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- [00:05]
A
Hey there. Welcome to Paging Dr. Gupta. This is the show where I get to tackle your health concerns. We're taking lots of real life questions from listeners. We're digging into the science and the stories behind them. And sometimes, like you'll hear today, we're calling a consult, getting another expert to weigh in as well. Kira's back with us with our first question.
- [00:27]
B
Hey, Sanjay. So like a lot of people that listen to the show, our first caller is really focused on staying healthy and strong. But she does have a very interesting question on timing. Here it is.
- [00:43]
C
Hi, Dr. Gupta. I'm a 45 year old menopausal or perimenopausal woman. I guess I'm trying to do all the right things. I'm trying to make sure I'm eating protein and I'm strength training to try to keep muscle mass as, as I aged. So given that strength training a few times a week, I'm just wondering when is the best time to eat, if I should be eating before my workouts. Thank you.
- [01:09]
A
All right, thank you so much for calling in. And also, it's great that you're being proactive about your health. You're asking a really important question. This is something I thought about as well in my own exercise routine. I'll get you an answer right after this break. Okay. Welcome back to paging Dr. Gupta. Our first caller is basically asking this, when is the best time to eat? On days when she is doing strength training. So first of all, when building strength, you want your food to work for you. You want your fuel to essentially prepare your body for stress and then to help rebuild muscle. So there's several things you're counting on those calories to do. Protein is key. According to Dr. Stuart Phillips, your muscles.
- [02:04]
D
Are made up of what we call amino acids. They're the building block of protein. And when we train them, when we lift some weights, our muscle is more receptive to amino acids or protein. And so delivering it in the form of food is a way of reconditioning and making the muscle bigger and stronger for the next time around.
- [02:22]
A
Phillips is the director of the Physical Activity center of Excellence and the McMaster Centre for Nutrition, Exercise and Health Research at McMaster University in Canada. I invited him to comment today because he is an expert on the impact of nutrition and exercise on human skeletal muscle. So the question is, does the timing of the meal and the workout?
- [02:48]
D
Yeah, we used to think that it mattered quite a bit about when the timing was immediately before or immediately afterwards. And I think all the research that's been done since that time has shown us that the window of opportunity for getting protein before or after is actually open for a really long time. So I stress about that far less and just say sometime in the three to four hours afterwards is probably a good window.
- [03:12]
A
Alright, so don't stress as much about the timing, but do think about this. Roughly 20 to 30 grams of high quality protein in the meal or snack is probably going to work best for most people. Now for strength training specifically, eating afterward is generally helpful, especially as we age. You don't need a big meal here, but having some protein and also some carbohydrates in the few hours after lifting supports training quality. And, and also that muscle building response that we were talking about. To be clear, if you haven't eaten anything and then you do resistance training or weight training, that's not harmful, but it's probably not optimal for muscle maintenance or gain. Again, particularly in older folks. And I think one thing you should absolutely not forget, no matter what kind of workout you're doing, is to stay hydrated. It's so important and so many people don't pay enough attention to this. Philips also wanted to add a little bit of perspective to the entire discussion.
- [04:10]
D
Really try to decomplicate a lot of this stuff. My take is that when I look at social media in particular, it's made very, very confusing and I think that's a little like it's a bit of a marketing ploy to get people to buy into someone's program or someone's supplements or whatever it is. So if you're exercising on a regular basis, I got to put my hand on my heart and say power to you because you're getting so much good done. And so all of these nutritional things that admittedly even I used to think mattered, I've sort of come to the conclusion they matter a whole lot less than we thought.
- [04:45]
A
I hope that helps. When we come back, we have a question about something I think no one wants to face. Unwanted hair loss.
- [04:56]
E
This week on the Assignment with me, Audie Cornish.
- [04:59]
A
The United States is very much the bad guys pretty much across the board right now.
- [05:04]
E
That's Will Leach. He's a contributing editor at New York Magazine covering sports and and film. And the Winter Games are coming up. So Will is joining me to talk about not just the athlete stories, but also the geopolitical tensions at play. I promise it's fun.
- [05:23]
A
Is there a time where the U.S. if things continue on the way they're going, they start to become kind of the Pariah on the global sports stage. The way that Russia has.
