Category Archives: Longevity Medicine

As an emergency medicine physician, I've seen the pitfalls of advance directives (ADs) firsthand. While ADs promise patient autonomy, they often fall short in the chaotic landscape of medicine. Dr. Dan Morhaim's recentpiecechampions ADs as a safeguard against wrongful prolongation of life lawsuits and a means to ensure personalized end-of-life care, but there is a starkly different narrative unfolding within emergency rooms, hospitals and post acute facilities across the nation.

My clinical experience and TRIAD Patient Safety Research suggests that ADs, in their current form, are far from foolproof and at times harmful. In fact some ADs, while crafted with the intention to respect patient autonomy, often lead to complex legal and medical challenges that can, paradoxically, incite litigation rather than prevent it. Its time they evolve to protect patients.

The fundamental issue with ADs is their presumed clarity and enforceability. In reality, these documents are frequently neither accessible in critical moments nor adaptable to the unpredictable nature of medical emergencies. They are static documents attempting to address dynamic situations. As such, the legal system sees an increasing number of cases where ADs are implemented yet families still resort to litigation, alleging that doctors wrongfully prolonged a loved ones life. These cases demonstrate that ADs are catalysts for dispute when they should be solutions for consensus.

Moreover, the very concept of ADs relies on the assumption that there is a clear delineation between treating and not treating a terminal condition or end stage medical condition. But the question remains: when is a condition truly terminal? If an untreated urinary tract infection can lead to death, should an AD dictate natural death in such a treatable scenario? This simplistic view fails to recognize the nuances of medical care, where the line between allowing nature to take its course and actively managing a condition is often blurred.

Thus, while ADs are intended to serve as definitive guides to a patient's end-of-life wishes, they instead become mere guesses when a patient is unable to voice their preference. The solution lies not in the widespread adoption of ADs in their current state but to make them evolve further. The evolutionary step needed is to know what the patient actually wants and when. The TRIAD of fostering a more robust ongoing dialogue (between patients, healthcare providers, and families), combined with required documents such as ADs and Patient safety tools such as patient to clinician video, can be the patient safety tool and evolutionary step needed to make the AD safe for patients who are either critically ill and desiring treatment vs when at end of life and wanting to allow the natural dying process.

To truly honor patient autonomy, we must ensure that ADs are not just checkboxes but living documents, revisited and revised regularly. It's troubling that only 22% of Americans have documented their end-of-life care wishes, with about 25% of White Americans, 22% of African Americans, 21% of Hispanics, and only a mere 7% of Asians having done so. This discrepancy highlights a systemic issue, particularly within minority communities, where there is a clear need for better engagement and trust in the healthcare system.

Dr. Morhaim rightly points out the potential for ADs to alleviate financial burdens by aligning end-of-life care with patient wishes, potentially curbing the substantial expenses incurred in the final months of life. However, this economic efficiency must not eclipse the individual's medical needs and personal values. ADs, while possibly cost-effective, run the risk of fostering a one-size-fits-all approach to end-of-life decisions. Our ultimate objective must remain to deliver compassionate, personalized care that honors each patient's unique life journey and respects their dignity in their final days.

It's time to evolve our understanding and implementation of ADs. We must ensure they are tools for clarity rather than confusion, and that they serve the best interests of patients across all backgrounds and circumstances.In order to avoid the inadvertent harm that ADs cause, we must also shift our focus from documenting preferences to engaging in meaningful conversations combined with safeguards (patient safety tools). Only through this active engagement can we ensure that the care provided aligns with the patient's values and the complex realities of modern medicine.

Ferdinando Mirarchi, D.O., is the Chief Executive Officer and Chief Medical Officer of USACS MIDEO, LLC.

Excerpt from:
Redefining advance directives: Beyond paper to patient-centered care - Medical Economics

Today, most people make it to their late seventies before dying of old age. If you were born in 1880 in the U.S., though, youd be lucky to see your 40th birthday when you were born. Over the years, our lifespan nearly doubled thanks to science and medicine. But why should we stop thereand what happens if we dont? For many, thats a billion-dollar questionliterally.

Investment in longevity startups surged to $5.2 billion in 2022, with the market projected to hit $44.2 billion by 2030. Billionaires like Sam Altman and Jeff Besos have been supporting ventures targeting longevity research such as cellular rejuvenation, gene editing, and AI drug discovery.

Take, for example, 46-year-old tech millionaire Bryan Johnson who has recently been making headlines with his extreme anti-aging regimen. He rises at 4:30 a.m., eats all his meals before 11 a.m., and goes to bed at 8:30 p.m., without fail. He told The Daily Beast he subsists on a strict diet of 2,250 calories, where every calorie has had to fight for his life, and takes more than 100 supplement pills every day. Johnson claims that this process has allowed him to become the most measured person in human history.

I want to be the personal embodiment of this idea of Dont die and to build an algorithm that takes better care of me that I can myself, he said.

Experimental technologies involving genomics, regenerative medicine, nanotechnology, and artificial intelligence are making their way from the fringes to the mainstream with longevity researchers and Silicon Valley types like Johnson pushing for a life extended by at least a couple of decades. In doing so, the wealthy and powerful have offered themselvesand their walletsup as guinea pigs, with the idea being that the fountain of youth will eventually trickle down to the point where it is available to all as has ostensibly been the pattern with other technologies.

My endeavor is to basically figure out how to not die, Johnson, who thinks of himself as a professional rejuvenation athlete, explained. People hear this and they jump to all these conclusions. None of its accurate, Im just playing the same game everyones playing: Dont die.

