kind of building your own confidence and go in your own way.

Nick, thank you very much for this conversation. Appreciate it as always for being on the podcast, and thanks for caring about men's health.

Dr. Galli: Absolutely. Thanks for having me.

Scot: Time for "Just Going To Leave This Here." It might have something to do with health or maybe it's just a random thought that's kicking around in our brain that we need to let free. Troy, do you have any random thoughts you need to set free?

Troy: Totally random thought, Scot. I am . . . and you probably are too. But I'm kind of a grammar nerd. So this is a grammar issue that has really bothered me and I've got to get your insight on this. So if I sent you a text message yesterday, how would you say that phrase? "I text you yesterday" or "I texted you yesterday"?

Scot: The thing that feels natural and normal is "I texted you yesterday."

Troy: I know. Me too. I mean, text has become a verb. It's a noun. A text is a noun. It's become a verb. In our daily usage it's become a verb. But people say "text" all the time, like, "Oh, I text you last week," "Oh, I text you yesterday," "Oh, I text . . ." And they're not saying texted, they're just saying text. I looked this up. I'm like, "What's the proper use of the verb text if I sent you a text yesterday, if I texted you?" And there is no proper use because it's just this noun we've turned into a verb, and we're all just using it. Some people are saying, "I texted you," and some people are saying, "I text you." Probably the best way to say it is, "I sent you a text message yesterday."

Scot: Yeah. I mean, if it's a noun, that's how you would say it.

Troy: Yeah, be on the lookout. Now it's going to start driving you crazy. You're going to hear people saying it all the time, like, "Oh, I text you this picture," or, "I text you this whatever." And you're like, "Text me right now, or you texted it two hours ago?"

Scot: I'm just going to leave this here. Thunder Jalili, our nutrition expert, has talked a couple times about time-restricted eating. So there's a lot of confusion when it comes to fasting because it can mean a lot of different things, but time-restricted eating is just taking the time that you allow yourself to eat during the day and keeping it limited to 12 hours or 10 hours or 8 hours so then you have a fast between then and when you eat again.

I started doing this when COVID first started, just before COVID first started. I've actually loved it. I felt great. I felt clear in my brain. I slept better. So I've started doing that again after Thunder came on, and it's only taken a couple days and already I feel so good.

Troy: Oh, nice.

Scot: So if you've ever considered time-restricted eating, there's also a documentary out there I just watched. I'm going to say right now that this documentary probably only needed to be about 40 minutes long, and it's an hour and a half. So you can just fast forward through the stuff you're not interested in.

Troy: One of those. I've seen too many of those documentaries.

Scot: Right? But it's called "Fasting" and it's on Netflix.

Troy: Nice.

Scot: First of all, go back and listen to some of our Thunder episodes. But if you're interested in time-restricted eating and fasting in general and why it works, you might want to check out that Netflix documentary.

Troy: So what are you restricting yourself to? Ten hours or 12 hours? What's your . . .

Scot: Yep. I've started it at 12, and I'm going to see how that goes. Now, Thunder has said that's a good maintenance kind of timeframe. And then in a couple of weeks I think I'm going to move to 10 or 8 because I have some body fat that I'd like to lose. So I decided to start with 12 because I thought that was doable, and then I'm going to try to get it 10 or 8. That's the plan.

Troy: Nice. That's great.

Scot: All right. Time to say the things that you say at the end of podcasts because we are at the end of ours. First of all, if you want to get in touch with us, you can do it in a lot of different ways. The way that would be kind of cool is if you called 601-55-SCOPE. That's 601-55-SCOPE, and leave us a voicemail with your message, your question, your feedback, whatever. But there are other methods as well.

Troy: You can contact us, hello@thescoperadio.com. We're on Facebook, facebook.com/WhoCaresMensHealth. Our website is whocaresmenshealth.com. Also, subscribe anywhere you get your podcasts. We're on Apple, Google Play, Spotify, Stitcher, Pocket Casts, whatever works for you.

Scot: Thank you for listening. Thank you for caring about men's health.

This is a transcript for the main segment of the show. You can read it if you like, but we encourage you to subscribe and listen for the full experience. It's more fun that way.

Dr. Galli: Most of us take for granted the things that we see as normal and expected. So hopefully, we've at least parked the thought of, "Oh, hey, maybe that's not how I have to be. It's how I think I should be," and where is that coming from?

Scot: All right. Welcome to the podcast "Who Cares About Men's Health." What we've got here are some guys who care about their health, and they're not afraid to talk about it either. We get this bad rap. Guys don't care or want to talk about their health. That's not true, proving it right now.

My name is Scot Singpiel. I am the manager of thescoperadio.com, and I care about men's health.

Troy: And I'm Dr. Troy Madsen. I'm an emergency physician at the University of Utah, and I'm glad that for the first time in the history of this podcast I actually sound better than Scot on this, and I care about men's health.

Dr. Galli: And I am Dr. Nick Galli. I'm an associate professor at The U in the Department of Health and Kinesiology, and I care about men's health.

Scot: So today, we're going to talk about a force. It's a force that controls us as men, and a lot of us don't even know it, but it's this invisible force that impacts how we think about our health, our body, and it could be responsible for a lot of bad health decisions. It's reinforced in magazines, TV shows, movies, social media, and communities. We cannot get away from it. As a matter of fact, the World Health Organization thinks it's the reason why men tend to live six to eight years less than women, this invisible force. What is it?

Troy: Dark matter.

Scot: Kind of. It's the notion of what makes a man a man, the forces called masculinity. Nick is an expert in this topic. I actually did for my master's program a research paper on masculinity and men's health, and what I found was fascinating. I don't know about you guys, but I hate the thought that anybody or any force is controlling what I'm doing.

Troy: Especially if it's shortening our life by six to eight years. I had no idea. Wow.

Scot: Yeah. Isn't that crazy?

Troy: That's crazy.

Scot: So, before we get going, Nick, maybe you can give us a definition of what masculinity is, because it's not a real thing. It's what's called socially constructed. It's just something that we as people made up.

Dr. Galli: Yeah. Let's say it's sort of the set of attitudes, beliefs, behaviors that dictate how men should behave, what they should think, what they should value. And as you said, Scot, it's pervasive. We're primarily talking about Western cultures and even more primarily the U.S. It cuts across everything that we do.

Scot: So an example of this and how it might impact our health is somebody offers you a steak or a salad and you take the salad, what happens? What happens if you've got your guy friends around?

Dr. Galli: Well, of course, it depends, but yeah, you're going to get . . . I mean, when I think back to when I was sort of in the prime of . . . Because it changes, right? So, for me, when I was in my late teens and in my 20s and spending a lot of time with my guy friends, now you're immersed in that. And so, for sure, you'd get some looks.

I mean, even on that specific topic, I remember going out to lunch and dinner with my guy friends and it was almost, "How much fatty food can you eat?" Like, it was a challenge. Everything is a challenge in the world of masculinity. Everything is a competition, including how much you can eat.

Troy: Nick, I wonder how much of this is learned, how much of this is just the fact that as a man you've got testosterone and testosterone tends to lead men often maybe to be more risk-taking or maybe more competitive. I don't know. I mean, are there certain elements there versus . . .

Dr. Galli: I think there's a biological component, but that becomes accentuated for sure by messages that begin very early on.

Troy: And by masculinity then, are we talking about . . . again, is it the way we're interacting with others? Is it the expectation I have for myself? Is it just this idea that I can't show emotion? What is it about this that's kind of the core element of it? And getting to that, what is it about it that's so detrimental that's really shortening our lifespan?

Dr. Galli: Well, I think too, before we go much further on it, true experts and scholars in gender studies and masculinity would probably argue that there are multiple forms of masculinity. And the kind that we're talking about here today and that tends to be especially problematic is sort of that dominant, what we call a very . . . this is a very scholarly term . . . hegemonic masculinity. Hegemonic is just a fancy way to say dominant.

I think one of the tasks and one of the goals is to try to diversify. There's nothing inherently wrong with masculinity, femininity, but building in some flexibility into those concepts that there's not just one way to be masculine or one way to be feminine.

