Episode 69: David LeMay talks about countering inflammation with SPMs
07/31/18 • 76 min
Dr. David LeMay is a sports medicine and rehabilitation physician who is a consultant for the NBA’s Washington Wizards, the NFL’s Oakland Raiders and the National Hockey League’s Washington Capitals, which won the Stanley Cup this year, their first in the franchise history.
Dave is also a neighbor of ours in Pensacola who has a practice called Lifestyle and Performance Medicine that is located just a few blocks from IHMC.
Dave and his practice partner provide personalized preventative care that helps people reduce the effects of stress on the body and mind to maximize function and health. In his practice, Dave works with a lot of athletes as well as retired and active military members, particularly people in special-ops, who have inflammation as a result of persistent injuries and traumas.
Dave often recommends specialized pro-resolving mediators, also known as SPMs, which help promote the natural termination of the inflammation process and allow a person to avoid anti-inflammatory drugs. We will especially be talking with Dave about this rather new way of treatment in today’s interview.
Some other topics we cover in Dave’s interview:
- Neuroendocrine dysfunction, especially among military veterans.
- The role of inflammation in concussions and traumatic brain injuries.
- Dave’s work with the NFL Players Association Trust.
- The role of specialized pro-resolving mediators in an aging population.
- The proper dosage of SPMs for subacute inflammation.
- Dave’s efforts to improve the diets of former NFL players.
- The key components of keeping athletes healthy through an entire season.
- The correlation between heath-rate variability and athletic performance.
- Proper sideline protocols for players who sustain head injuries.
- Optimal treatment for people who suffer TBI and concussions.
- Establishing baselines for a person’s neuroendocrine function.
- The role of DHA and EPA consumption for maintaining optimal brain health.
- And much, much more.
Show notes:
[00:04:18] Dave begins the interview talking about growing up in Reno, Nevada, and playing sports non-stop as a kid.
[00:4:35] Dawn comments on how Dave’s love of sports lead to some injuries, including a few broken fingers and torn ligaments, and says she understands that this is how Dave first became interested in science.
[00:05:31] Dawn asks Dave about his decision to head to California after high school to attend Azusa Pacific University.
[00:06:37] Dawn asks what lead Dave back home to attend med school at the University of Reno.
[00:07:13] Ken asks Dave at what point he decided to specialize in physical medicine and rehabilitation.
[00:08:33] Dawn mentions that the University of Texas Health Science Center has one of the best physical medicine and rehab programs in the country. She asks Dave if this was the reason he decided to go there for his residency.
[00:09:21] Ken comments on how after Dave’s residency, he stayed in Austin for almost a year. But then Dave moved Pensacola and Ken asks how that came about.
[00:11:04] Dawn asks about Dave’s private practice, called Lifestyle and Performance Medicine, which he and his partner opened in 2013 after their time at the Andrews Institute.
[00:11:27] Ken points out that veterans, and some active-duty folks, particularly those with special operations backgrounds, comprise about half of Dave’s practice. Ken says he understands Dave has seen a great deal of neuroendocrine dysfunction in this group, and asks Dave for his observations.
[00:12:56] Ken mentions that Dave is the medical director for a program that is run through the NFL Players Association Trust. He asks Dave to describe the type of rehab that this program provides the former NFL players.
[00:14:54] Dawn comments on the concept of inflammation being a unifying component of many diseases that afflict Western Civilization, and how it is also a major contributor to the magnitude and persistence of different sports injuries and traumas. She asks Dave to talk about inflammation, and specifically its role in concussion and TBI, as well as give a brief overview of what inflammation is.
[00:17:51] Dawn mentions how Dave has been looking at how targeting inflammation may serve as a therapeutic way to also treat fear- and anxiety-based disorders.
[00:20:34] Ken asks if the process of EPA and DHA conversion into SPM’s through an enzymatic process diminishes in its efficiency as one ages.
[00:21:18] Ken asks if Dave thinks there is a role for exogenous SPM’s for the aging population.
[00:22:13] Ken asks if there is a particular SPM brand, or collection of brands, that Dave finds to be the most interesting or efficacious.
[00:23:01] Ken asks what dosage would Dave suggest for subacute inflammatio...
Dr. David LeMay is a sports medicine and rehabilitation physician who is a consultant for the NBA’s Washington Wizards, the NFL’s Oakland Raiders and the National Hockey League’s Washington Capitals, which won the Stanley Cup this year, their first in the franchise history.
Dave is also a neighbor of ours in Pensacola who has a practice called Lifestyle and Performance Medicine that is located just a few blocks from IHMC.
Dave and his practice partner provide personalized preventative care that helps people reduce the effects of stress on the body and mind to maximize function and health. In his practice, Dave works with a lot of athletes as well as retired and active military members, particularly people in special-ops, who have inflammation as a result of persistent injuries and traumas.
Dave often recommends specialized pro-resolving mediators, also known as SPMs, which help promote the natural termination of the inflammation process and allow a person to avoid anti-inflammatory drugs. We will especially be talking with Dave about this rather new way of treatment in today’s interview.
Some other topics we cover in Dave’s interview:
- Neuroendocrine dysfunction, especially among military veterans.
- The role of inflammation in concussions and traumatic brain injuries.
- Dave’s work with the NFL Players Association Trust.
- The role of specialized pro-resolving mediators in an aging population.
- The proper dosage of SPMs for subacute inflammation.
- Dave’s efforts to improve the diets of former NFL players.
- The key components of keeping athletes healthy through an entire season.
- The correlation between heath-rate variability and athletic performance.
- Proper sideline protocols for players who sustain head injuries.
- Optimal treatment for people who suffer TBI and concussions.