Bryan Johnson on stage of the Web Summit in Lisbon on November 7, 2017. Johnson is known for his numerous unorthodox treatments and practices that he claims is making him younger including a strict diet and sleep schedule, penis injections, and swapping blood with his son.

It may sound obvious that most causes of death are age-related. In order to live longer, it is simply a matter of treating or preventing these age-related diseases. One option, as Johnson is attempting, is to simply not age.

At the moment, when you were born a long time ago, you have no way to escape going downhill, both mentally and physically, biomedical gerontologist Aubrey de Grey told The Daily Beast. No one looks forward to this mental and physical decline, so this is where researchers like de Grey step in.

Common sense says if you live a healthy lifestyle you stand a stronger chance of living longer. For de Grey, life extension is the next logical step after living such a lifestyle. Its simply about developing new medicines that can achieve this goal to a larger degree than what we can do with todays technology, whether that be lifestyle, diet, or exercise.

In the same way that medicines, treatments, and the simple concepts of hygiene and sanitation have doubled our life expectancy from 40 to 80 or more, de Grey explains. Science is now beginning to address the next thing thats killing people who are no longer dying of that first thing.

A lot of people will persuade themselves that aging is just not like other medical problems. That it's kind of woven into the fabric of the universe and it's inevitable, universal and natural... That's also nonsense.

Aubrey de Grey

Faced with the idea that someday soon we will have the option to slow down or reverse aging, one question continually crops up: Do we even want this? It only takes a look at the headlines and research generated over the past few decades to deduce that the field of life extension has been complicated and controversial. On top of an already aging population, some question if longer lives could threaten our social and economic systems. Others wonder if the quality of life is more important than the quantity.

For de Grey, the answer to the first question is obvious: Yes. The people who ask that question are just as keen to go to the hospital when they get cancer as anyone else, he explained. They dont have to have a reason; they just dont want to get sick any more than anybody else does.

Aging is bad for our health, but up until now we havent been able to do much about it. As a result, people have found ways to cope psychologically, de Grey explained. One way is to somehow trick yourself into thinking that its some kind of blessing in disguise so that then if we didnt have aging, wed have even worse problems.

Some argue that aging is a natural part of life and something we should embrace rather than run from. A lot of people will persuade themselves that aging is just not like other medical problems, de Grey said. That it's kind of woven into the fabric of the universe and its inevitable, universal, and natural.

He added, Thats also nonsense.

What is natural is not fixed. Instead, it is determined by our environments, John K. Davis, a philosophy professor and bioethicist at California State University, told The Daily Beast. We evolved so that we dont maintain ourselves any longer than our environment lets us, he added. Were now living in a human-made environment, so what was natural when we were essentially smart primates is not natural now.

So, as technology advances and we have the means to live a few extra decades, why wouldnt we?

Of course, theres the question of who gets to live longer. Inequality underpins human society, where some people live longer than others simply because they have the means or access to better health care. Some say these inequalities would only get more entrenched if there is a miraculous life-extending medicine or treatment on the market.

If some people dont get access to it, lifes gonna be much tougher for them, Davis said. Itd be much harder for them to accept death. Theres a kind of harm involved there.

For example, Johnson reportedly spends $2 million a year on his team of 30 doctors and cutting-edge technologies. Meanwhile, the likes of Bezos, Mark Zuckerberg, and Sam Altman are also pouring their billions into longevity research, while also having access to higher standards of medical care than the rest of us. It seems unfair for billionaires in Silicon Valley to celebrate their 150th birthdays while the majority typically reach 70 or 80 before biting the dust.

However, longevity proponents argue that its not morally right to deny access for some just because there cant be access for all. Health and wellness isnt a zero-sum game. We dont deny people heart transplants because there arent enough hearts to go around, Davis said. Its not a general principle of justice that we achieve equality by leveling down.

Then theres the question of should we be spending money solving aging in a world where many people lack access to basic health care. To that, Davis asks, How confident would you be that, by inhibiting life extension, those other needs would in fact be met?

No one comes to death as the solution for these problems, Johnson explained. We try to figure out other ways to solve problems because we value life and so these other things are just tangents to the real questions.

However, one common concern that doesnt have such a simple answer is overpopulationwhich can be exacerbated if people have more time to have babies, and when people stick around longer. Its something that Davis admits is a big challenge when it comes to a potential reality where people live much longer. Its really tough to solve that problem, because its simple arithmetic, Davis explained. Theres no drug that's going to fix that.

Of course, all technologies have their upsides and downsides. When dealing with the negatives, time is on our side. Despite the challenges that life extension presents, history suggests that society would adjust. From the genes of our paleolithic ancestors mutating over time to protect from hazards, to public health advances contributing to the doubling of life expectancy between the 19th and 20th century, humans are quick to adjust. Then there are the potentially positive social consequences to consider when adding an extra few decades onto our lifespans.

The main impact would be, we wouldnt be spending trillions of dollars a year keeping people alive because they wouldnt be getting sick in the first place, de Grey said. Preventing age-related diseases would lead to a more comfortable old age, making retirement-management simpler due to prolonged work. Moreover, it might end up benefiting younger generations too, outside of helping them live longer.

I think as people get older, they do become wiser, Davis added. We might be more inclined to take an interest in future generations because we think were going to be there.

Living a long and healthy life is not a controversial idea. When it comes down to it, whats a few decades tacked on to the end? At the moment, our lives and careers are structured around a beginning, a middle, and an end. With longevity research gaining steam, we might see that structure stretch out quite a bit more into something newand transformative.

