Search for tag: "troy"

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Troy: You've got to say something like, "Troy puts the stud in studies," or something like that. Something good. I'm just kidding.

Scot: I will never say that.

Troy: I was just trying to think of something better than "Troy's articles" or whatever you called it.

Scot: That's us. It's a "Sideshow" episode. That's what we like to call a soft start. You caught us in the middle of a little prepping trying to decide what we're calling this segment, where Troy scans the medical journals so you don't have to and then shares an article that hopefully is of some interest.

Troy: Hopefully.

Scot: Yeah, this is "Who Cares About Men's Health," a "Sideshow" episode. My name is Scot. With me, as always, the MD to my BS, Dr. Troy Madsen.

Troy: Hey, Scot.

Scot: And Producer Mitch.

Mitch: Hey there.

Scot: All right, Troy. Let's take a look at your articles, hear what you've got. Go ahead and put those articles on display.

Troy: Look at the articles.

Scot: Yeah. Go ahead and put those articles out on display for us. We're going to pick one.

Troy: Oh, we're picking?

Scot: Oh, yeah. I mean, unless you just decided you had one that you . . .

Troy: I decided.

Scot: Oh, okay.

Troy: This title is so good that I knew even if I gave you my list of five, including the one on green urine that I keep trying to get you to pick, I know you'd pick this one.

Scot: All right.

Troy: And I'm just going to read it to you and if you don't like it, if you're just like, "No, we would not have picked that one," let me know and I'll pull up some other ones.

Scot: Okay.

Troy: The title of this article from the "Journal of Emergency Medicine," the title is "Battlefield Acupuncture Versus Standard Pharmacologic Treatment of Low Back Pain in the Emergency Department: A Randomized Controlled Trial."

Mitch: Oh, Troy, I did a bunch of interviews about this. Keep going.

Troy: Yeah. Tell me I have not piqued your interest.

Scot: So when you say battlefield, you mean like a war battlefield?

Troy: That's a good question.

Scot: Oh, okay. Well, I guess, Troy . . .

Troy: I'm hoping I piqued your interest enough that I can . . . I'll explain what battlefield acupuncture is. I didn't know before this article.

Scot: Move forward with this one. Go for it.

Troy: Okay, we got it. So battlefield acupuncture, to your question, is a technique using acupuncture. So you're familiar with acupuncture? You use these little needles in different spots. Ideally, the way this is designed, it's supposed to then relieve pain or lead to different effects.

Acupuncture, of course, is considered an alternative therapy, and it's one of those things where it has gained more mainstream acceptance as these types of studies have come out. But it's been considered a traditional therapy, an alternative therapy. It is not something I have ever done or have ever practiced. I did spend a day shadowing, spending time with an acupuncturist during med school, which was really cool, to kind of see what she did and hear her philosophy and see her approach and see the patient's response.

But battlefield acupuncture is a technique where there are certain little needles that look more like little tiny darts that are placed in specific places in either one or both ears.

The idea behind this is that these spots are said to influence the central nervous system pain response. And by putting these little needles in these different spots in the ear, they then decrease pain that is coming from other sites in the body. I mean, that's the theory. Again, I'm not a traditional practitioner, but I'm just kind of reading what I found on it.

Scot: Time out. In the ear, or in the part around the ear, or the earlobe?

Troy: In various parts. So yeah, let me clarify that. Not in the tympanic membrane. You're not going in the ear hole. These are different spots . . .

Scot: Okay.

Troy: Yeah, these are different spots on the auricle of the ear. You do not want to puncture the eardrum. These are spots . . .

If you just do a Google search for this, you can see photos of where these spots are. They're basically at the very top of the auricle of the ear, so the very top of the ear, and then kind of maybe half an inch down from there. And there's another spot half an inch down from there. There's a spot on the earlobe. There's a spot just on the very front part of the earlobe.

So they're like little tiny darts, and they actually have a tool that you use to place these. They just stay in place until they fall out. So it's usually three or four days. You put these in there, you leave them in, and you just send people home with these in place.

Scot: Wow.

Troy: Yeah, it's fascinating. Again, I have never done this. I've never been trained on this. This is the first article I've seen looking at treatment of low back pain.

And then you might ask, "Why would I even care about this? Because surely I have some great treatment for low back pain." I can tell you that when you see a patient come to the ER, the first thing you'll see is their name and a chief complaint and that's what shows up. And when the chief complaint is low back pain, that to me is one of the most frustrating things to go and see because there is so little that I can offer.

It used to be these patients would come in and everyone would just get opioids, like, "Okay, here's your script for Norco or Lortab." That's a horrible way to approach it and that's what's led to the current opioid epidemic.

So now when people come in, I say, "Well, you can try ibuprofen or Tylenol." "Well, I've already been trying that."

"Well, you could try some lidocaine, some numbing cream on there." "Well, I've tried that."

"Well, you could try physical therapy." And we actually had a physical therapy in our emergency department and did a study on it, and that was great. But that person was only there 30 hours a week and the emergency department is open 24/7, so that's not something I can offer that often.