What's problematic about this dominant form that, as Scot alluded, seems detrimental to our health is that, yeah, we box ourselves in as men into a certain way of being, and that's fueled by things that we see and expectations that we hold of ourselves and that others hold of us. And really, what needs to happen, and this is maybe skipping ahead to more practical, is there needs to be a much more flexible conception of what it means to be a man in society.

Scot: And that's difficult, right? Because I bet you we could all tell our stories . . . I don't know. I can only speak for myself I guess, but I grew up in a ranch environment in western South Dakota and there was a certain kind of way that guys were supposed to be there, which is all just created in our own brains. There's nothing inherent about a lot of it. And I didn't fit in, right? I was a little bit more sensitive. I was a little bit more delicate. I wasn't a big muscular guy, right? I didn't like to ride bucking broncs and bulls and I didn't like to fight. So that made me less than.

Dr. Galli: Absolutely.

Scot: And I spent a lot of my life, and I still think about it to some extent, but not as much, trying to come to terms with, "Oh, I'm not a man. I don't look for a chance to . . ." Like, if somebody gets in my face, I don't get right back in their face. That's not how I choose to handle it. Maybe I choose to talk it out. That's not manly, right? That doesn't fit that masculine definition. So, for a long time I've . . . and especially then comparing myself to my dad who was all those things.

Dr. Galli: Well, thanks for sharing that, and I think that speaks to one of the earlier manifestations of how this can become problematic, is when we see young boys in school who maybe prefer different types of activities that aren't perceived as masculine or act in ways that aren't perceived as masculine, and then they can become the subject of bullying. We know well the consequences of bullying on mental emotional health.

Scot: And also just my own emotional health not living up to this ideal.

Dr. Galli: That you're not good enough. That you don't . . .

Scot: Exactly.

Dr. Galli: . . . meet that standard. I relate. I mean, where I grew up in a mid-sized city in central California, at my high school, for the boys, there were sort of two ways to be popular: one if you were a tough guy and/or two, if you were good at sports, and physical sports particularly, so football or the mainstream sports. If you couldn't check either of those boxes, you were sort of on the fringes of popularity or of acceptance.

Troy: Scot, it's interesting to hear you talk about that because I think I too . . . I mean, I didn't grow up in a ranching community. I grew up in a coal mining community, a small town. And as a skinny nerdy kid, middle school was miserable. I got beaten up. Not just bullied, but physically beaten up by kids in school and it was awful.

Scot: Wow.

Troy: And that kind of stuff sticks with you. I think probably over my entire life that element or that definition of masculinity, that's probably affected me.

And it's funny. I think back to two years ago, Scot, when you approached me and said, "I want to do a men's health podcast. Will you co-host with me?" It was like this sense of this imposter syndrome, like, "Who am I to talk about men's health? I am not a manly man."

And obviously, as we do this podcast, you realize that masculinity or that sense of the manly man, that's not who most men are. I don't think that's really who most men are. I think, like you said, Nick, that's the image that's out there and that's what we feel we should be. But you look at the men you know in your life and the men work with, most men are not that way.

Dr. Galli: If we were to all Google "men's health" right now, what would come up is probably very different than the things that we're discussing today. I mean, there's even a magazine called "Men's Health," and what do you get in that magazine? You get chiseled muscular bodies, very much an aesthetic and physical version of what health is.

Scot: Yeah. And not only that, but you get these attitudes of a man in "Men's Health" is great in the bed and takes care of his woman, and just all of these images and these thoughts that . . .

Troy: Well, not just takes care of his woman, takes care of multiple women. If you read "Men's Health" magazine, it's like . . . yeah, that's been my image of men's health is "Men's Health magazine. How often do you see a thin guy on the cover of "Men's Health" magazine? It's usually dudes who are just totally ripped and built and just these massive dudes.

And all the articles there, it's about that. It's about living a lifestyle. Not all of them, but a lot of them have to do with maximizing that lifestyle, live hard/play hard, work hard/play hard lifestyle, and a certain element of sexual prowess or whatever else some of these articles . . . and so it's a . . .

Dr. Galli: This makes the battle even harder, right? Because now we have sort of the big media hijacking the concept of men's health. Not just masculinity, but men's health, and selling it to the masses.

Scot: Yeah, it's that either/or, right? So it doesn't leave you any in between. It's either you're working out and you're doing high intensity exercise and you're eating just perfectly, or if you can't live up to that ideal, which sometimes I think I can't do that. So then it's just like, "Well, why even bother if that's not what I'm going to get?" So I think it's a little dangerous that way as well.

Troy: For sure.

Scot: Hey, Nick, I want to share another little aspect and then I want to kind of steer the transition of the conversation into how maybe each one of us can claim our own form of masculinity, because I think ultimately that's what we should be able to do.

So I can't speak for Troy, but I wasn't very confident and I lacked confidence for a long time in my life because I didn't fulfill this ideal of masculinity. And that can lead to mental health issues. That can lead to feelings of inadequacy. But I have noticed, too, that there are some men that are very confident in themselves and they might not fulfill that norm of hegemonic masculinity, but yet they create their own, right? To some extent, showing control and restraint in not doing all those dangerous behaviors can be a form of masculinity.

How exactly does that work and what are your thoughts on developing your own version of it? And then how are you confident in that version as you interact with the rest of the world?

Dr. Galli: That's a big question.

Scot: Hey, listen, I gave you a little bit of warm-up to get to this point. So I figure you should have all the answers by now.

Dr. Galli: Okay. There's not going to be a simple answer to this, but there are forces at play. I think two of them come to mind, as I think about folks who are sort of able to transcend what we've been talking about here.

One is just time and maturity. The young adult males are the ones who are kind of most at risk I would say for really trying to live this ideal that can be dangerous. As we get older, we care less about what other people think, we have different priorities, and so it becomes easier as we get into more middle adulthood to just sort of be our own person and not give a crap about what people say I should be. Now, that said, there are definitely some people who struggle with that. So I think time and normal development is an asset.

And then I think another asset that some folks have are support of influence and people in their family who are just unconditionally okay with a boy being how they want to be, and for that matter, a girl being how they want to be. Of course, there are forces outside the family, but that primary family tends to be the most powerful force for a lot of kids. And I think that goes a long way.

And as a young boy, if you want to play with Barbie dolls, that's fine. If you want to watch "My Little Pony," that's fine, or whatever. That's what it was when I was a kid growing up.

I think it seems very subtle, but when you are surrounded by folks who are just okay with you being you and not making snide comments or forcing you to be something that you don't want to be, then I think that allows for the possibility of just, as you said Scot, being comfortable in your own skin, even if that doesn't align with what you're seeing of other boys and men.

Troy: And I guess though, Nick, as we talk about this . . . I mean, certainly there are some elements of masculinity that are valuable, but at what point do you feel like that truly becomes toxic? We talk about masculinity or toxic masculinity. When does that sort of thing become toxic? And are we talking toxic to others, toxic to ourselves? How does that play into it?

Dr. Galli: Yeah, I think both. I mean, any time that somebody has fully internalized . . . I think of heavy drinking, womanizing, or having multiple partners and not exhibiting safe and thoughtful sex behaviors, over-imbibing in alcohol, drug use, steroid use, not going to see the doctor on at least a yearly basis because "I'm invincible." I mean, I think it's all about the behaviors, and underlying that is the thought that, "I am impervious to a lot of these issues, and also I don't need to talk about what's bothering me because that would suggest weakness."

And going back to something you said there, Troy, too about some of the advantages, I do think there are advantages, and in many ways I think our society is set up to favor and advantage men who do exhibit these dominant traits. So it's reinforcing, right?

Look at who we see as CEOs and in leadership positions. And that's starting to change, but it tends to be men. And there are some positive characteristics for sure. There are also positive characteristics of . . . and I keep pointing to femininity as sort of the other side of the coin here. Things that we associate with femininity that are also very positive, such as compassion and having a nurturing side, sort of those stereotypical feminine qualities, that many men feel like, "Well, that's not what I'm supposed to do." So they deny themselves the opportunity to explore that side of who they can be.

But in many ways our society is set up to really favor folks who exhibit these dominant alpha male qualities.