If youre living indefinitely, maybe itll be a different structure, Davis said. More like a TV series than a movie.

Continued here:
Why Bryan Johnson and Jeff Bezos Are Betting Big on Immortality - The Daily Beast

One of the most challenging aspects of growing older is dealing with changes in your body. After hitting 30, testosterone starts to decline in both men and women. This can result in muscle loss and speed up a "disorder of carbohydrate metabolism," which affects almost everyone, explains Florence Comite, MD, an innovator in precision medicine with multiple specialties in endocrinology and the founder of the Comite Center for Precision Medicine & Health. These changes make you more susceptible to age-related diseases such as stroke, diabetes, osteoporosis, heart disease, and cancer. To continue to lead an independent, healthy existence, we found out the best exercises for stronger muscles from a longevity expert.

"As a physician-scientist specializing in optimizing healthspan, I know that exercise, specifically resistance exercise, to maintain muscle mass is a key factor in prolonging a healthy lifefrom metabolic function to reversing aging disorders," Dr. Comite explains. "Typically, I recommend our clients include two sessions of strength training workouts in addition to cardiovascular exercises, like walking, running, cycling, swimming (especially ideal with joint pain or difficulty walking), or playing a favorite aerobic sport. Add HIIT, or high-intensity interval training, at least two times, as described later."

Below, you'll find some of the best exercises for stronger muscles a longevity expert swears by. Gear up to sculpt and maintain your muscles, along with strengthening your heart in the process. But before starting any new workout, it's always recommended to check in with your physician to see if it's the right fit for you. If it is, start slow and work your way up to some of the more vigorous exercises on Dr. Comite's list.

Lacing up your shoes and heading out for a brisk steady-state walk is a stellar form of low-impact cardiovascular exercise and endurance training. "Specifically, focusing on Zone 2 heart rate training (65% to 75% of your max heart rate) can help improve aerobic capacity, enhance fat utilization as an energy source, and increase blood flow that aids exercise recovery," Dr. Comite tells us. "A steady-state walk that maintains your heart rate in this zone can help joint health, mental health, longevity, and even pain management." She suggests walking for 45 to 90 minutes.

RELATED: People Swear by the '12-3-30' Workout for Weight Loss: 'I Lost 30 Pounds in 10 Weeks'

Amid the busy world we live in, how many times a day are you truly mindful of your breathing? Dr. Comite informs us that the main reason why you experience muscular discomfort through tightness is because you're not breathing correctly during the day and in your workouts.

"We 'chest-breathe' when we should be 'belly-breathing,'" she says. "To practice diaphragmatic breathing, place a hand on your belly and take a deep breath, concentrating on allowing your belly to rise before your chest does. Once you get the hang of deep belly or diaphragmatic breathing, try two breathing exercises, 90/90 and Quadruped breathing These moves help prime the nervous system for activity, reset our bodies from prolonged seated positions, and help ease lower back and neck pain through proper alignment." Your goal should be to complete three sets of eight to 10 breaths each every day.

RELATED: 9 Best Chair Yoga Exercises for Belly Fat

Performing plans and side plans is an excellent way to boost your core muscles and enhance your isometric strength. "A strong core is essential for stability, balance, and proper posture, and [it] transfers directly to correct exercise techniques," Dr. Comite explains. "These are also low-impact exercises, making them suitable for individuals of various fitness levels and ages. Strong core muscles are essential to preventing injury both during exercise and everyday activities." 6254a4d1642c605c54bf1cab17d50f1e

Whether you perform pull-ups or inverted rows, you're putting your body weight to work, using it as a "load" for these upper-body exercises. "They both are fantastic exercises for improving posture, mobilizing your shoulders, and strengthening your upper-back muscles," says Dr. Comite. "They also improve grip strength, which is an important metric for longevity and contributes to slowing the process of immune defense loss associated with aging. Exercises that leverage your own body weight are great ways to gain familiarity with your muscles and build proper form before progressing to more intense activities."

RELATED: The #1 Daily Walking Workout To Slim Down

Next up, Dr. Comite recommends goblet squats, which involve squatting as you hold a dumbbell or kettlebell like a goblet. "Squats are a crucial exercise for adding strength to our quads, knee joints, and connective tissue in our knees and hips," Dr. Comite explains. "Goblet squats are effective because they require your core, upper body, and lower body strength to work in conjunction to move the load, enhancing muscular proprioception and coordination. By increasing the weight used over time, you will build and strengthen muscles across your entire body."

RELATED: 10 Best Resistance Band Exercises for a Slimmer Stomach

High-intensity interval training (HIIT) is a key part of any efficient fitness routine. This form of training will cause heart rate variability and ensure that you achieve 80% to 90% of your max heart rate, Dr. Comite says. "Using an Airbike, treadmill, rower, elliptical, or Starimaster to work at an intensity that you can hold steady for the course of the two minutes, followed by a two-minute rest for several rounds, can achieve the benefits of this exercise," she adds. "HIIT workouts are helpful as they burn many calories, lose fat, and build muscle. Your metabolic rate is also higher for longer following a HIIT workout, which can help reduce heart rate, blood pressure, and blood sugar."

This list of the best exercises for stronger muscles wraps up with the trap bar deadlift, where you perform deadlifts using a trap bar. The act of deadlifting is a key strength training exercise that boosts your longevity and promotes better pain management, according to Dr. Comite. "Trap bar deadlifting reduces shear force on the lumbar spine, is easier on your joints and shoulders, and is more versatile than a conventional deadlift," she says. "This exercise is crucial as it engages your entire posterior chain muscles (glutes, hamstrings, calves, erector spinae, lats, and rear shoulder muscles), which helps with functional tasks and chores in your daily life, as well as promoting balance and coordination. Additionally, it will help with long-term muscle preservation, mitigating the effects of osteoporosis and bone mineral loss." Dr. Comite suggests starting with five sets of five reps, using the correct form.