So if there was something I could actually do and say, "There's evidence behind this and this is going to help you," and people actually did it and said, "Wow, it helped me," that would be really cool.

So this study, essentially what they did is they took patients who came into the emergency department . . . It's a fairly small study, more of a pilot study we would call it, where it's kind of like, "Hey, let's try to see if it works. If it works, let's do a bigger study."

So they only had 52 patients. Twenty-six of these were randomized either to getting this battlefield acupuncture done or to just standard treatment, which would be the stuff I talked about where it's just like, "Hey, do whatever you normally do."

The patients with the battlefield acupuncture had a significant decrease in their pain score when compared to the patients who just had standard treatment.

And they then contacted these patients two to three days after they were there and found that the patients who had the battlefield acupuncture continued to have a significant improvement in their pain scores compared to those who were sent home either with a prescription or with just standard stuff we would do for low back pain.

Of course, there were no difference in any adverse effects. It's not like these patients were getting a lot of infections, they were complaining of a lot of pain or bleeding, or anything like that.

So their conclusion was that this potentially shows some promise. I can tell you please don't come to the ER right now and ask for battlefield acupuncture, because we don't have the tools there. It is not something we're doing. But maybe a study like this and some subsequent studies, if they continue to show this works, maybe it's something we're going to learn to do. I would love to be able to offer something better than what I can realistically offer in the ER.

So kind of a cool study. A pretty simple thing, it looks like, to do. It's just something we're not doing now, but maybe we'll see more of this in the future.

Mitch: I have to chime in because I've done it.

Troy: So when you say you've done it, have you performed this on people?

Mitch: Yes, I have.

Troy: Wow. This is cool.

Mitch: Okay, so 2011, it was my old life as a documentary filmmaker. We were working on a project called "The Painful Truth," and we were traveling all over the country investigating chronic pain patients and how they are treating their different conditions and how it impacts their family. And I got to actually go to this big medical conference. And one of the rooms where they were doing a breakout session was all about battlefield acupuncture.

You go in there and up on front, there's like this cute small woman who's been studying it and she published the paper. And then there are these military guys in full uniform with all their awards and medals and everything, talking about how they were using acupuncture in the ears and the tragus and all these different parts to stop people from going into shock on the battlefield.

Troy: Wow. So that's where it got the name then. I had no idea before this.

Mitch: So I was actually able to get one of them to be interviewed with us. And when we were talking about the interview, he pulls out first an orange and he's like, "Here's the tool. I want to show you how easy it is here. Here, why don't you go ahead and put some of these little brads in." And it's like a little gun and it's just, "Pew, pew, pew." So I bedazzled an orange.

And then he's like, "Do you want to see what it feels like?" And I'm like, "Absolutely, yes, a thousand times." And so he clips my ear. I'm trying to find some photos of it right now. But he clips my ears, and I didn't feel anything because I wasn't going into shock. But I'm like, "Wow."

And then he asked if I would feel comfortable doing it with my cameraman, and I said, "For real?" And the guy was not sure, but I'm like, "Oh, come on. It'll be fun." So yeah, I got to basically bedazzle my cameraman's ear with this tool. And it was just . . .

Troy: Did they draw the spots on there for you to shoot this little gun into, or did you just see it and you're just like, "Okay, there, there, there"?

Mitch: So they had a little printout and they were like, "Here's where you're going to do it." And then when I was doing it, he took his little Sharpie and did little dots on the guy's ear to be like, "Here's where you're going to shoot it."

Troy: Make sure you hit the right spots, yeah.

Mitch: And so the big part of it is that this for them at that time was . . . This was not necessarily something that a battlefield medic would need to have special training for. They can train anyone to do it, right?

Troy: Yeah. It's sounds so simple.

Mitch: So it was really kind of cool to . . . And especially for him, the guy who was giving me the interview and everything, he was like, "These for so long have been treated as 'alternative medicine.'" Big quotation fingers there. But they're starting to find real applications. And so it's kind of exciting to hear that you also found a study about it.

Troy: Yeah, that is fascinating. Again, it's not something I've ever been trained on. And there probably are other emergency-department-based studies that have done this kind of thing, but there are not a lot. And maybe there are some others with low back pain, but this is the first time I've seen this.

I would love to be able to do this. Again, I would love to also maybe see some larger studies just saying, "Yeah, this panned out and we are seeing an improvement and this works."

Again, Mitch, like you said, it sounds super simple to do. As I've looked at pictures of it, it's like, "Okay, just hit these five spots." It's not rocket science, and you just need that tool, the same tool you had, which we don't have. But that's so cool you were doing that.

So if we can do this, I'm going to bring you in to teach us all how to do it, Mitch. Apparently, you're the expert now. You have more experience with this probably than any physician in our emergency department. So you're coming in.

Mitch: Okay. All right.

Troy: I love it.

Scot: Can we get you one of these guns on eBay?

Mitch: I don't know.

Troy: They have them on eBay?