Troy: And it seems that in terms of just where masculinity truly becomes detrimental, it may be that it's that masculinity at the point where we really try and push away any sort of feminine qualities within ourselves, any sense of nurturing, any sense of emotion, those kind of things and . . .

Dr. Galli: Except for anger. Anger is okay. Anger is okay for a man.

Troy: It's okay for a man.

Scot: I think that's the only emotion, isn't it?

Dr. Galli: When a woman is angry, oh, there's something wrong. It's so true, right?

Troy: Yeah, but it seems though that that often . . . as I'm hearing you talk about this and talk about these different elements, it seems that when masculinity really becomes an issue and a problem, it is when we, like you said, take that masculinity to the extreme in terms of risk-taking, detrimental behaviors, in terms of how we treat others and interact with others, and then we push aside anything that would be associated with that feminine element, again the nurturing, the caretaking, all those sorts of things.

Scot, as you talked about, the years lost on our life, I would imagine that those are the things that really caused those years to drop off when we are pushing aside our ability to feel emotion and ability to care, and nurture, and those sorts of things, and then add on to that the risk-taking behavior and everything else there. That seems like that combination is what is truly toxic and what really hurts us.

Scot: As we wrap this up, here are a couple of my takeaways, Nick, and I'd love to hear yours as well. So I think the goal of this particular episode is just for those that weren't aware that this is an invisible force in one's life that is actually impacting your decisions or how you feel about yourself, just to become aware that it's out there and it's a thing. I think, obviously, awareness is the first thing.

And then I think developing your own definition of what you are as a person. Maybe just abandon the notion of men and women. What are you as a person? And I'm guessing that the super toxic masculinity individuals have dropped off this episode way before this point. So we're not talking to them necessarily.

Dr. Galli: But we could be talking to parents of children who have a role in shaping them.

Scot: Yeah. I mean, the way you shape them could either empower them to go out and accomplish great things, and feel good about themselves, and be mentally well off, or it can burden them if we're forcing those types of things, I suppose, on kids.

So I think becoming aware and I think realizing that it's okay to be you. I tend to be more sensitive, I tend to be more thoughtful, I don't react and come to anger as quickly as maybe some men, I don't believe in fighting. That's okay. That's my outlook on life, and that's fine.

Troy: Have you ever been in a fight, Scot? I'm just curious.

Scot: Actually, I never have, believe it or not.

Troy: Like a physical fistfight? Not even in elementary school?

Scot: No. I was a "doorman" at a bar for a couple years, and I never got in a fight.

Troy: You were a bouncer.

Scot: I know, right?

Dr. Galli: A bouncer. Yeah.

Troy: Scot is like the world's worst bouncer.

Scot: Actually, I wasn't.

Troy: He's like, "It's all right, guys. Let's talk this out."

Dr. Galli: He's actually willing to talk and . . .

Troy: I know. I was just joking. Yeah, you're totally breaking the mold of the bouncer. You're like the negotiator. I love it. That's great.

Scot: Nick, any final thoughts or takeaways from this episode? What do you hope that it accomplished today?

Dr. Galli: Oh, yeah. Raising awareness primarily. I talk about internalizing, and I think most of us take for granted the things that we see as normal and expected. So hopefully, we've at least sparked a thought of, "Oh, hey, maybe that's not how I have to be. It's how I think I should be," and where is that coming from? Maybe more men or women willing to have conversations, like we just did right now, about these topics.

Troy: Obviously, we say, "Be yourself." Sometimes that's hard because it's like, "Well, yeah, but there are different elements of myself." I think it's be your best self. There are elements of masculinity that are, I think, good.

Scot: Yeah, but it's also tough to sometimes be yourself if you're not in the environment. There's no way as a young man I would have been able to buck the trend, I don't think, of what was expected of me. I don't know. Maybe there could have been had I been more confident.

Troy: Still.

Scot: You've just got to try the best you can.

Troy: Yeah, embrace the best of these things and don't . . . I think that's it, too. Again, getting to that thing about, "Well, these things are associated with femininity in terms of emotion and caretaking and all that," but if that's part of you, embrace it. Embrace that and just . . .

I think one takeaway too, like I said, Scot, is just that most men are not that stereotypical man. I think that's been one thing that's come to me in terms of this podcast as we talk to so many experts. It's just opened my eyes and I look at the people I work with, and the patients I see, and all these things. Most men are not the stereotypical manly man that we sometimes think we should be, and that's not the norm. Maybe what's held out there is what we should become, but that's not what most men are.

Scot: And there's a certain strength . . . I guess if I was to give advice to young Scot, like how you could still be yourself and be in an environment where there's a different definition of masculinity, I think . . . and I could be completely full of crap and might get the crap kicked out of me. I think there's a certain strength in knowing who you are and owning that and making no apologies for it.

I think you can stand up to people, most people. I mean, there are going to be outliers, like anything, but I think there's a certain strength in that. And I think if you do it enough and you're resolved enough, that can help.

Nick, what do you think? Am I completely crazy?

Nick: I think for the most vulnerable people, which is kids and adolescents, they need support from parents, from teachers, from church leaders, because . . . I mean, when you're 8, 10, 12, 14 years old, we could be delivering this message to them all day, "Love who we are, own it, be okay with it," but they need to see more than that. And they need role models who they can look up to, who are confident, but also caring, but also strong, but also compassionate. They need to see that, I think, to really buy in.

Troy: Yeah. And it's a lot easier as an adult I think to do that than as a kid with the perils of just the peer groups and all that. That's a tough place to be.

Scot: Yeah. As an adult, you to some extent can choose where you go. As a kid, you can't. You have to go to this place called school and everybody's thrown in there, and it's just a big old free-for-all. But I can avoid the type of people I want to avoid in my work life.

Troy: Yeah. It's a lot easier, but for those listening who you're an adult, you can embrace that. And if you're in a work . . . because there are certain work environments where I think it's difficult. I think certain work environments it may be difficult to truly be who you are, and maybe certain co-workers, but you can always find a new job or even switch professions, or all those sorts of things.

I think it's a lot easier as an adult, but I think that's probably the point, is to really embrace that, embrace who you are, and not feel like you have to fit a certain mold that's held out there.

Scot: Yep. Realize that masculinity is a thing. It's not a real thing. It's just created by all of us in society that have come to these assumptions, and these assumptions can be challenged, and you can define your own way.

One of the things I love that you said, Nick, is question why we call things normal. I think that can even go beyond this notion of masculinity. Why is this considered normal? Do I subscribe to this thought that this is normal? What are my thoughts on it? When you start asking those questions, I think you can start really kind of building your own confidence and go in your own way.

Nick, thank you very much for this conversation. Appreciate it as always for being on the podcast, and thanks for caring about men's health.

Dr. Galli: Absolutely. Thanks for having me.

Scot: Time for "Just Going To Leave This Here." It might have something to do with health or maybe it's just a random thought that's kicking around in our brain that we need to let free. Troy, do you have any random thoughts you need to set free?

Troy: Totally random thought, Scot. I am . . . and you probably are too. But I'm kind of a grammar nerd. So this is a grammar issue that has really bothered me and I've got to get your insight on this. So if I sent you a text message yesterday, how would you say that phrase? "I text you yesterday" or "I texted you yesterday"?

Scot: The thing that feels natural and normal is "I texted you yesterday."

Troy: I know. Me too. I mean, text has become a verb. It's a noun. A text is a noun. It's become a verb. In our daily usage it's become a verb. But people say "text" all the time, like, "Oh, I text you last week," "Oh, I text you yesterday," "Oh, I text . . ." And they're not saying texted, they're just saying text. I looked this up. I'm like, "What's the proper use of the verb text if I sent you a text yesterday, if I texted you?" And there is no proper use because it's just this noun we've turned into a verb, and we're all just using it. Some people are saying, "I texted you," and some people are saying, "I text you." Probably the best way to say it is, "I sent you a text message yesterday."

Scot: Yeah. I mean, if it's a noun, that's how you would say it.

Troy: Yeah, be on the lookout. Now it's going to start driving you crazy. You're going to hear people saying it all the time, like, "Oh, I text you this picture," or, "I text you this whatever." And you're like, "Text me right now, or you texted it two hours ago?"