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7 Exercises for Stronger Muscles, From a Longevity Expert - Eat This, Not That

Ketch Secor is the frontman of the Americana band Old Crow Medicine Show, as well as an author and a teacher based in Nashville; Valerie June is a singer-songwriter, multi-instrumentalist, and author from Memphis. Earlier last month, the two old friends got on a Zoom call to catch up about Valeries new guided workbook, the origin story of their friendship, Nashville, and much more. Annie Fell, Editor-in-chief, Talkhouse Music

Ketch Secor: Where are you?

Valerie June: Im headed down to Texas this week Im in New York right now and then to Tennessee.

Ketch: Back home again.

Valerie: Yeah. What about you?

Ketch: Im here in Nashville. I just got in off the road. Tell me about your trip to Africa!

Valerie: Oh, my goodness, it was so amazing. It was the trip of a lifetime. The first thing that I experienced was being on this tiny, tiny plane and landing on a dirt landing strip in Lamu, [Kenya] which is right on the beach. And then the way you get around in Lamu is by either boat, donkey, or walking. [Laughs.] So that was new for me. I performed, I read poetry, and I got to collaborate with artists from different parts of Africa. There were some musicians from South Africa, some from Kenya, some from Tanzania, Uganda. It was a small gig its called Littlegig and it was really, really cool just to hear other peoples work. There were painters and fashion designers, and writers, and you would just go to their show and listen to their talk or their speech or whatever. And from there I went to the safari. Have you been on a safari, Ketch?

Ketch: I have not. But the first part youre describing sounds so inspiring. I love the thought about the fellowship of trans-continental artistry and finding like minds from different cultures. Ive taken such a deep dive on African folk music styles, particularly equatorial Africa so music from Tanzania to Zimbabwe and Zambia and Congo, I know so much more about it than I ever did at any other time in my life. So I want to get this gig!

Valerie: Well, the thing about it too is, you and I were talking at Edmonton Folk Festival, and I was telling you that I was going and you were like, Oh, they have a huge country music scene in Kenya. And so when I returned from the safari and went to Nairobi, I went to a record shop in this market. It was full of all these vinyl records and 78s and all kinds of things, and this older gentleman owned it. I was looking through the records, and there was a lot from the Congo and a lot from many different parts of Africa, but the biggest section in the record shop was country music. You wouldnt believe it. And so I said to the gentleman, Do a lot of people here listen to country music? He was like, Are you kidding? Tons of people! And he was like, I dont really like it, but I sell a lot of it [Laughs.]

Ketch: Thats great. I feel like Nashville has a lot of work to do in its creating the relationships with the far flung places that have been impacted by country music, and I think that Africa is certainly a principal among them. But I also think that there are other regions of the country that Nashville just doesnt really consider as part of its story. One place I always wanted to go theres two places on Earth that are on my bucket list, and one is Equatorial Africa, and the other is the Arctic of Canada another place where people love country music, where you can play country songs up there and people just go wild for it. Its entered the consciousness.

Valerie: Wow. Every time I talk to you, its like speaking with an encyclopedia. I love it.

Ketch: Lets let em know how we first met, because I think our story is a pretty interesting one.

Valerie: Well, I was in Memphis and I got invited to open for Old Crow at Rhodes College, and thats what I remember. I was such a fan. I was very, very excited to get that invitation. It was like, Oh, my goodness, I cant believe it! And the students of Rhodes College were the ones who put my name in the hat, and thats how I got so lucky.

Ketch: Well, I dont remember it that way at all, because all I remember was walking into a room and seeing you play and being instantly fascinated, a fan interested, wanting to know more, loving what you were doing, and knowing that I was seeing somebody who was doing something that that I loved already in a different way than anybody Id ever seen do it before. And thats a pretty, thats a jaw-dropping experience, because by that time Id been in Old Crow for about 15 years or something Id been around the block and yet you were just such a captivating performer. I think you were doing a Carter family tune, or just a really old song, and doing it with such a unique voice that I was stopped in my tracks. You were playing on a different floor of this sort of student conference center, and it was pouring down rain outside. I just knew right then and there I needed to learn everything I could about you, and I remember walking up to you, and I think I boldly asked if I could get your number. And I think I called you the next day. [Laughs.]

Valerie: I was so shocked at your warmth because, I mean, everybody knows Wagon Wheel I knew every lyric. Sometimes, you know, you meet people that you respect and admire, and theyre big stars, and youre like, Oh, my god, they werent very sweet. And you just beam, in every way, and the band as well. You were like, Hey, if you ever want to record some music, let me know, because Im just in Nashville and if you come our way, well make it happen. So yall invited me up, I said, Sure, Im going to do it. And we went to was it Whites Creek?

Ketch: Yeah. You came over, it was wintertime because I remember it was really cold and I feel like it might have been around maybe 2011 or 10 or 12 or 09. I get mixed up on the dates, but you had already done some work in Nashville. You knew some people. And of course, your sister was at MTSU, so you had that family connection. I was impressed with how far along you already were, and I was just trying to be a collaborator. But we made some music together and recorded it, and Gill [Landry] and me and Bo Stapleton, I think, was pretty influential on it, too, and this guy Larry, who had that studio up in Whites Creek. Thats all no more. I think theres, like, 17 tall, skinny houses where that all was.