Scot: What do they cost? What does one of these things cost?

Troy: I don't know. I've never looked into it.

Mitch: It was like a handheld staple gun. It was between a hole-punch, like one of those single handheld hold-punches. It was kind of like that plus a staple gun. It didn't feel too technical.

Troy: Yeah. We should probably clarify. Don't do this at home with a staple gun. It would be unwise and unsterile. But yeah, it seems like if you have the proper tools and a sterile device that's designed for this, it doesn't sound difficult.

Scot: Troy is a physician, right? Mitch mentioned something that resonated with me. Alternative medicines, right? There's a lot of stuff out there that people swear by. But as a physician, or at least many physicians I've talked to, until they can see some hard evidence that it actually makes a difference, they don't really accept it as a treatment. But it sounds like you would be in all the way on this because of this study?

Troy: I would like to see at least a couple more studies that replicate the results. At the same time, I don't want to just do something just to do it. It would be nice to see something that helps. I would be open to doing this if a patient . . . if I talk to them about options and I said, "Hey, there's been a small study. It seems to make a difference."

The big thing for me is, "Is there a big downside to this? Am I going to be causing harm?" And if I'm not going to be causing harm, and they did not report significant adverse effects with this, if I'm not going to be causing infections in their ear, or a lot of bleeding or things like that, and there's reasonable evidence to support it, I would offer it to a patient specifically that way. I would say, "This is something . . . there's been a small study." I'd say, "We can try it if you're interested."

Scot: And if this really did work, that sounds like it would change your life. It would make you go from seeing name and back pain to name and I can help this person. Name and back pain, going, "Oh, geez," to name and back pain and, "I have something I could probably do."

Troy: I would love to have that. If anyone asks me, "What is the most frustrating thing you deal with in the emergency department?" it is back pain, because people come there wanting answers and wanting a quick fix and it's a 15-minute discussion often of saying, "Hey, this is what you need to do. It's going to be a long process. You're going to have to do physical therapy. I'm not going to prescribe opioids for this. I do not want to do that. I do not want to create potential for addiction." And then I'll offer them the Lidocaine, things like that, and say, "Well, maybe this will help."

But yeah, to be able to just be like, "Yeah, I can try this. We can do this and there's evidence to support it," would be wonderful.

So we'll see what happens. Again, it's one of those articles where you see it like, "Oh, that's really cool." I can't say it changes my practice right now where I'm going to start doing this. Obviously, I don't have the tools to do it right now or the training. But it's one of those that maybe we're going to see more on this. It takes a while for these things to come into practice, but maybe in five years, this will be a standard approach in the emergency department. Who knows?

Scot: All right. You made it to the end. Good for you. Be sure to check out some of our other "Who Cares About Men's Health" episodes.

What you just heard is what we call a "Sideshow." It's where sometimes we talk about health topics that aren't necessarily directly related to what we normally would talk about, which is the core four plus one more. That is to be healthy now and in the future, you should concentrate on your nutrition, your activity, your sleep, your emotional health, and you've got to know your genetics.

Plus, we also have episodes that are dedicated just to men's health issues. So check out some of those episodes as well.

And if you know somebody that would find any of them useful, please go ahead and let them know about the podcast. It's the best way that you can help us grow the podcast.

If you want to reach out, lots of ways to do that. You can call us at 601-55SCOPE and leave a voicemail, you can email us at hello@thescoperadio.com, or you can check out our Facebook page. That's facebook.com/whocaresmenshealth.

Thanks for listening, and thanks 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.

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.

Health is more than just diet and nutrition and how you look in the mirror. In order to live your best life, taking care of your mental health is crucial. Your mental state allows you to feel good about yourself, be confident to live the life you want to, and have positive, enriching relationships.

Kevin Curtis is a licensed clinical social worker with University Neuropsychiatric Institute. He suggests asking yourself three questions to assess the state of your mental health:

• Are you having thoughts that are useful to you?
• Are you having thoughts that impact your ability to function?
• Is your emotional state supporting or hindering achieving your goals?

Kevin is joined on this episode by his friend Ben. Ben works at the University of Utah and considers himself a regular guy who has been working with professionals to improve his mental health over the past decade.

Ben admits that he's not the paragon of mental health, but feels tons better than he was 10 years ago. He's learned a few tools and techniques that have helped improve his mental health over the past 10 years. He shares the three tools he feels were the most helpful for him.

1. Box Breathing/Tactical Breathing
   The way you feel during an emotion is ultimately a physical response. The increase in heart rate when anxious. The flush of blood to the face when angry. These physical changes can start a feedback loop with your emotional state that can lead to an overwhelming response.

   To help keep your mind calm when feeling stressed, Ben focuses on his breathing. He will breathe in for a count of four. Hold that breath for a count of four. Breath out for a count of four. Pause for a count of four. Repeat as necessary. This is called "box breathing."

   This breathing technique allows you to shift your mind to a physical response rather than an emotional one. It changes the way your body feels, and in turn is able to help make the emotion feel less overwhelming.