Scot: I'm just going to leave this here. Thunder Jalili, our nutrition expert, has talked a couple times about time-restricted eating. So there's a lot of confusion when it comes to fasting because it can mean a lot of different things, but time-restricted eating is just taking the time that you allow yourself to eat during the day and keeping it limited to 12 hours or 10 hours or 8 hours so then you have a fast between then and when you eat again.

I started doing this when COVID first started, just before COVID first started. I've actually loved it. I felt great. I felt clear in my brain. I slept better. So I've started doing that again after Thunder came on, and it's only taken a couple days and already I feel so good.

Troy: Oh, nice.

Scot: So if you've ever considered time-restricted eating, there's also a documentary out there I just watched. I'm going to say right now that this documentary probably only needed to be about 40 minutes long, and it's an hour and a half. So you can just fast forward through the stuff you're not interested in.

Troy: One of those. I've seen too many of those documentaries.

Scot: Right? But it's called "Fasting" and it's on Netflix.

Troy: Nice.

Scot: First of all, go back and listen to some of our Thunder episodes. But if you're interested in time-restricted eating and fasting in general and why it works, you might want to check out that Netflix documentary.

Troy: So what are you restricting yourself to? Ten hours or 12 hours? What's your . . .

Scot: Yep. I've started it at 12, and I'm going to see how that goes. Now, Thunder has said that's a good maintenance kind of timeframe. And then in a couple of weeks I think I'm going to move to 10 or 8 because I have some body fat that I'd like to lose. So I decided to start with 12 because I thought that was doable, and then I'm going to try to get it 10 or 8. That's the plan.

Troy: Nice. That's great.

Scot: All right. Time to say the things that you say at the end of podcasts because we are at the end of ours. First of all, if you want to get in touch with us, you can do it in a lot of different ways. The way that would be kind of cool is if you called 601-55-SCOPE. That's 601-55-SCOPE, and leave us a voicemail with your message, your question, your feedback, whatever. But there are other methods as well.

Troy: You can contact us, hello@thescoperadio.com. We're on Facebook, facebook.com/WhoCaresMensHealth. Our website is whocaresmenshealth.com. Also, subscribe anywhere you get your podcasts. We're on Apple, Google Play, Spotify, Stitcher, Pocket Casts, whatever works for you.

Scot: Thank you for listening. Thank you for caring about men's health.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Mental health issues impact one in five adults in the U.S. and up to 35% of American men are struggling with some sort of mental health condition. Despite its prevalence, it seems like men are unlikely to talk about their mental health with others.

Listener Ben first realized he was struggling with mental health issues roughly 10 years ago. Some big changes at work early in his career started making him feel like his life was getting out of control and unmanageable.

Ben was unaware of the extent of his trouble until his father approached him during a family dinner. He mentioned that Ben didn’t seem like the same person he used to be. This was Ben’s wake up call to seek professional help.

Ben’s entry into mental health services came through the Employee Assistance Program (EAP) that was included in his insurance plan. He learned that the service was created to be a short-term treatment with outcome-focused results. He called the number, made an appointment, and his handle on his mental health dramatically turned around.

Kevin Curtis is a licensed clinical social worker and one of Ben’s good friends. According to Kevin, it is pretty common for people to not realize there is a problem with their mental state until someone in their lives mentions something.

It can be extremely difficult to self diagnose mental health problems. "Most people can see when other people are not doing well," says Kevin. "But they are poor at judging when they aren’t doing well themselves." Even Kevin, as a therapist, uses a mental health professional to work through his troubles. Building Your Mental Health Toolbox

Ben met with a licensed clinical therapist through the EAP program. He appreciated the objective outside perspective and the tools, techniques the therapist provided. After just a few sessions, Ben had the starting of what he calls his "Mental Health Toolbox." A set of techniques he uses to this very day.

In just a few short months Ben notes the marked improvement the therapist had on his life.

Kevin explains that it’s quite common for people to mistake mental health as something that is approached differently than physical health. When a person talks about typical physical health, they understand that there is a broad spectrum of the type of help available depending on the ailment. Primary care physician for maintenance. Specialists for specific issues. Emergency room for a crisis. But when most people think of mental health, they assume you only seek help during a crisis.

He likens this misconception to utilizing a financial planner. You don’t only go to a financial planner when you are in bankruptcy. It’s better to go to a planner before it’s an emergency so they can help set you up for success.

"It’s not what are the problems you are experiencing you want to solve," Kevin explains. It’s more a question of how could your life be better, and what are you willing to do to make it better?" How to Find Help

If you feel you could use some professional help with your mental health, Kevin shares a few avenues you can use to find care.

• Most people that are employed with insurance have some sort of EAP program included with their benefits. Reach out to your employer to find out what services are available to you.
• For people without insurance, there are plenty of low-cost counseling services and organizations available.
• Ask the licensed clinical social worker, therapist, or psychologist, if they use a "sliding scale." Many providers offer services at a cost that is relative to your financial situation. Asking that question should help you find help that won’t break the bank.

Troy received an email from a listener. Apparently this individual found a bat in the woods and played around with it. His family is now insisting he needs to go get a rabies shot, even if he wasn’t bitten. So he reached out to Dr. Madsen to ask what he should do.

Short answer: Better safe than sorry. There is no treatment for rabies, only a preventative shot. The series of shots are not the terrible ones you may have heard of that go into the stomach. The rabies vaccine goes right in the arm like any other injection.

Bats should not be played with. Rabies can be passed not only from a bat bite but from their saliva as well. The chance for infection is so serious, the CDC recommends you get a rabies shot if you wake up in the same room as a bat.

Additionally, it’s smart to avoid playing with wild animals, especially ones that eat meat. These creatures can be asymptomatic carriers that can transmit the disease to humans even if they don’t show any signs. Odds and Ends

The Who Cares About Men’s Health 5K is on June 20. We encourage anyone who wants to join this virtual race and show support for Mitch as he gets closer to his goal of going from couch to 5K. The virtual race can be completed any way you’d like, whether it be running, biking, walking, skipping, whatever you can do to get in your physical activity that day.

Troy shared a photo of him and his corgi in their race bibs to show support for Mitch and his goal of running a 5k. Visit our Facebook page to get your 5k race bib. Download and print the file so you’re ready for race day. Take a photo of yourself in the bib and post them to the Who Cares Facebook page or using the hashtag #WCAMH5k to show your support. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Troy has finally joined social media and is afraid he won’t have any friends and Scot wishes he looked as cool as his shadow does when he runs. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Sleep is absolutely crucial to your health. A lack of sleep can contribute to an increase in stress, weight gain, and a whole slew of potential health problems. Getting a good night's sleep is so important to your health, we consider it one of our Core 4. For optimal health, adults should be getting seven to nine hours of restful sleep a night.

Yet, a recent Harvard study said that as many as 70% of people in the U.S. are getting less than six hours of sleep a night and experiencing "sleep difficulty" at least once a week. Considering so many people struggle to get a good night's rest, what are people to do?

Dr. Kelly Glazer Baron is a clinical psychologist specializing in sleep. She works with patients at University of Utah Health to improve their quality of sleep through behavioral modification rather than medications. It's called Cognitive Behavioral Therapy for Insomnia (CBT-I) and it may prove beneficial to most people struggling with their sleep.

Dr. Baron suggests patients try following these four basic rules for CBT-I to start improving their sleep.

1. Spend the same number of hours in bed that you sleep.
2. Don't stay in bed unless you're actively sleeping.
3. Don't go to bed unless you're tired.
4. Wake up and get out of bed at the same time every morning.

Like any health journey like weight loss or getting in shape, the road to consistent good sleep takes time. Don't expect immediate results, but following the rules of CBT-I may help a person see significant improvement in their sleep in just a few short weeks.

If you are still struggling to get a good night's sleep, talk to your doctor and consider working with a sleep specialist. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Recently, Who Cares producer Mitch Sears went to the ER with what he believed were stroke like symptoms. It started in the morning with a mild twitch in his left eye that he assumed was caused by eye strain. That afternoon while eating lunch, a spoonful of soup suddenly slipped out of the side of his mouth. He ran into the bathroom to see what was the matter and was shocked to see the left side of his face had begun to droop down. In the course of just a few minutes, Mitch had an unresponsive face and difficulty speaking.