Valerie: Wow. Well, it did feel like we were driving far out into the country. Even though its very close to the city, its rural out there, so it reminded me a lot of where I grew up Humboldt, Tennessee and just being in the middle of the country. And you mentioned that I knew people in Nashville my lawyer at the time, Coy Martin, introduced me to all these people. We would meet people, and those connections were grounding for me in my career, but the doors just werent opening. The doors opened after working with you, and just the warmth yall created a home and a space for me in that in Nashville. Because I certainly didnt feel very embraced at first, when I hit the ground there. So it was great to meet yall and see a different side of it. And then we did a performance over at I cant remember the name of it, but it was a family restaurant type place.

Ketch: You and me played at a family restaurant?

Valerie: Yeah! In Nashville. It was like a restaurant, but they had music. And so we got to do some of the songs in front of an audience after recording them. I cant remember what the name of that place was, but that was so cool.

Ketch: I just remember getting ready for the showcase gig. Because, I mean, I always wanted to do more than just be a singer-songwriter guy. I wanted to be a producer guy. And I also had management type instincts. I always was really interested in the business of music just as much as I was in the performance of it, or the conjuring of it. And so I was 30 or something when we met, and you were somebody who made me think, Oh, maybe Im supposed to get into another side of this work. Maybe Id be like a talent scout, you know? Because I always thought that a woman like you belonged in country music and in Nashville, and yet it didnt seem like Nashville thought that at all. And I wanted to stand up to that, because I felt like Davey and that looked like Goliath to me, and I wanted to hit him in the eye with a rock and wake him up out of its slumber to say, This is a woman from an hour outside of Nutbush, Tennessee this is what Tennessee music sounds like! Nashville, especially 10, 12 years ago, was a lot more old guard. Its a tough word, but the country music business has had a bit of an apartheid-like stance for about 100 years, and its been an edifice that needs to be cracked really deliberately. Its a wall that needs to come down brick-by-brick, and its still coming down. And yet as it comes down, its still being erected, so we really gotta hustle to take it apart. I just feel like thats what I was called to do.

Valerie: Deep breath on my end there. [Laughs.] In all these years, I see the growth and Im so grateful for it, and the way you just said that Im emotional today anyway, but definitely it brings a few tears to the sides of my eyes. Because being from Tennessee and that being my home Joyce Cobb is a Memphis jazz musician and years ago she said, You sound amazing. If you ever want to make it, you need to leave here. I was like, OK. [Laughs.] Shes an older woman and she is very successful she teaches at Memphis University and it just really hurt me. I dont want to hear that. But she was very wise to say that.

And its still like that to me, because I feel that in Tennessee, we embrace things outside ourselves, but we dont really embrace what is there what was born drinking that muddy water from the Forked Deer River or walking those fields where the cotton was grown. Well embrace all the other states and well embrace anything but what came from our own. And so the way you just said that, I couldnt have said it any better. But to be embraced at all and be of color is worth something. Ill say that. So were getting somewhere.

Ketch: Well, its about damn time, Ill say that.

Valerie: [Laughs.] Yes, Lord. Its a little wild. But you know, as you said, as soon as we were [taking down] this one side, then this other side is being built at the same time. But thats why I like to work in spirit ways, and I like to work small, because I think the work of just laying one brick at a time, were doing this for the future. We might not see the end result be what we want it to be in our lifetime because for you, you said [its been] 15 years youve been doing your own music with Old Crow before you even met me, and you and I have known each other for a decade now! So this work is long. It takes a lot of longevity.

Ketch: Well, Ive loved seeing where youve taken things since I first crossed paths with you, and did my best to try and impart wisdom and fellowship for you in those early days. You just took to flight. So its been pretty cool to see the ways that that youve grown, adapted, and expressed yourself, going on to New York and making some really powerful, critically acclaimed records and becoming a mainstay on the circuit. I didnt see you there because you were working so hard for about five years after we first met, and then we caught up in Australia in about 2016 or 17. And thats when I got to finally touch down with you and learn about some of some of the things that you were feeling and thinking. Since then, I only got to spend a little bit of time with you this summer I guess I thought when I first met you that I was going to see a whole lot more of you in my life. Im glad that this conversation has brought us back together, and that show we did up in Alberta. And your book, which you just sent to me tell me a little bit about that. Im an author, too, and Im curious how its been for you since your book came out.

Valerie: Well, its been a month, and I was in Africa when it came out. Its been really sweet since, because I went on tour right after I got back, and we did something before the performances that was like a mini workshop. We didnt allow any more than 30 people to come to the venue before the performance, and we did some of the exercises from the book together. It was so wonderful to just have that one-on-one contact with people, and then afterwards, them be able to ask me questions about sharing light and beauty in this dark world.

What I found with this book is that it opens the door for conversations to be had, and for me to learn from my listeners and from people that are inspired by my work. Im learning so much there. Its a guide book, a guided journal so its like, I dont feel like I have any answer for what this world could be, but I think collectively we all have a lot of questions, and if we start asking them of each other and having conversations and holding space, then we start writing new stories. And thats kind of whats been happening in small spaces for me.

Ketch: I just love the concept behind the guided journal, that theres a collectivism to us telling our personal stories. I cant think of a better contribution and really a more Valerie June way of putting herself out there. Its so you. I remember when your first record came out and you had a moniker for it that was so original I think it had the word moonshine in it, and it might have had organic in it too.

Valerie: [Laughs.] Organic moonshine roots music.