   Tactical breathing uses the same four-second breathing technique but removes the pauses between breaths. This alternative will provide the same benefit, but is best used in a situation when you need to be able to breathe regularly.

2. Check fo BLAST(H) Conditions
   We've all had a friend, partner, or child in our lives that make poor decisions or are particularly irritable because something more physical is going on. It's sometimes easy to see exactly why another person is stressed, but hard to recognize it in yourself. As such, Ben's second technique takes a personal inventory of the following if you are feeling overwhelmed:

   B: Bored
   L: Lonely
   A: Angry
   S: Stressed
   T: Tired
   H: Hungry

   If these "BLAST" conditions are present, recognize they may be having an impact on your emotional state.

   A good step to improve your mental health is to adopt strategies and daily habits that will keep you out of these conditions as often as possible.

3. The Reach Out
   While professional help can be an integral part of your mental health strategy, it's also important to build a network of support and "emotional scaffolding" with people in your life and network.

   "The Reach Out" is a technique that aims to build and strengthen your connection with others. If you are feeling down, or upset about a situation, reach out to two people you trust. These people can be friends, family, coworkers. Take the opportunity to tell them what is going on in your life and how you feel about it. Explain that you are not seeking solutions to your problems, but rather you are merely reaching out to let them know what you are experiencing.

   By expressing vulnerability without setting an expectation, you are inviting these people to join a network of support without placing pressure on them. Additionally, by reaching out and getting personal, you are inviting the possibility of sharing a meaningful interaction that can deepen the bonds you have together.

In times of stress, be sure to take care of your mental health. These tips may help maintain and improve your day to day mental resiliency. However, if you are experiencing overwhelming feelings of depression or contemplating self-harm or suicide, reach out to a professional.

For people in Utah consider the Crisis Intervention Services at University of Utah Health. 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.

Consuming too much sugar can be quite detrimental to your health. While they may taste good, refined sugars add no nutrients but a lot of calories to the feed we eat. They can lead to packing on extra pounds, impact your cardiovascular health, and increase your risk of diabetes.

According to the American Heart Association, men should have no more than 9 teaspoons or 36 grams of added sugar a day (6 teaspoons and 25 grams for women). That may sound like a lot of sugar in a day and seem pretty easy to avoid, but you may be surprised at how much added sugar is in the food you eat every day.

Nutritionist Thunder Jalili, PhD, explains that even in the food that is "healthy" there can be a shocking amount of added sugar you don't realize you're consuming. For example:

• 2 slices of white bread - 3g or 1 teaspoon of sugar
• Fast food bean burrito - 3g or 1 teaspoon of sugar
• A small cup of flavored yogurt - 10g or 2.5 teaspoons of sugar
• One Packet of flavored instant oatmeal - 18g or 4.5 teaspoons of sugar
• Name brand energy bar - 31g or 8 teaspoons of sugar

All of these items may seem like pretty normal items to consume every day. Some foods may even be bought on the health food aisle. It wouldn't be strange for a person to eat all of these in a single day. But when you add up the hidden added sugars it comes to 66 grams or 16 teaspoons of sugar in a single day. Nearly double what the AHA recommends. Summer Plans During COVID-19

As the weather turns warmer and we get deeper into summer, we're all yearning for summer activities and vacations. But with the outbreak of COVID-19, a lot of summer plans have been canceled. Plus, with the risk of the virus still present, how can we still enjoy the summer while keeping ourselves and others safe?

First, consider risk. How much risk are you personally willing to tolerate? How does your home or work situation impact your risk toleration? Who are the people in your life that will be impacted by your decisions?

After you have a good handle on what you're comfortable with risk wise, you can then assess the riskiness of an activity based on these three values:

• Time - How long will you be in close contact with another person?
• Proximity - How close will you be to other people? How many people will be present?
• PPE (Personal Protective Equipment) - If you can't maintain physical distance, do you have equipment like masks to help reduce the risk of infection?

Analyze your summer activities to deem how risky they will be. It may not be a good idea to do a multi-day river rafting trip with a group of strangers, but a camping road trip to some of the more remote places of the country would be safer.

Get creative on how you can manipulate time, proximity, and PPE this summer to get out and have some fun while staying safe. Odds and Ends - The 5k is this Saturday

The Who Cares About Men's Health 5K is this Saturday, 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. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot really appreciates Brad Stulberg (@BStulberg) on Twitter and his simple, holisitic approach to health. Troy is so desperate for sports that he has begun watching bowling and NASCAR. 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've ever looked up your medical symptoms online, it can seem like every website assumes the worst possible scenario. These results can be alarming to say the least. So where can you find reliable health information online?

Dr. Troy Madsen has dealt with the stress of trusting bad online information personally and professionally with his patients. He's put together a list of websites he uses and has found to be the most reliable to find information on any medical topic.

• Centers for Disease Control and Prevention (CDC)
• The Mayo Clinic
• The Cleveland Clinic
• University of Utah Health
• MedScape.com
• UptoDate.com

Each of these websites are from reputable health organizations run by professionals. Dr. Madsen highly recommends using these sources over a basic web search to make sure you're getting the best information possible. How Can You Tell if a Health Article is Valid?