With panic setting in, was Mitch having a stroke? What is a Stroke?

Before getting any further into Mitch's story, the symptoms of stroke are:

• Facial weakness/drooping
• Difficulty speaking
• Problems with coordination
• Tingling or numbness
• Muscular weakness on one side of the body

If you or a loved one are having any of these symptoms, seek treatment immediately. Time is of the essence for treating a stroke. Clot-busting medications and clot removal surgeries are available to minimize or reduce the effects of a stroke, but they are time sensitive. A stroke victim typically only has a window of three to four hours to receive treatment. So seek treatment immediately. The Brain Attack Protocol

After arriving at the emergency room, Mitch was brought back to be seen immediately. Doctors began running tests on his ability to speak and think as well as his strength and sensitivity. The physicians were concerned enough to start the "Brain Attack Protocol."

A brain attack is a lot less scary than it sounds. At University of Utah Health, "brain attack" is what they call a stroke. If a doctor suspects a patient may be having a stroke, a neurologist is brought in immediately to help diagnose the patient.

The "brain attack protocol" helps doctors and patients receive faster care and jump the lines for CT and MRI imaging. It helps make sure that stroke patients are identified and treated immediately rather than waste time in the waiting room. Remember, the window for treatment of a stroke is three to four hours, so it's important to get diagnosed and treated ASAP.

After starting the brain attack protocol Mitch was taken immediately to imaging. After a quick CT scan and spending an hour in an MRI listening to Marilyn Manson, he had his diagnosis.

It wasn't a stroke. It was Bell's Palsy. So What's Bell's Palsy?

Bell's Palsy occurs when the nerve running from your spinal column to one side of your face becomes inflamed. The inflammation can occur after an injury or - in most cases - a viral infection. There are many viruses that can cause Bell's palsy, including cold-sore causing herpes, dormant chicken pox, or even influenza.

This increased pressure on the nerve causes muscle paralysis on one side of a person's face. This facial drooping can sometimes be confused with the symptoms of a stroke, but the condition, while irritating, is not life threatening and often temporary.

Treatment of Bell's Palsy typically includes an anti-inflammatory medication and a round of antiviral drugs. Unfortunately for patients, even with medications, recovery can take anywhere from 10 days to 6 months depending on severity. After a round of medications, patients just have to wait to regain control of their face.

"Bell's Palsy just happens," says Troy, "and I don't think anyone knows why." The condition can affect anyone of any age and there are no known increased risk factors. The Stress of Not Functioning

"At least it wasn't a stroke," jokes Mitch. It's been a week since his incident, but he's still not able to move his face completely. While Bell's Palsy isn't as life-threatening as a stroke, a loss of functionality can be stressful on anyone.

Mitch found his quality of life to immediately change. "Suddenly not being able to speak correctly. Suddenly not being able to eat very easily. There were a lot of things that were killing me," he says, "I loved my smile."

The disruption to his life has been difficult. Symptoms kept getting worse throughout the first week. He was unable to blink so he had to use eye drops and tape his eye closed every night. He explains that there's a lot of stress that comes with waking up every morning knowing that all you can do is wait for the symptoms to subside.

"I know it's nothing super serious to my health, but it's a big deal."

Luckily, as of today, Mitch is beginning to see vast improvements very quickly. He blinked for the first time since the incident. It's small, but a good sign he's on the road to recovery. How One Trainer Helps Celebs Get Movie Ready

Scot recently found an article about a personal trainer's approach to fitness he just had to share. Jason Walsh is personal trainer to the stars. He's worked with celebrities like Matt Damon and Jennifer Aniston. He's the trainer that helped Bradley Cooper gain 40 pounds of muscle in 3 months for his role in American Sniper and helped Emily Blunt get strong enough to carry around a 70 pound exoskeleton in Edge of Tomorrow. He seems to know what he's doing to help people get fit.

Scot was struck by the sensible approach Walsh brings to fitness. Rather than putting a person on a high protein diet with a high intensity workout routine, Walsh focuses on a more holistic strategy to getting his clients in shape. He also works to help his clients improve their overall nutrition, sleep, and mental health.

Before beginning any workout routine, Jason Walsh first works to get his clients a "clean bill of movement." This means that he works with the actors to get all of their nagging physical issues under control. Whether it be a weak knee, a problematic back, a bad shoulder, Walsh works with physical therapists to get a person's body moving correctly. Those issues need to be fixed before anyone can get on track to get the body they want.

Sounds a lot like this podcast's Core Four strategy.

For more information on Jason Walsh and his fitness strategy click here.

How a Celebrity Trainer Got Matt Damon, Jennifer Aniston & More in Shape

How a Celebrity Trainer Gets Actors in Shape for Movies ER or Not: Seizure

Seizures can be scary. A person suddenly begins shaking and convulsing. It sounds serious. But is it serious enough to go to the ER?

According to Dr. Madsen, if the person has never had a seizure before, it's an emergency. Call 911 and get to the ER immediately. Doctor's need to see what's causing the seizure and make sure it isn't anything life threatening. Some seizures can be caused by brain bleeds and tumors, so it's important to get a scan done quickly to diagnose and treat these serious conditions.

Alternatively, there are many people who have a seizure disorder. These conditions can cause a person to regularly have seizure episodes. Sometimes these seizures occur daily. Doctors will treat these conditions with anti-seizure medication, but sometimes episodes still occur. For patients like these, there is no reason to take them to the emergency room unless there are any new symptoms. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Troy learns all about the differences between left and right handed people - and animals; and Scot can't resist those sweet treats sitting in the break room. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Maintaining a healthy diet today seems nearly impossible. The built environment of modern day America makes it so easy to eat poorly. 100 years ago we had to work to get food and spend energy to get energy. Today there's no limit on the foods we can eat, and it's a little too easy to indulge in our built in biological drive to consume high fat and high sugar foods.

Dr. Alex Pastuszak has worked hard to become an "intuitive eater." He's practiced for years to get a good understanding of how much food and the types of food his body needs to stay healthy. He even finds himself looking forward to eating food that makes him feel good like a salad for lunch.

His secret is to make sure that he's never on a "diet." Diets are short term and focused on getting a person to lose weight or gain muscle. These quick-fix approaches to look better don't necessarily lead to good dietary habits. Dr Pastuszak urges people to focus on their health and forming good eating habits that can last a lifetime, rather than a fad diet that will help you lose a couple pounds for just a couple months.

Scot is working towards getting to a place where he can eat intuitively. He watches his diet closely and still weighs out his food. He hates weighing his food all the time, but is teaching himself what portion sizes should look like and how much he should be eating. He looks forward to the day he can stop weighing his food and eat intuitively. Is Testosterone Therapy Right for You?

You may have seen the ads about testosterone therapy or "T" treatments. They make it sound like testosterone can cure just about anything that ails you. Have low energy? Testosterone is the answer. Putting on a few pounds of fat? Get T. Having trouble sleeping? Testosterone will help you sleep like a baby.

"In the right person, testosterone can help a lot," says men's health specialist Dr. Alex Pastuszak, but he admits that it isn't the cure-all the advertisements lead you to believe. Most of Dr. Pastuszak's patients will come in with complaints of low sex drive and general fatigue. They can't seem to power through a day and find themselves tired by lunch time.

The difficulty with diagnosing low-testosterone is that the symptoms are extremely non-specific. For example, if a guy is feeling fatigue, it can be caused by just about anything- lack of sleep, poor diet, depression, etc. Same goes for symptoms like low sex drive and insomnia.

The only way to know if a man is experiencing the symptoms of low testosterone is to get a testosterone level test. What is a Normal Range for Testosterone?

A testosterone level test measures the amount of male hormones in the bloodstream. The results are measured in nanograms per deciliter. A healthy range for a guy is 300 to 1000 ng/dl, with around 600 being average. Anything around or below 300 is considered low by most physicians.

According to Dr. Pastuszak, most men feel better with a level of 600 or higher. Any man with a level below 600 will likely feel better with testosterone therapy and it's worth trying out. It's important to remember that testosterone therapy is typically considered a "lifestyle therapy" meaning you can use the treatment as long as you'd like if it helps you feel better.