- [05:34]
E
Listen to the Assignment with me, Audie Cornish. Streaming now on your favorite podcast app.
- [05:41]
F
Hey, I'm Anderson Cooper. On my podcast All There Is, we explore grief and loss in all its complexities. My guest is Eun Lee, an award winning author and a professor of creative writing at Princeton. She's written a number of highly acclaimed novels and memoirs. Her latest is called Things in Nature Merely Grow. You don't like the word grief or you don't use the word grieving?
- [06:04]
C
I don't use the word grief the way people use it. People talk about their grief as a process. It's a state that we're going to be in forever and ever and I choose to be here.
- [06:16]
A
You choose to be?
- [06:17]
C
Yes, because the alternative is you forget you are lost people. And I don't want to forget.
- [06:25]
F
Talking grief, building community. That's what the podcast is all about. This is all there is. Listen and follow wherever you get your podcasts.
- [06:40]
A
Okay, I hear that it's time for another question. Kira, who do we have next?
- [06:45]
B
Okay, so our next caller is actually dealing with something that can be really frustrating, honestly, often super emotional. I'm talking about hair loss and she's just looking for some guidance. Take a listen to her question.
- [07:02]
C
Hi, Sanjay. My name is Gina and I'm from Minnesota. I'm a 51 year old woman who's newly experiencing hair loss at what I believe is a higher than normal rate for my age. I've had my hormones checked and at the time of the check, everything was normal and my doctor prescribed vitamin D. I'm also supplementing with hair loss vitamins and medicated shampoo. However, I feel like I'm throwing multiple solutions at a problem that I don't know the root cause of. No pun intended. My question is, where do I go to find the cause of my hair loss? The Internet is overwhelming. Thanks so much for your show. We listen to you all the time.
- [07:42]
A
Gina, thank you so much. And I really appreciate you listening. Thank you for calling in. Look, hair loss is a sensitive issue and we get a lot of questions about this. So let me give you some context. First of all, according to the American Hair Loss association, by age 35, 2/3 of American men will have some degree of hair loss. And when it comes to women, they make up about 40% of people with hair loss. So this affects men and women both. As many as 2/3 of menopausal women experience some thinning or even bald patches. And that has an impact beyond just Physical looks. It impacts self image, emotional well being and can cause a lot of distress according to these surveys, in addition to anxiety and depression. So let me give you some quick facts. Healthy adults have about 80 to 120,000 strands of hair on their heads. We normally shed normally about 50 to 100 strands of hair every day. Hair is constantly going through these growth stages. There's four phases. The first and the longest is what's known as the anagen or growth phase. Next is the catagen or transitional phase, followed by the telogen or resting phase. And remember that word, telogen. We'll come back to that. And finally there is the exogen or shedding phase. But to answer your question, where do you go to find the cause of your hair loss? Well, your first stop should probably, probably be your dermatologist's office. They can examine your scalp. They can tell you what kind of hair loss you are experiencing. There are different types of hair loss. Some common types include androgenetic alopecia, that's age related pattern baldness. This is the most common cause of hair loss. It's hereditary and it happens with aging usually occurs gradually and in predictable patterns. In men, a receding hairline, a bald spot. In women, more diffuse thinning on the top of the head, often including a widening part. There is something known as traction alopecia. And that's caused by excessive hair styling or hairstyles that pull the hair tight, such as buns and ponytails or braids and cornrows using hot oil. Hair treatments and permanents can also cause the hair to fall out, as can heat damage. There is telogen effluvium, remember that word, telogen. Again, that's diffuse and significant shedding. That happens when a trigger such as stress or medication or pregnancy even forces a large percentage of hair follicles into that telogen phase, that resting phase. And this happens at once. And then hair loss will tend to happen two to three months after the stressor event. And then there's frontal fibrosing alopecia. This is a bit more uncommon than the others. It's typically diagn in postmenopausal women. Starting slowly at the hairline, working its way back. And can also affect the eyebrows and other parts of the body. Autoimmune diseases, genetics, hormones, environmental factors. In people who are genetically susceptible, those are believed to play a causal role. Now there are various common causes of hair loss and some of the ones I just mentioned may overlap a bit as well. But