Ketch: [Laughs.] Thats right, thats what you called it! I think youve always had a unique way of expressing yourself that is so true to you. And that truth is just so refreshing, because theres a lot of different ways to be a musician. One of them is to try and get famous doing it, and I think thats a motivator for a lot of people. I always saw you as a more process-oriented type of artist who was just looking to make peaceful her corner of the world.

I feel myself more of a duality. I feel resigned to folk music. You know, I probably wanted to rock I probably wanted to be an actor or a tap dancer or a movie star but through the twists and turns of my coming of age, I gravitated towards the banjo and the fiddle, and that became my soapbox. But it also became my ceiling, because I think Ive taken it as far as you can take a fiddle and a banjo. But I always wanted to take it further. I think that for me is one of the reasons why Ive sought out artists like you and others, and have sought to work with them in the capacity of development so that I can help expand it, make the ceiling higher. You know, if I can make the ceiling higher for you, then Im making it higher for me too.

Valerie: And you are such an excellent mentor for me and so many of us coming up. Watching you even in being an author and knowing, Oh, well, thats possible too, the door is open there, too. I dont have to just choose one form of using my creativity. Whats it like for you? Do you feel divided when youre writing a book? Do you feel like youre not focusing on your music? Or do they go side by side?

Ketch: Well, I wrote this book its a childrens book and its called Lorraine: The Girl Who Sang the Storm Away, and it is a book that I first started thinking about when I was a kid myself, about 18. I had been up in East Tennessee, where behind me there was a tobacco field. I was squatting in this old ladys house, didnt have any running water it was sort of like some intentional hillbilly boot camp kind of lifestyle thing that Old Crow was doing back in the late 90s. And so this elderly woman had given me her house to stay in as long as I fixed it up. West Tennessee is really different from East Tennessee, particularly when it comes to topography you know, East Tennessee has really high and rugged mountains, and West Tennessee is rolling hills. But what West Tennessee has a lot of is ramshackle, fallen down houses, and thats what I was living in up on the east side of the state.

Anyway, I met this woman of Cherokee descent named Lorraine, and she told me a story about her pet crow and I started thinking, Thatd be a good story for kids. So I spun out this book, but I couldnt find anybody to illustrate it. The publisher was sending all these cheesy, sort of computer generated looking graphics, and finally I was on the website of the art college here in Nashville, and I met this woman, Barbara Higgins Bond. Now, Barbara, who went to Memphis State and is from Little Rock, was the first African-American woman to design a US postage stamp. She hadnt illustrated a book in 20 years shes in her early 70s now. Well, I brought her out of retirement, and she created this character based on her granddaughter, and its just been such a powerful combination of her artwork and my words to be able to tell the story. Ive read this book to more than 10,000 children, and I just know that the change that we want to see in the world begins with sitting down with kids and exemplifying peace and love and and opportunity.

We live in a tough state. You know, theres a high infant mortality rate in our state, one of the highest in the country. There is a low graduation rate, one of the lowest in the country. Tennessee is a problematic place for children to come of age, so its just ever so important that artists like you and I take a stand for our kids, because the continuum continues and we really gotta raise them up. Right?

Valerie: Its true. Ive visited several schools around the kids book, Somebody to Love, and so many of the schools, in a musical state, dont have much of a music program anymore. So the kids were really excited to have music coming in. And I was just coming in to play and and read the story. But I think about it and the literacy rates and just ways we can get kids excited about learning and growing in that way and music, I think, is a big way to do that. I think its a good way to open the door for kids, because most kids love sound. They love just playing with sounds and seeing where it goes, you know? So if you can somehow connect that to science and math and reading, then youre getting ahead on something. Hows your school?

Ketch: Oh, pretty good. Were in our eighth year. We got a permanent building now. We got 150 kids when I started it, there were 16. So its really coming along. Its not without its problems, because its so hard to raise money, but, you know, both my children go to this school, and 153 other kids. About half of them are on scholarship, and we have a really great, diverse community. I think a lot about the concept that others and, of course, Dr. King came up with called the Beloved Community and Valerie, I feel like you and me are in the Beloved Community together. And I think that our work together and as individuals expands the Beloved Community to include others. So youre over there in Tanzania, and youre inviting people into your Beloved Community that we all share, and Im inviting people in and I want people of all stripes in my Beloved Community, because thats what makes it so beloved.

We got a short time here and theres a lot of work to be done. I know Im feeling really heavy hearted about the affairs of the world, and I was curious how youre feeling when you turn on the news.

Valerie: Definitely super emotional. I have days where, you know, I just cry. But I also have never felt more moved to create spaces of beauty and to highlight beauty, and to use beauty as a political force. Because what we really want to see, us in the Beloved Community, is more expansion of beauty. And so I think where we focus our energy is what we create. So while I think we need to know whats going on in the news and we need to be aware of whats happening in the world, we also have to take that and be alchemists with that energy. We cannot stay in the place of the heaviness and the darkness. We have to use that as motivation for creating and expanding the Beloved Community. Because every single second that we spend spiraling and spinning and feeling helpless is a second that we could be spending in the opposite direction.

So, I dont know. I feel that sometimes when I talk about beauty or I think about beauty, or I speak about small things or what a single person is able to do with one breath or one thought, it just seems like speaking to the side of a brick wall or something. Because people really, really want to hear something thats going to make them jump up and feel some kind of rage or whatever. But I think theres something to be said for creating a space of something beautiful and something tiny in just your home, your heart, your community and how that expands out across the world.