When it comes to research you see in your news feed, it's easy to get bad information. There are a lot of potential problems with online health journalism. Media groups often write articles about science and medicine in a way that can get them clicks. Due to limitations, the story is not always able to go as deep into a topic as is necessary to fully understand the complex nature of scientific studies. And finally, most journalists lack the medical or scientific background to accurately present the findings.

Dr. Troy Madsen has a list of tips that he suggests everyone follows when reading any study to help you decide if it's true.

• First and foremost, make sure the article links to a published scientific study. If there's no study, there's a good chance the information in the article is misleading.

• Make sure the linked study actually claims what the article says. Most scientific journals will give access to the abstract or short summary of the research for free. Read through to make sure the journal isn't twisting the findings.

• Make sure the study is published in a reputable scientific journal. There are "predatory journals" that allow any group to pay to publish research in official sounding publications. To be safe, only trust journals like The New England Journal of Medicine, The Journal of American Medical Associations, The Lancet, or The British Medical Journal.

• Avoid studies that make bold and definitive claims. Science is nuanced and seldom makes hard and fast claims about anything.

• Make sure the claims are backed up by multiple studies. For example, if chocolate really did cure cancer, multiple studies would be looking into it.

• Be sure to check the sponsor of the research. It's not uncommon for companies to back skewed research that shows the positives of their products.

Be a skeptic! Next time a scientific story comes across your feed, keep an eye out for these elements to make sure you really are getting reliable information. What Makes a Good Scientific Study?

Troy also suggests a few things to look out for when judging the validity of a study. A good scientific study should have the following:

1. Low "P-values." A p-value is a statistic that describes the likelihood of the collected data having errors. As such, a lower p-value means a more reliable study. Look for data with a p-value less than .05. That means there is less than a 5% chance of the data being wrong.

2. Large numbers of subjects. A scientific study about health should include over a thousand subjects minimum. Ten thousand is even better.

3. The best type of studies use "randomized control trials."

4. The gold standard for medical research are "prospective studies," where the scientist actively follows the patient and their behavior rather than rely on anecdotal information.

Maybe you didn't chew as well as you should have. Now you have a piece of food stuck in your throat. It's not obstructing your airway, but it's definitely uncomfortable or painful. The food won't come up, it won't go down. ER or Not?

First, make sure the food isn't obstructing your airway. Any blockage of the airway needs to be seen at an ER immediately.

If you can't get the piece of food up, you may need to go to the ER to get it removed by a professional. But first, there's a trick you can try at home that may save you a trip and the cost of an ER visit.

Take a drink of a soda, preferably a cola. Try to get a swallow of the cola down your throat and let it sit there for five minutes or so. Carbonated cola has some properties that will help the esophagus relax. It may be able to relax your throat enough to swallow the food the rest of the way. Repeat a few times if necessary.

If the cola trick works, it is important to go talk to your doctor afterwards. There are some conditions that can be related to getting food stuck in your throat that would be important to catch to diagnose and treat.

If the cola didn't help push the food through to your stomach, you will need to go to an ER. You will need to be treated by a gastroenterologist immediately. An urgent care will not have that kind of specialist on hand. Try to go to a larger ER that would have an oncall specialist. Housekeeping - Hello Ladies.

This podcast is called "Who Cares About Men's Health." The goal of the show was very focused and very singular. Create a podcast by men, for men. Yet our our most recent statistics surprisingly show that about 40% of our listeners are women.

Guess this just goes to show that women also care about men's health.

Listener Danielle recently gave us a shoutout on Facebook.

"I love listening to bits and pieces of this podcast Who Cares About Men's Health. You don't have to be a man to find it interesting."

Women, if you are listening, be sure to share it with the men in your life. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Troy would rather have a broken finger than a long-lasting cold, because he can't get sympathy. Scot has a moment of honesty about his personal health struggles and he reminds us that health is a practice with ups and downs, not a linear journey. 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.

Scot received two at home genetics testing kits last Christmas. He wanted to share his second test, but producer Mitch had already taken one, and Troy was adamantly against taking the test. He decided to give away his second test to one of our listeners. Seemed simple, but over the past month the Who Cares guys have been looking deeper into the realities of consumer genetic testing. What they've found is worth talking about.

The winner of the competition is listener Matt. Matt is a father with one young daughter and a son on the way. Matt wanted to take the test because he was curious about his genetic predisposition of certain health conditions and the likelihood of passing them on to his kids.

Karin Dent is a certified and licensed genetic counselor at the University of Utah. We brought Karin on to discuss with Matt the realities of consumer genetic testing and have a conversation about whether or not he still wanted to take the test. You Cannot "Un-know" Your Genetics

The first question we asked Matt was whether or not he had read the terms of service for the genetic test. He had not. It was important to share one term that many people don't think about when it comes to their genetics:

Once you obtain genetic information, the knowledge is irrevocable. You should not assume that any information we may be able to provide you whether now or as genetic research advances will be welcome or positive. You may learn information about yourself you do not anticipate. This information may evoke strong emotions and has the potential to alter your life and worldview.