Having a low testosterone level between 300 to 400 isn't dangerous to you health. However, if a man's testosterone drops below 300, there is an increased risk for osteoporosis and cardiovascular issues. What Kind of Testosterone Therapy is Available?

Testosterone therapy can be administered in several different ways depending on the patient's needs, wants, and expectations.

The very first question Dr. Pastuszak asks is whether or not a guy plans on having kids in the near future. It may come as a surprise, but testosterone does not improve a guys fertility. In fact, testosterone does the exact opposite. After six months to a year of taking testosterone, most men see a dramatic drop in fertility.

Testosterone therapy is often made up of several different medications:

Testosterone
The basic form of the treatment is to add more of the male hormone to the body. This can be through injections, creams, pills, or even injections under the skin. These hormones aim to raise a man's testosterone levels to a more typical range.

Human chorionic gonadotropin or hCG
hCG is a drug that helps to stimulate the testes to produce testosterone naturally. It is prescribed with testosterone to prevent the testicles from shrinking during treatment. If testosterone is taken by itself, it interrupts the connection between the brain and testicles. The testes will stop producing testosterone and over time will begin to shrink. In some cases, the testicles will shrivel up to the size of raisins. hCG helps keep them the right size during testosterone therapy.

Clomid
Clomid is an oral medication that stimulates the brain and testes to make more testosterone. Clomid has less of an impact on fertility, but is less effective at raising testosterone levels as significantly as T creams and gels. It is often prescribed to men with slightly low levels of testosterone or men looking to have children.

There are many different testosterone treatments available. Work with your doctor to find out what type of therapy will work best for your situation The Side Effects of Testosterone Therapy

Like any medication, testosterone therapy comes with its own set of potential side effects. The two major side effects are infertility and testicular shrinkage. Infertility can be avoided by taking a less intense treatment route like Clomid. Testicle shrinkage is prevented with hCG and should always be taken with testosterone.

Testosterone therapy can also lead to an elevated level of estrogen. It may be confusing that increasing a male hormone would also increase a female hormone. Biochemically, testosterone is a precursor compound to estrogen. The human body needs testosterone to create estrogen. Therefore, in some men, having too much testosterone can lead to the overproduction of estrogen. If a guy's estrogen levels are too high they can develop tender, sensitive nipples, and in extreme cases, begin to develop breasts.

Additionally, testosterone can lead to erythrocytosis, or a significant increase in red blood cells in the blood. If a person's red blood count gets too high it can increase cardiovascular conditions like heart attack and stroke.

If you're on any sort hormone management like testosterone therapy, it's important to maintain regular follow up care. The hormones can keep you feeling really good for a really long time, but it's important to keep tabs on how they're affecting your body with a professional. After first starting testosterone therapy, your doctor may insist on frequent visits and tests to track your treatment and adjust medication as needed. After you and your doctor get the treatments zoned in, you can expect to visit your doctor every 6 months or so to make sure everything is running smoothly. Choosing to Stop Testosterone: Scot's Story

Scot has had his own experience with testosterone therapy. After not feeling his best for a while, he went to a doctor to test his testosterone levels. The results showed that while he was within the acceptable range, his testosterone levels were on the lower end of the range. His doctor prescribed him a testosterone cream that he rubbed on his chest. After using the cream for a while, he didn't feel like he was feeling better. For him, the testosterone didn't turn out to be the cure-all he had been led to believe. He stopped the treatment and started focusing on other aspects of his health.

Scot recognized that his lack of energy may have been caused by something other than low testosterone. At the time, he was only getting around five hours of sleep a night. He says he was a little overweight and wasn't exercising as frequently as he should. Those bad habits were probably the real cause of his low energy levels, and he felt that testosterone couldn't cure his lifestyle.

After focusing on improving those aspects of his health, Scot began feeling better. Even better than he did when he was on testosterone therapy.

Dr. Pastuszak agrees that testosterone therapy isn't the cure for everything that the commercials will lead you to believe, but for some guys, it can get them on the right track. For example, an overweight thirty year old with low testosterone levels may be suffering from extremely low energy. That low energy leads him to not exercise or eat as well as he should. He comes in. Get tested and finds out he has low testosterone. The low testosterone level may likely be caused by the extra weight and lack of exercise, but with how low his energy levels are, it's going to be hard to be active.

Dr. Pastuszak would put this guy on hormone therapy as a "lifestyle intervention." The treatment makes him feel better and improves his energy levels. He then has the energy to go to the gym and exercise, which will bring his weight down, and get his body producing testosterone again. In a case like this, testosterone therapy can break the bad health spiral long enough for a man to improve his health and eventually stop using testosterone.

Testosterone therapy is a deeply personal and complicated issue. If you have any questions about treatments or suspect you may have low testosterone, submit your questions to Dr. Pastuszak by email at hello@thescoperadio.com. ER or Not: Food Poisoning

You've decided to eaIf you've had food poisoning, you know how terrible it can be. You've eaten somewhere that's not so great and now you can't seem to stop throwing up. Should you go to the emergency room?

According to Troy, you don't necessarily need to go to the ER for food poisoning. Food poisoning usually strikes six to twelve hours after eating contaminated food, and will last for about just as long. Over the counter anti-nausea medication can help with the symptoms, but it'll have to run its course before you feel better.

However, if you are vomiting incessantly and can't keep even liquids down, you run the risk of becoming severely dehydrated. In this situation, go to the ER. An emergency room will be able to put you on an IV drip and help keep you hydrated during the food poisoning. Most urgent care facilities lack the means to start an IV, so if you're at risk for severe dehydration, an emergency room will be your best bet for treatment. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot is thinking about the critters in his gut and how the microbiome could help your immune system stay strong and Troy is not ready for winter. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

If you're trying to lose weight, there are so many options available. Especially if you search online. There are so many sources on the web, arguing that they have the absolute best diet plan. It can be hard to decipher what will help you lose the weight.

Thunder Jalili, PhD is the Director of Graduate Studies in Nutrition and Integrative Physiology at the University of Utah. He knows nutrition and is willing to help shed some light on how to best help you lose weight.

According to Thunder, no single diet is perfect. It's more important to pick something that works for you. Pick a diet that is something you can stick with for the rest of your life.

If you choose a diet that is extremely different from what you already eat, it's going to be hard. It may be food you don't like. It may be a strange eating pattern that will ultimately help you lost that stubborn extra ten pounds, but one you start eating "normally" again, you'll put the weight right back on.

Don't try to 'diet' just to lose a few pounds. Focus on changing your daily eating habits to help improve your health and fitness. When You Eat is as Important as What You Eat

It may come as a surprise to some, but the timing of your meals in the day has as much to do with weight loss as the kinds of food you eat. The human physiology is made to cycle between two states: fed and fasted. The fed state right after eating is when your body increases insulin and utilizes nutrients in food to create stores of energy for the future. In the fasted state, the body uses these nutrients and stores to keep you functioning without falling apart. The human body functions best when it is able to go back and forth between these two states on a daily basis.

Unfortunately, most people end up staying in the fed state all day long. Think about it, you wake up and eat breakfast. Then at work you may have a snack before lunch. Then you eat a snack to help get you through the afternoon slump. Go home for dinner. Then probably a late night snack before bed.

It's not uncommon for the average person to be eating a bit of food every two to three hours between 7AM and 10pm. Your insulin levels stay high and you're body is stuck in a fed state for most of the day. Remember, the fed state is characterized by the body storing nutrients and building fat. Try Getting at Least 12 Hours of Fasting a Day

Giving your body enough time to be in the fasted state is easier than you may think. According to Thunder, if you want to lose weight, it's important to get in at least 12 hours of fasting every day. If you're able to get 14 hours or more, even better. To maximize your benefits, that fasted time needs to be sustained and continuous. But when are you ever going to get that fasted time in your day? Simple: when you sleep.

If you eat dinner around 6PM every night and don't eat breakfast until 8AM, that's a full 14 hours of fasting. All it takes is eating breakfast and dinner at a regular time and cutting out any after dinner snacks. Your meal times don't need to be exact, just remember that even twelve hours between meals will give your body a benefit.