Ketch: Im glad youre not getting too down to continue that work. I agree with you. And yet, sometimes it feels like Im watching the children of Gaza flee or the children of Israel run from bullets and I think, Wait, Im supposed to write songs? Im supposed to make sure that my kids go to the orthodontist? What are my responsibilities in comparison to, you know, the moms and dads of Crimea or the east of Ukraine? So I feel a little bit paralyzed sometimes when I take scope of my artist life and the privileges of having a life in which the expansion of beauty seems like thats what Im here to do.All you can do in the wake of tragedy, if youre a person like you or me, is sing and build community and offer music as restorative, as hope, as optimism, as healing, as mourning, as lamentation. But were dealing with notes and sounds, and it just feels like when the perpetrator is dealing in bullets or in crimes or in injustice or in environmental catastrophe going back to little Davey and big old Goliath, its just like hurling stones at a missile thrower, hurling rocks at a rocket ship. It just seems like you have to make an awful lot of beauty in the world if youre going to counteract all the evil, all the ugliness.

Valerie: As I think about that, I think about my ancestors and what they went through as enslaved people, and what the mindset of being like Harriet Tubman had to be to pull out of conditions that were war zones. And even for our kids living in Memphis which is such a violent town, and theyre not even able to go out on the street and play I think about, Well, what does the mindset have to be in order to truly embody Dr. Kings Beloved Community? What do I need to think today as I watch these kids run in fear in war zones? What do I need to do? What can I do? What is my space and where is my power? Because every day were making small choices that add up to justify certain things that are happening in the world. And I think it starts first with the mind. So having our minds in a certain space to open up a way for growth to happen, for energies to shift. So thats what I think in terms of beauty that if my ancestors were to hold on to the pain and the trauma only, then I would probably not be sitting here free today. They had to shift their energy and focus and call forth something new in order for that to even start to be a possibility, they had to begin to see it. And so if all we can see is the pain and the heaviness, then it makes it very difficult for us to really, really start to put our boots on the ground and move toward what we want it to be like.

Ketch: Right on. I think its a thorny branch, and you are the flower.

Valerie: Uh, not alone. [Laughs.] Not without you, dont put me out there like that!

Ketch: [Laughs.] Yeah, well, were gonna keep rippling this pond together. Were going to keep throwing the big rocks and making them splash and making waves and were going to ride them waves, and the new generations coming up that is going to ride those waves. Im really glad you reminded me of Memphis theres so much work that musicians can do to help be inspirations, to shine a light in the dark places, in Memphis, Tennessee. We need it in Nashville too. And we need each other. And Im so, so grateful that the Great Spirit brought us together.

Valerie: Me too, me too.

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Valerie June and Old Crow Medicine Show Are Rippling the Pond ... - Talkhouse

40 0 Posted on Nov 16, 2023, 2 p.m.

Physical fitness since childhood is associated with cerebellar grey matter volume in adolescents. Those who were stronger, faster, and more agile were found to have better neuromuscular fitness since childhood, and had larger Crus I grey matter volume in adolescence according to recent research conducted at the University of Jyvskyl and the University of Eastern Finland published in the Scandinavian Journal of Medicine & Science in Sports.

This study was designed to examine the associations between physical fitness and grey matter volume of cerebellar lobules related to cognition in adolescents, and whether these associations differed between males and females. The analysis was based on the FitBrain Study involving 40 participants with a mean age of 17.9 years old with 8-year follow-up examinations from the Physical Activity and Nutrition in Children Study (PANIC).

Cerebellar volumes were assessed using magnetic resonance imaging technology. Cardiorespiratory fitness was assessed with a maximal ramp test on a cycle ergometer, and muscular strength was assessed with standing long jump. Speed agility was assessed with the 10 x 5 shuttle run test, and coordination was assessed with the Box and Block Test. Finally, neuromuscular fitness was assessed as the sum of the standing long jump, Box and Block Test, and shuttle test z-scores.

The researchers report that adolescents with better neuromuscular fitness since childhood had larger Crus I grey matter volume, but those with better cardiorespiratory fitness had smaller total cerebellar grey matter volume. Additionally, males with better neuromuscular fitness since childhood had smaller Crus II grey matter volume.

"Our study highlights the importance of physical activity through childhood and adolescence, leading to better physical fitness, as it might be relevant to cerebellar volumes related to cognition and learning. However, the associations we observed are in part contradictory," says Doctoral Researcher Petri Jalanko from the Faculty of Sport and Health Sciences at the University of Jyvskyl.

"The study sheds light on the associations between physical fitness and the cerebellum. Future randomised controlled trials utilising direct cardiorespiratory fitness measurements and novel brain imaging to assess a larger population and both sexes separately are needed to better understand the associations and causality between physical fitness and cerebellar volumes in adolescents," Jalanko says.

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Fitness Since Childhood Associated With Cerebellar Grey Matter ... - Anti Aging News

"ACLM is delighted to honor the 2023 award winners for the dedication, expertise and passion they have contributed to the rapidly growing field of lifestyle medicine."

Among the awards presented were the Lifetime Achievement Award, the Trailblazer Award, the President's Award and the Special Recognition Awards.

"ACLM is delighted to honor the 2023 award winners for the dedication, expertise and passion they have contributed to the rapidly growing field of lifestyle medicine," ACLM President Beth Frates, MD, FACLM, DipABLM, said. "Thanks to these leaders' remarkable achievements, more health professionals are using evidence-based therapeutic lifestyle medicine to treat and sometimes reverse chronic disease, individuals worldwide are embracing healthier lifestyle habits, and more health systems and policymakers are recognizing lifestyle medicine as a solution to the epidemic of lifestyle-related chronic disease. ACLM is grateful for their service."