According to Karin, this is something a person should think about taking the test. The goal of genetic counselors is to help people understand the medical, familial and psychosocial implications of genetic data and how it can impact their health and overall well-being.

She explains to her clients they can't "unknow something." Once you learn you may be genetically predisposed to a health condition, you will always know that bit of information. It may change your life in ways you don't realize.

Karin says as a patient and consumer, you have the right to not know something just as much as you have the right to information about yourself. A DNA Test May Not Provide the Answers You Seek

The main purpose of genetic counseling is to make sure the patient is fully aware of the limitations, benefits and risks associated with genetic testing. Many people are like Matt, and looking for a potential genetic predisposition they may have. Unfortunately, genetic tests today don't test for every single condition.

Karin suggests that if a person is wondering if there is a specific genetic condition you are curious about, make sure the test you are taking actually provides results for that condition. Tests may be limited in the diseases and conditions they test for. No test on the market covers everything. Additionally, most tests available will only provide results for a small subsection of known genetic factors that may contribute to developing a condition. Your DNA is Not Your Destiny

Matt is specifically curious about conditions like Parkinson's disease as well as a predisposition to obesity and diabetes.

Most conditions these at-home genetics kits report on are complex conditions that form in adulthood. While there may be a research backed genetic predisposition for these conditions, lifestyle and environmental factors play a large role in whether or not a person will develop the condition.

"[The test] gives you an assessment," says Karin, "but it isn't a black and white result."

Despite how these tests are marketed, there is more involved in the development of a condition like obesity.. While a limited set of genes may suggest a predisposition, the diet and lifestyle of a person likely plays a bigger role in whether or not a person becomes overweight.

"One thing I like to tell everyone I meet with, patients, clients friends, is that your genetics is not your destiny." says Karin "Even if this came back and said you have an increased risk or there's an increased association with obesity based on the genetic factors that you have, remember, that is only a small subset of the genetic contributions we know currently that contribute to obesity."

There's a limitation on the information genetics test can provide. The results are not - and should not - guide your healthcare plan. These test results should not replace routine healthcare screenings. Just because your genetic results say you have a reduced chance of developing prostate cancer, that doesn't mean you should stop getting your screenings.

As such, some professionals have begun to refer to direct-to-consumer genetic testing as "recreational genomics." Meaning, the results of the test may be interesting, but shouldn't guide how you approach your health. You Are Ultimately Testing Your Whole Family

After getting your genetics results, you may be faced with not only a personal dilemma but an ethical one as well. If you found out you have an increased risk of a certain cancer, that can have a huge impact on your relatives too.

"When you take a test, you're testing a family," says Karin.

It's rare that a genetics test will find something that only impacts one person. You share much of the same genes as your parents, siblings, and children. The results you receive may be present in others. Some members of the family might not want to know. On the other hand, if you find something is there an obligation to tell the rest of the family? It's important to consider what you are willing to share with these people, and how it will impact them

Matt has had discussions with his wife about how this information may impact their family. She might have to deal with his genetic results as a wife, and as the mother of their kids. The two of them have discussed how they would approach those topics as a family. He is also considering how he will share his results with his brother. There Currently Isn't a "Professional" Option

Direct to consumer testing is unique in the genetics world because it is a test that targets healthy people. These tests are often marketed as a way to keep healthy people healthy by giving them knowledge about themselves so they can take the steps necessary to prevent different health conditions.

Clinical genetic testing isn't typically for "healthy" people. Clinical testing is used to find the cause of a severe health condition or birth defect already present in a patient. There currently isn't a readily available clinical test for healthy people who are merely curious about their genes.

There are "adult healthy screens" available in some clinical settings, but these are often very specific tests that are screening for specific conditions for rare circumstances.

With this in mind, genetic counselors do not typically suggest getting an at home test due to the limitations of the information these tests can provide. Consumer genetics testing companies are ultimately targeting you as a consumer, not a patient. There Is No Rush to Get Tested Today

Karin personally refuses to take an at-home genetics test despite her genealogically minded father's urging. For Karin, she feels there are too many limitations in the testing right now and the information it may provide is not of any value to her.

"[A direct-to-consumer genetics test] is not going to tell you anything that will change your life in a positive way," says Karin. She has met with people that have regretted what they have learned from these tests. They feel that it has changed a part of their life that they can't get back. There's a time before they learn something, a time after.

With that in mind, Karin explains that there should be no rush to go and get your DNA tested today. Unlike a lab value, your genes don't change. You will have the same genes five, ten, fifteen years from today. As genetic research advances there may come a time when the results given by genetics testing will be more valuable - and perhaps cheaper. There's no reason you can't wait to get the test later in your life. Will Matt and Scot Take the Test?

After all of this discussion with a professional, it comes down to this: Will they still take the test?