One of Thunder's college buddies was able to lose 10 pounds by thinking about his fasted state. His friend was very active, always watched what he ate, but always seemed to have a bit of excess body weight he never could seem to lose. He was one of those guys that always drank a big protein shake before bed because that was supposed to help him build muscle mass. What that high calorie shake was really doing was messing up his food timing. By cutting out the shake before bed, but keeping his active lifestyle and diet the same, he finally lost that stubborn extra weight. You Will Not Lose Muscle By Fasting

Some guys are afraid that fasting will make them lost muscle mass. That's just not true.

According to Thunder, fasting won't impact your muscle mass as long as you eat your meals during the day at a regular time. A majority of muscle growth happens when your insulin levels are high. Every time you eat, insulin and amino acids are created, which in turn give your body the building blocks to grow muscle. As long as your body enters the fed state several times throughout the day, your muscles will be fine.

Thunder also explains that one of the common mistakes guys make is eating a ton of protein to make muscle gains. That's just not true. The amount of protein necessary to stimulate muscle growth for the average man is 20 grams per meal. For some guys, their genetics and metabolism will work best with 25 to 30 grams a meal. Eating higher amounts of protein with every meal will not help you grow more muscle.

Basically, you don't have to plow through a ton of protein at every meal to see a gain in muscle mass. Stop chugging those shakes or powering through a half dozen eggs every morning. Just make sure you eat 20-30 grams of protein several times a day, rather than shooting for a really high total amount of protein at the end of the day.

Remember, more protein in a day doesn't lead to more muscle growth. Space your protein throughout the day and keep the portions reasonable. You Won't Be That Hungry During Fasting

Most guys are afraid that they'll be painfully hungry with any amount of fasted dieting,. especially late at night before bed. We all know that late night hunger often leads to bad eating decisions. When you're hungry at midnight, a salad is the last thing on your mind. You'll skip straight to the cookie dough in your freezer. So how's a guy supposed to stave off that hunger if they cut out an after dinner snack?

"Short answer, man up," says Thunder, "You'll get through [your hunger] really quick, and it won't be that bad in the morning."

Thunder says that the hunger isn't as bad as you'd think. Most people will feel hungry around five or six hours after their last meal, but then it goes away relatively soon afterward. If you time your dinner correctly, you may be a little hungry before you climb into bed, but the hunger should be gone by morning.

"You'll get over it," says Thunder.

Another strategy is to add exercise first thing in the morning. Your body will naturally feel less hungry right after exercise. So if you find yourself feeling hunger pangs right when you wake up, consider working out before breakfast to help you get the 12-14 hours of fasting you need to help you lose weight. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Troy visits a historic mine in Park City and has been thinking a lot about how it impacted the history of Utah. Meanwhile, Scot turns to twitter to find the ideal components of a fitness program. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Dr. Rodney Barker lives an active life, getting outdoors and hiking with his wife whenever he can, but it wasn't always that way. This surgeon had his own turning point story that came when he first started practicing medicine.

Dr. Barker had been in practice for about 5 years when he had his wake up call. Like many men as they get further along in their career, he began to get very busy. He wasn't working out or eating quite as well as he used to. He had put on some fat and had lost some muscle. He was feeling not as good as he used to.

As a surgeon, Dr. Barker does a lot of standing in his job. As he stopped working out, he soon found himself having trouble staying on his feet all day. He would come home after a day of surgery and feel worn out and sore. He'd lie on the couch in front of the TV until he fell asleep, just to find himself getting up and doing it all over again. He was in a cycle that was significantly impacting his health.

Dr. Barker woke up one of these mornings, took a hard look at himself in the mirror and decided he needed to make a change.

He gets outside whenever he can and tries to work up a sweat at least once a day for 30 minutes. This new focus on his daily activity level has lead to looking better, feeling better, and is helping him stay able-bodied enough to do what he loves as he ages.

Remember, 30 minutes of activity a day can lead to immense health benefits for anyone. "That's all it takes," Barker agrees. You don't need to spend two hours in the gym every day to be fit. What Is A Hernia?

A hernia is a defect in the muscle layer of the abdominal wall that causes the muscle lining to be thinner than usual. Eventually, that muscle wall weakness may form into a hole that allows organs and tissue inside the abdominal wall to poke out into places they shouldn't be.

Hernias can form anywhere along the abdominal wall, typically from the belly button down. A majority of cases are inguinal hernias that form at the very bottom of the abdomen, leading to a lump in the groin area.

The media will often portray a hernia being caused by someone lifting something heavy, then feeling a pop. That's not quite true. Hernias are caused by many factors. Remember, the hernia itself is a weak spot caused by your genetics. The contents of your abdomen can move through the hole by many means. The act of lifting something heavy, coughing or sneezing, or just going about your daily activities can cause the hernia to form. Some people have a hernia present at birth and don't even realize it until they're older and their muscle tissues begin to weaken. You Don't Need to Rush to the ER if You Find a Hernia

Troy will often have patients rushing into the ER when they discover a hernia. Patients will feel bump, get scared, and think it's an emergency.

Hernias do not typically a medical crisis. Unless the hernia is incarcerated - meaning the bowel is stuck in the hernia and kinked - there is no need to go to the ER. Incarceration is not subtle. People with an incarcerated hernia they will suffer extremely painful cramping and vomiting. You will know if you need immediate medical attention. Hernias Will Not Go Away On Their Own

You may have heard that hernias happen when a person is moving something and they hear a pop. While some patients do experience something along those lines, it's not the most common way people find a hernia.

A majority of people will first find their hernia while in the shower. A patient will be washing themselves when they feel a bump that wasn't there before. THe bump may go away when they lie down, then come back when they stand up.

While a hernia is not a condition that requires immediate medical attention, a hernia will never go away on its own. A hernia will need to be treated with surgery, but not immediately. A lot of hernias are asymptomatic, meaning there is no pain or other complications. It's just an annoying lump. These types of hernias can be monitored for a long time before surgical intervention. Dr. Barker has had patients that lived with hernias for ten years before seeking treatment.

When any hernia becomes symptomatic, it will need surgery. What to Expect with a Hernia Surgery

Hernia surgery is a very simple procedure with a great success rate. Barker does most hernia surgeries laparoscopically, using small tools through a small incision in the stomach..

The procedure itself starts with three small little incisions under the abdominal muscle layer. Dr. Barker will then separate the muscle layers without making any cuts. He then puts the displaced tissue back through the hernia, into the abdomen where it belongs. Finally he places a patch of surgical mesh over the hole to prevent anything from coming back through.

Most of Dr. Barker's patients will be able to go home the same day as the procedure. The recovery is relatively quick, with most people back to their regular activity within ten days to two weeks. In fact, some of Barker's patient heal up even faster. He has run into some of his patients on the slopes skiing less than a week after he's repaired their hernias. How Can a Person Prevent a Hernia?

Hernias are congenital. People are born with the likelihood of a weak abdominal wall and the potential for a hole to form. But is there anything a person can do to prevent them?

Dr. Barker says that hernias happen to everyone, but anecdotally, he has found that people that stay physically fit are less likely to form hernias. He emphasizes that there is no hard data to back that up, but with his long career of treating hernias he is confident in shape people are less likely to form them. A majority of hernia patients are getting older and forming hernias as they age.

A common misconception is that weightlifters are likely to form a hernia as they strain to lift heavy in the gym. Dr. Barker says this isn't the case. Lifting heavy objects doesn't cause hernias.

Additionally, a hernia is not a reason to stop exercising. Exercise will not make the hernia any worse. As long as the hernia isn't causing any pain or interfering with your daily activity, you can carry on with your life as normal. However, if you do experience any pain at any time with your hernia, you should seek treatment. Hernia Trusses, Belts, and Briefs: Do they Actually Work?

A hernia truss is a supportive undergarment that tries to keep the protruding tissue in place and relieve discomfort from a hernia. These devices can also be called hernia belts or briefs. If you have a hernia, should you consider using one of these devices?

Trusses were very common just a few decades ago. They could be bought at any drugstore to help men with hernias. Back then, hernia surgery was not as effective or simple as it is today, so patients would turn to whatever relief they could find.