Lifetime Achievement

ACLM awarded its Lifetime Achievement Award posthumously to Hans Diehl, DrHSc, MPH, FACN. Dr. Diehl, a visionary in the field of lifestyle medicine who dedicated his career to helping people live healthier and longer, died Aug. 2. His wife, Lily Pan Diehl, along with his children and grandchildren, accepted the award on his behalf.

This award recognizes a lifetime of achievement in the field and is the highest honor ACLM bestows. It recognizes a significant body of work over a significant span of time that has advanced the field of lifestyle medicine, and, in the process, paved the way for others to follow.

Dr. Diehl, founder of the Lifestyle Medicine Institute and the Complete Health Improvement Program (CHIP), was a clinical professor of preventive medicine at Loma Linda University and a founding member of ACLM and its Board of Advisors. He was also the first research and education director at the Pritikin Longevity Center, where he aspired to make better health accessible to the masses. The over 85,000 participants and clinical results published in 45 peer-reviewed scientific journals are a testament to Dr. Diehl's passion and legacy.

Trailblazer Award

The 2023 Trailblazer Award recipient is James Rippe, MD, founder and director of Rippe Lifestyle Medicine, a professor of medicine at the University of Massachusetts Chan Medical School and founder and editor-in-chief of the American Journal of Lifestyle Medicine.

The Trailblazer Award recognizes an individual who is currently providing leadership in the field of lifestyle medicine, helping strengthen the foundation laid by others, while advancing it through innovation.

In the past 25 years, Dr. Rippe has established and operated the largest research organization in the world exploring how daily habits and actions impact short- and long-term health and quality of life. That organization, Rippe Lifestyle Institute (RLI), has published hundreds of papers that form the scientific basis for the fields of lifestyle medicine and high-performance health.

President's Award

Dr. Frates presented the 2023 President's Award to Sami Bg, MD, MPA, MPH, FACLM, an ACLM member since 2008 who founded digitalLM as a one-stop, turn-key digital health agency that helps lifestyle medicine clinicians succeed online with professional website development, SEO and more.

The President's Award is given in recognition of exceptional dedication to ACLM as an organization in advancing its vision and mission as well as service to the field of lifestyle medicine through exemplary contributions to ACLM.

Dr. Bg was elected to ACLM's Board of Directors in 2012, when he also served as founding chair of ACLM's Business Development Committee. He chaired the ACLM Awards Committee from 2015 to 2022 and helped Dr. Frates establish the Donald A. Pegg Student Leadership Award in support of Lifestyle Medicine Interest Groups (LMIGS) and student leaders. He also served for many years on the ACLM Fellow Review Panel.

Special Recognition Awards

ACLM awarded Special Recognition Awards in four categories:

Health Systems Koushik Reddy, MD, DipABLM, FACC, FACLM, Certified Lifestyle Medicine Intensivist, is a foremost champion of lifestyle medicine at the Veterans Affairs Healthcare System (VA) in Tampa, Fla., where he serves as an interventional cardiologist. He has tirelessly promoted ACLM's complimentary 5.5-hour CME/CE accreditedLifestyle Medicine and Food as Medicine Essentials courselocally and throughout the U.S. Department of Veterans Affairs.

Graduate and Undergraduate Education Michelle Tollefson, MD, DipABLM, FACOG, FACLM, a professor in the Health Professions Department at Metropolitan State University of Denver, created and oversees the nation's very first bachelor in lifestyle medicine program, enabling students to "major" in the field of lifestyle medicine.

Clinics/Business and Innovation Cliff Morris, MD, DipABLM, and his team at the Morris Cardiovascular and Risk Reduction Institute in Chester, Va., have enthusiastically integrated lifestyle medicine into their cardiology practice, embracing various initiatives such as facilitating group medical appointments, prescribing dietary recommendations, and allocating office space for an on-site gym where patients can exercise under the guidance of a medical fitness specialist.

Health Policy and Government Affairs The United States Air Force Lifestyle and Performance Medicine (L&PM) Working Group was chartered in 2019 with 20 core members. From this working group, the Lifestyle and Performance Coalition of the Interested (COI) was created as a grassroots effort to reach Department of Defense-affiliated healthcare professionals with a mission to infuse L&PM into every aspect of the Military Health System.

The award was accepted by: Air Force Colonel Mary Anne Kiel, MD, FAAP, FACLM, DipABLM; Retired Army Major Kati Monti, DMSc, PA-C, DipABLM; Air Force Major Jeff Smith, DSW, LCSW, BCD; Air Force Captain Matt Diotte, PA-C, DipACLM; Air Force Second Lieutenant Kevin Puri, OMS-4; and Former Air Force Flight Surgeon Regan Stiegmann, DO, MPH, DipABLM, FACLM.

ABOUT ACLM The American College of Lifestyle Medicine is the nation's medical professional society advancing lifestyle medicine as the foundation for a redesigned, value-based and equitable healthcare delivery system, leading to whole-person health. ACLM educates, equips, empowers and supports its members through quality, evidence-based education, certification and research to identify and eradicate the root cause of chronic disease, with a clinical outcome goal of health restoration as opposed to disease management.

Media Contact

Alexander Branch, American College of Lifestyle Medicine, 19719835383, [emailprotected], American College of Lifestyle Medicine

SOURCE American College of Lifestyle Medicine

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American College of Lifestyle Medicine announces 2023 award ... - PR Web