again, a dermatologist can run tests and help you pinpoint the underlying reasons. Aging, genetics, some chronic conditions including Things like type 2 diabetes, polycystic ovary syndrome, psoriasis, eczema. Some medications. In particular medications for high cholesterol, high blood pressure, heart arrhythmias and also the new class of weight loss drugs, GLP1 drugs. They have been linked to hair loss and some people, although it's not clear if it's the medication itself or the significant weight loss some patients experience, keep an eye on certain dietary deficiencies such as protein, iron, zinc and vitamins B7, also known as biotin, B12 and D. Stress, as I mentioned, both mental and physical. Another cause of hair loss, events like grief or bereavement illness, inflammation, Surgery. One dermatologist told us when the body is stressed it has to shift priority from non essential things to more essential things. And hair, as important as it is for looks, is a non essential appendage. So this brings us to treatments and again talk to your dermatologist about this. They can help guide you to the best solution or solutions for you. Specifically, let me throw a couple medication names at you, some of which you may already know. Minoxidil. This comes in different forms. Liquid foam cream comes in two strengths, 2% and 5%. And it's also now available as a pill. Spironolactone. That's an antiandrogen medication available to women as a topical or a pill. It blocks dihydrotestosterone which can shrink hair follicles. There are two medications out there that are not approved for use in women. But for the men who may be listening to this episode, they are finasteride and dutasteride. They both block dht. There's ketoconazole. Shampoo which can help reduce inflammation, has been shown to prevent hair loss. And for that condition that I mentioned earlier, telogen effluvium. It might be enough to correct the underlying cause like inflammation or a hormonal imbalance, remove the underlying stressor and oftentimes the hair regrowth will get back on track. Some dermatologists recommend peptide based serums to stimulate growth factors, improve follicle health and reduce inflammation. They don't require FDA approval, they often contain multiple ingredients and as Gina noted, the information from the Internet can be overwhelming, especially when it comes to peptides and things like that. According to dermatologists we spoke to, some ingredients are worth Rosemary extract, saw, palmetto, antioxidants, caffeine, castor oil. Now there are some other treatments you may have heard of that have had success in some people. Red light therapy that's essentially using laser light to increase blood flow and cellular activity and stimulate hair follicles. And also platelet rich plasma injections that involves processing a patient's own blood to concentrate the growth factors and platelets and then injecting that into the scalp. And finally, don't underestimate the role of lifestyle factors. This is going to be a big thing for most people. Adopt proper hair grooming techniques. Avoid tight hairstyles, minimize heat damage and stay away from processes like bleaching and coloring. Also, don't smoke. Studies have shown a link between baldness and smoking. Eat well balanced meals to get enough protein and micronutrients needed to support healthy hair. Drink lots of water. Dehydration can be a problem. Get sleep. Reduce stress. Look, I know it can be stressful just to think about hair loss, but as one dermatologist said, the sooner you address shedding or thinning, the easier it is to maintain your hair because it is easier to prevent loss than to regrow hair. Gina, I hope that helps. And that's all the time we have for today's episode. Thanks to everyone who sent in questions. Your curiosity, your stories, your voices. That's what brings the show to life. So keep the great questions coming. If there's something health related you've been wondering about, send it to us and we might answer it next week. Record a voice memo, email it to pagingdrgupta.com that's pagingdrgoupta.com or give us a call the old fashioned way 470-396-0832 and leave a message. Thanks so much for listening.
- [15:54]
E
This episode is brought to you by Greenlight. Get this, Adults with financial literacy skills have 82% more wealth than those who don't. From swimming lessons to piano classes, us parents invest in so many things to enrich our kids lives. But are we investing in their future financial success? With Greenlight, you can teach your kids financial literacy skills like earning, saving and investing. And this investment costs less than that. After school treat start prioritizing their financial education and future today with a risk free trial at greenlight.com Spotify greenlight.com Spotify.
- [16:25]
A
News cycle making your head spin the have I got news for you crew is here to help with a comic take on the week's headlines. New episodes Saturdays at 9 on CNN and next day on the CNN app.