Matt still wants to take the test. He has spent a lot of time considering the realities of this kind of testing. He understands the limitations. He understands he can't unknow his results. He knows his test will impact not just him, but his whole family.

But for Matt, he reasons that he's still young. Knowing his genetics may be able to help him better understand steps he can take moving forward in his own life. He's thought about what he would do with the information and his kids. He's making an informed decision about his genetics, and that's what Karin supports.

After spending the last few months considering it, Scot has decided he isn't going to take the test. For him, he was moved by Karin's discussion of not being able to "unknow" something. He works hard to live a healthy life. He has a good understanding of his family history. He feels that there is nothing the test will tell him today that would positively impact his life.

Scot may consider taking the test in the future, but he recognizes that there's no pressure to take the test today just because it's trendy. Just Going to Leave This Here

On this episode's Just Going to Leave This Here, Scot challenges Troy to guess what's wrong with his ear and Troy hates shaving so much he jokingly considers laser hair removal. 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.

Scot: Hey, happy holidays and holiday season from the "Who Cares About Men's Health?" team. Quick little minisode during our hiatus. We'll be back January 7th?

Mitch: Seventh.

Scot: January 7th with a new show. In the meantime, listen to some of these shows from the past. But this is brand-new stuff here. I thought it would be kind of fun from Troy's perspective to think about, like, Christmas presents under Troy's tree.

Troy: That's right, under . . .

Scot: Like, as an ER doctor . . .

Troy: Not in my home. Not under my . . . but yes, the Christmas tree that we have in the ER, the middle of the ER, that we can just distribute gifts to our patients, things that are going to help them and hopefully keep them out of the ER. That's the goal of my Christmas tree is keeping people out of the ER.

Scot: Oh, okay. That's good. All right.

Troy: I love seeing you there but, you know, you don't want to come to the ER, let's face it.

Scot: All right, so Christmas presents under Troy's tree in the emergency room. Let's go ahead and unwrap one right now.

Mitch: Crinkle crinkle crinkle. Crinkle.

Scot: Those are our low-budget sound effects.

Troy: This is low budget, yeah.

Scot: We can't afford real sound effects.

Troy: That's Mitch opening my very poorly wrapped gift to him. And to Mitch, I am gifting you a prescription for Zofran.

Mitch: For Zofran?

Troy: Yeah, it's an anti-nausea . . . are you excited?

Mitch: Yes. Wow, I don't know. What is this?

Troy: Have you ever gotten Zofran before?

Mitch: Yeah.

Troy: I bet you've never . . . oh, you have?

Mitch: Unh-unh.

Troy: Yeah, so you've never gotten this gift before. Zofran's a medication that will keep you out of the ER. It's an anti-nausea medication. If you're traveling, I always recommend to people to talk to your doctor about getting a prescription for Zofran. This is the one thing if you're ever traveling, it can be a lifesaver, because nothing's more disabling than getting sick and throwing up. You take some Zofran, you can keep fluids down, avoid a trip to the ER.

Mitch: Wow, thanks.

Troy: You're welcome, Mitch.

Scot: Oh boy, me next, me next!

Troy: Any day. Scot, what would you like? Do you want to open your gift next?

Scot: I'm going to take that red one right there.

Troy: Okay. Open it up.

Scot: Crinkle crinkle crinkle. Oh, it's super glue.

Troy: It is super glue.

Scot: Thanks, Troy.

Troy: This can keep you out of the ER, too. Again, I'm kind of thinking more in terms of travel. I'm not recommending just putting super glue on yourself randomly. But when you're traveling, super glue can be a great way to fix lacerations. It's the same stuff almost, besides one little chain on this chemical molecule, that we use in the ER. You know, we use this kind of super glue stuff to repair lacerations. If you're traveling, if you have a small laceration, clean it out really well, put a little super glue on it. It can keep you from having to go to the ER.

Scot: Oh, great.

Troy: Yeah.

Scot: Thanks, Troy.

Troy: You're welcome.

Scot: All right, looks like we have one more. I don't know who this is for.

Troy: Okay, well, we're not going to name names here, but this is Naloxone.

Scot: Okay.

Troy: So I don't want to make light of this, because Naloxone is actually the one thing I would love to give everyone who comes to the ER, because Naloxone is an absolute lifesaver in an opioid overdose. If someone has a heroin addiction or if they just have prescription pills, or you have a child who gets a hold of prescription pills, opioids, and takes them, you know, we have one of the top five death rates in the country from opioids. If everyone had access to Naloxone, we could save a lot of lives. So this is one of those things, you can inject Naloxone. There's a nasal spray. It reverses the effects of the opioid, gets the person breathing again. It's a lifesaver.

Scot: And I want to destigmatize it a little bit. Like, for somebody that just even, we've heard stories about grandmas and grandpas who, the kids come over for the holidays, and grandma and grandpa has an opioid pain medication for legitimate reasons, and the little kid gets into it and takes it, it could have a terrible outcome. But with a Naloxone kit, it's the antidote.