Trusses do not treat the hernia. Only surgery can actually fix the condition. These devices do little more than hold the hernia in place. While these trusses may help some patients with asymptomatic hernias, the only solution available is surgery. Is Surgical Mesh Safe?

If you've recently stayed up late watching cable TV, you've probably seen an ad about patients experiencing complications from the surgical mesh used during hernia surgery and class action lawsuits against the mesh manufacturers. These ads can raise some serious concerns and may lead patients worry about the safety of using mesh during their hernia surgery.

Dr. Barker uses surgical mesh in his operations and vouches for the mesh's effectiveness. Surgical mesh significantly reduces the chance of the hernia reforming after surgery. According to Barker, there is no research based evidence that modern surgical mesh used in hernia surgery causes post-surgical complications.

Dr. Barker has been treating hernias since before mesh was regularly. He has found that the very low occurrence of patients suffering from chronic pain after surgery is the same now as it was back when hernias were treated without mesh.

If you find an unusual bump in the shower and believe it's a hernia, go get it looked at by a professional. Your physician should be able to diagnose what that lump is and prescribe what your next steps in treatment should be. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot learns that ER doctors will actually call poison control themselves, The first thing you should do is call poison control. And Troy second guesses himself after learning that an Apple Watch saved a man's life after it sensed a total heart block. On a previous episode he was concerned about the frequent false positives from the device. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.

This content was originally created for audio. Some elements such as tone, sound effects, and music can be hard to translate to text. As such, the following is a summary of the episode and has been edited for clarity. For the full experience, we encourage you to subscribe and listen— it's more fun that way.

Dr. Rich Doxey is a culinary medicine expert and physician at the internal medicine clinic of University of Utah Health. He's a young doctor who decided to start taking his health seriously during his undergraduate studies.

Rich had no medical problems at the time, but after reading a book on nutrition he started taking control of his health. He had read about how food interacts with your genes and your body. He learned that the food you put into your body creates chemical changes the same way medicine can, so nutrition needs to be taken seriously.

He swapped out frozen burritos and occasional fast food, for fresh fruits, vegetables, nuts and whole grains. He soon was cooking his own meals from scratch every day.

He feels that he has avoided a lot of illness due to his diet change and taking his nutrition seriously. What is Culinary Medicine?

Dr. Doxey's early interest in his own diet led him down a path as he entered medical school. He had a strong desire to get engaged with ‘lifestyle medicine' that not only treats and prevents illness in patients, but teaches them how to take control of their own health.

There were not a lot of options available in medical school or this new field of medicine, but that changed in residency. Dr. Doxey searched online and found Dr. Timothy Harlan, a doctor running a website called "Dr. Gourmet." It focused on treating serious health conditions through dietary changes and approaching food as medicine. Dr. Doxey was inspired and after a bit of work, found himself in New Orleans as the first resident to study culinary medicine under Dr. Harlan.

Dr. Doxey would work in the New Orlean's teaching kitchen, running cooking classes that taught members in the community how the skills and nutritional know-how to cook healthy dishes that were cost effective, fast, and - most importantly - delicious. And he would bring the culinary medicine skills he learned in New Orleans back to Utah and apply them to his practice. The Mediterranean Diet is One of the Best Diets

For patients looking to change their diet, Dr. Doxey will begin with taking a 24 hour diet history to get a feeling of what the patients are already eating. He then prescribes one to two small changes they can make today to help improve their lifestyle.

He makes his recommendations based on science and research. And he has found that the Mediterranean Diet is the most researched, most evidence based diet strategy, to show significant improvement in heart health and promote weight loss.

The second most effective diet is a vegan-whole food plant based diet, but he has found that it is very difficult for most patients to sustain such a drastic change in their daily eating habits.

One of the major strengths of the mediterranean diet is that it is based on a set of principles that can be easily adapted to fit any patient's needs:

1. Eat a lot of fruits, vegetables, and whole grains
2. Eat fish a couple times a week
3. Use more unsaturated fats than saturated fats
4. Limit dairy and red meat to less than a serving a day
5. Consume only a moderate amount of alcohol

Dr. Doxey says there are three major barriers for his patients adopting a healthier diet: Time, cost, and staying power. He explains the challenge each one poses to a patient's efforts and how to overcome them.

• Time - Time is the biggest challenge to dietary changes. Buying ingredients and cooking your own meals can seem to take a lot of time out of your day, especially if you have a busy job or kids to take care of. But Doxey insists that if you actually compare the time to cook your own food to the time it takes to go out, the difference in negligible. By the time you drive to a restaurant, sit down, wait for the food, pay the bill, and drive home, you could have cooked dinner at home. The secret is to keep your meals simple so they don't take a lot of time to prepare.
• Cost - Buying fresh produce and whole foods every week can seem to cost more at the checkout line than the processed option, but it doesn't have to be. Doxey repeats to "keep it simple." Don't just buy the expensive so-called superfoods with the fancy packaging. Stick to the basics. The staples of a healthy diet will be legumes and brown rice. Buy them in bulk and they won't hurt your wallet. Also minimize your food waste by learning to repurpose ingredients from one dish to another and actually eat your leftovers. Less food waste means less wasted money. Do it right and cooking at home can cost much less than eating out.
• Staying power - The first week on a healthy diet can be a bit challenging, but doable. It's the second, third, seventh week where willpower can falter. Dr. Doxey suggest you commit and get social support. Get your spouse, partner, or friends onboard with your healthier diet.

Dr. Doxey's background in culinary medicine has shown him that all of these barriers can be easier to overcome if a patient has the ability to cook. Watch some videos online, take a cooking course. Your ability to eat healthier can best be served having some training to make healthy food quickly and make that healthy food taste delicious. If a Truck Driver Can Do It, So Can You

One of Dr. Doxey's success stories came from a trucker. The truck driving lifestyle sure doesn't make healthy living easy. Long hours of the day are spent sitting behind a wheel. Fast food and quick bites at gas stations are the norm. It can be tough to stay in shape.

This patient came to Dr. Doxey after getting some blood work test results back. He was in the early stages of diabetes and had gained over 100 pounds from driving and eating road food. If his diabetes progressed, he would have to start taking insulin, which would mean he couldn't drive anymore. He found himself not only in a health crisis, but in danger of losing his job. It was time to make a change.

By adopting the tenants of the mediterranean diet and following Dr. Doxey's nutritional recommendations, this trucker turned things around. Over the course of a few months he started losing a significant amount of weight. His diabetes marker dropped 0.6 points, which kept him in a healthy range. After changing his diet, he prevented himself from developing full diabetes, kept himself from needing insulin, and he kept his job.

For the rest of us, this story should serve as inspiration. Most of us aren't stuck sitting behind the wheel of a truck for most of the day, eating nothing but road food. If a trucker can get their diet and health on track, so can you. First Steps to Improving Your Diet

Dr. Doxey likes to keep things simple when it comes to diet. Cook simple meals that are cheap and don't take much time. Stick to the handful of rules of the mediterranean diet. His strategy for improving a patient's diet are straight forward too.

First, assess where you are. Write down everything you ate over the past 24 hours. No need for a month's worth of logging food. Just remember the last few meals, snacks, drinks, etc. and write them down. Take a hard look at what you're eating and see if there's anything that needs to change.

Next, start by making one or two small "congruent" dietary changes with your next meal. Dr. Doxey explains that a "congruent change" is one that stay in line with the eating habits and food you already like to eat.

It's near impossible to go directly from eating cheeseburgers and fries for lunch to a small serving of hummus and carrot sticks. Keep it simple. Make small changes and build on them.

Go from eating a cheeseburger and fries, to a hamburger with lots of vegetables and sweet potato fries. Next, replace those sweet potato fries with a baked sweet potatoes. Eventually swap out that hamburger to a chicken sandwich. Slowly but surely, these small congruent changes build up, without the shock of switching to the stereotypical health food overnight.

"Don't go whole hog on your diet," says Dr. Doxey, "It makes it impossible to maintain." Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot has declared war on single use plastics and it's proving harder than he imagined. And Troy is shocked by a new study that shows a spike in avocado related knife injuries. Really. ER docs have seen a 10 fold increase in avocado knife injuries since 2013. Talk to Us

If you have any questions, comments, or thoughts, email us at hello@thescoperadio.com.