Troy: It's the antidote. It is an absolute lifesaver. So this is something everyone should have, and you can pick it up at public libraries. Go down to the Salt Lake City Library. You can come here to University of Utah to the Health Sciences Center to the library. They'll just hand it to you, no questions asked, no prescription needed. I would love just to give this to everyone.

Scot: All right. That's a pretty interesting and cool Christmas tree.

Mitch: I'm glad I got my gift.

Troy: You got your Zofran. You're a happy man.

Scot: Sorry, Troy, we didn't get you anything.

Troy: It's all right. I'll let it go this year.

Scot: Merry Christmas, Troy.

Troy: Thank you, and a happy holidays to you too.

Scot: Time to say the things that we say at the end of podcasts. Troy, don't try to hog the whole thing. Go. Once Troy gets started . . .

Troy: See, you can't get me started, because I'm like, what's the next thing I'm supposed to say here? So if you like us, please give us five stars. If you don't like us, let us know. Tell us directly so we can make changes.

Scot: And then get the five stars.

Troy: And then give the five stars later. So you can contact us at hello@thescoperadio.com.

Scot: All right, and you can also reach out to us at facebook.com/whocaresmenshealth. If you want to find out where you can get the podcast and subscribe, which is awesome, because then we just pop right into your little pod catcher, you can go to whocaresmenshealth.com, and we've got links to all the popular podcast listening apps. And thank you for caring about men's health, and be cool.

Troy: Be cool, man.

Mitch: Be cool.

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.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: It's time for another From the Front Lines with Dr. Troy Madsen, emergency physician at the University of Utah Medical Center. As an emergency room physician you see things first-trends, what is happening right now? What is it we need to be aware of?

Dr. Madsen: So right now the big thing we're seeing and the big thing people are talking about is air quality. As the temperatures go up in Utah we get ozone that develops. This is stuff in the air that can then get in your lungs; if you have lung problems like asthma or emphysema, it can really make things worse.

Interviewer: So in the E.R. you're seeing increased cases of this?

Dr. Madsen: We are. We're seeing more cases of people coming in who are having trouble breathing, definitely just in the last few days.

Interviewer: And that's attributed to air quality? No doubt about it.

Dr. Madsen: It is. I hadn't seen the numbers we've had recently until just now and just looking at the ozone levels and the fine particulate matter, this is all the stuff that's released from forest fires and different range fires. We are seeing our numbers up, associated with that.

Interviewer: So what's going on exactly, you've got the bad air, somebody breathes it in, and what's going on at a physiological level?

Dr. Madsen: Yeah, so the big thing that's going on, for people who have asthma or emphysema, there lungs are already sensitive, so when you get this stuff in your lungs, if you get this ozone in there or these particles in the air, it just causes the lungs to get inflamed. They produce more mucous, they just get really inflamed and red, if you were to look at them and see them, and then they get really tight. So these are people who already are more likely to have their lungs just tighten up, where their airways just can't get air through them. This just makes things that much worse.

Interviewer: So what can you do for a person like that?

Dr. Madsen: So the big thing is if you already know you have asthma or emphysema, make sure your medications are refilled, make sure your inhalers are full, and make sure you're using them. Do you have preventive medications? Be sure to use those on a daily basis. If you start to have trouble breathing, use your Albuterol or whatever you're using to help you out. And if things get really bad, come to the E.R. A lot of these people we're having to keep overnight on breathing treatments and on steroids to try and get their lungs opened up.

Interviewer: What about healthy people, is it going to affect somebody that's healthy as well?

Dr. Madsen: So the big thing we're seeing with healthy people is a lot of times they're getting what feels to them kind of like allergies or a cold, clearing their throat a lot, having a lot of congestion maybe runny nose, stuff that feels kind of like allergies, maybe their eyes are watering a little bit, so it's causing some of these issues with them as well. So I would say if you're younger, if you're healthy, get outside, exercise, enjoy it but try and do it more in the morning when it's not quite so hot, because as the day gets hotter, that ozone, that stuff in the atmosphere builds up more and can be more of a problem.

Interviewer: How long are we going to have to endure?

Dr. Madsen: Hard to say, yeah, in terms of what we have in line and in store for us, I think it's really going to depend on what happens with fires. I sure hope that we don't see forest fires and issues like we had last summer. I can say I've never seen a summer in the E.R. like last summer, in terms of the number of cases we had of people with trouble breathing. It was worse than what we see in the winter, which is usually pretty bad, so let's just hope it doesn't get to that point.

Interviewer: So it's really the fire particulate matter more than the heat and the ozone that's causing the problems?

Dr. Madsen: Well I think what happens, the ozone is there, it's always there with the heat, we know about it, people who have asthma kind of know what to watch out for but then you throw that smoke in on top of it, for the bad forest fires, and that's when things really get bad. People usually aren't prepared for that and that's when we start to see a lot of problems. It kind of pushes people over the edge who already have some issues.

Announcer: We're your daily dose of science, conversation and medicine. This is The Scope, University of Utah Health Sciences Radio.