- Establishing baselines for a person’s neuroendocrine function.
- The role of DHA and EPA consumption for maintaining optimal brain health.
- And much, much more.
Show notes:
[00:04:18] Dave begins the interview talking about growing up in Reno, Nevada, and playing sports non-stop as a kid.
[00:4:35] Dawn comments on how Dave’s love of sports lead to some injuries, including a few broken fingers and torn ligaments, and says she understands that this is how Dave first became interested in science.
[00:05:31] Dawn asks Dave about his decision to head to California after high school to attend Azusa Pacific University.
[00:06:37] Dawn asks what lead Dave back home to attend med school at the University of Reno.
[00:07:13] Ken asks Dave at what point he decided to specialize in physical medicine and rehabilitation.
[00:08:33] Dawn mentions that the University of Texas Health Science Center has one of the best physical medicine and rehab programs in the country. She asks Dave if this was the reason he decided to go there for his residency.
[00:09:21] Ken comments on how after Dave’s residency, he stayed in Austin for almost a year. But then Dave moved Pensacola and Ken asks how that came about.
[00:11:04] Dawn asks about Dave’s private practice, called Lifestyle and Performance Medicine, which he and his partner opened in 2013 after their time at the Andrews Institute.
[00:11:27] Ken points out that veterans, and some active-duty folks, particularly those with special operations backgrounds, comprise about half of Dave’s practice. Ken says he understands Dave has seen a great deal of neuroendocrine dysfunction in this group, and asks Dave for his observations.
[00:12:56] Ken mentions that Dave is the medical director for a program that is run through the NFL Players Association Trust. He asks Dave to describe the type of rehab that this program provides the former NFL players.
[00:14:54] Dawn comments on the concept of inflammation being a unifying component of many diseases that afflict Western Civilization, and how it is also a major contributor to the magnitude and persistence of different sports injuries and traumas. She asks Dave to talk about inflammation, and specifically its role in concussion and TBI, as well as give a brief overview of what inflammation is.
[00:17:51] Dawn mentions how Dave has been looking at how targeting inflammation may serve as a therapeutic way to also treat fear- and anxiety-based disorders.
[00:20:34] Ken asks if the process of EPA and DHA conversion into SPM’s through an enzymatic process diminishes in its efficiency as one ages.
[00:21:18] Ken asks if Dave thinks there is a role for exogenous SPM’s for the aging population.
[00:22:13] Ken asks if there is a particular SPM brand, or collection of brands, that Dave finds to be the most interesting or efficacious.
[00:23:01] Ken asks what dosage would Dave suggest for subacute inflammatio...
Previous Episode
Episode 68: Steve Anton talks about diet, exercise, intermittent fasting and lifestyle interventions to improve health
What’s the best way to eat and the right way to exercise to ensure a healthy lifespan? Our guest today is Dr. Stephen Anton, a psychologist who has spent his career researching how lifestyle factors can influence not only obesity, but also cardiovascular disease and other metabolic conditions.
Steve is an associate professor and the chief of the Clinical Research Division in the Department of Aging and Geriatric Research at the University of Florida. In today’s episode, we talk to Steve about his work in developing lifestyle interventions designed to modify people’s eating and exercise behaviors in an effort to improve their healthspan and lifespan.
One of Steve’s best-known papers appeared in the Obesity Journal titled “Flipping the Metabolic Switch.” The study looked at intermittent fasting and suggested that the metabolic switch into ketosis represents an evolutionary conserved trigger point that has the potential to improve body composition in overweight individuals.
Topics we cover in today’s interview include:
- The increasing prevalence of metabolic syndrome associated with aging.
- Why so many hospital health and wellness programs fail.
- How fasting and intermittent energy restriction promote autophagy.
- The relationship between muscle quality, body fat and health.
- How age-related loss of muscle function and mass leads to sarcopenia.
- Effects, risks and benefits of testosterone supplementation in older men.
- Optimal exercise methods for long-term health.
- Therapeutic approaches that potentially can help avert systemic inflammation associated with aging.
- Steve’s study that looked at the effects of popular diets on weight loss.
- Controversies surrounded calorie restriction as a strategy to enhance longevity.
Show notes:
2:30: Steve talks about growing up in Tampa and playing sports as a kid.
3:53: Dawn asks Steve about his decision to attend Florida State after high school.
4:17: Dawn comments on how Steve bounced between medicine, business, and psychology before finally deciding to major in psychology. She asks if having two parents who were also psychologists played a role in his decision.
5:24: Ken asks about Steven’s experience pursuing his Ph.D. at the University of Florida.
6:28: Dawn brings up that Steve became a fellow of behavioral medicine at the Pennington Biomedical Research Center in Baton Rouge, La. She mentions that Pennington has one of the nation’s premier programs in obesity metabolism and diabetes. She asks if that was the reason he decided on Pennington.
9:33: Dawn asks what prompted Steve to return to the University of Florida.
10:08: Ken asks what is driving the increased prevalence of metabolic syndrome that’s associated with advanced age.
11:19: Dawn brings up how hospitals have tried to promote health and wellness programs for decades, but notes how hospitals are designed to treat people who are sick and injured rather than delivering lifestyle interventions. She asks if Steve can give a summary of what he has learned in looking at ways to deliver interventions.
13:23: Dawn mentions that the traditional treatment and management approaches for type 2 diabetes are relatively ineffective and only reverse the disease in about one percent of the cases.
15:02: Ken mentions that Jeff Volek, STEM-Talk Guest on episode 43, has been a pioneer in researching type 2 diabetes.
16:49: Dawn points out that she and Ken had an in-depth conversation with Dr. Mark Matson about autophagy on episode seven of STEM-Talk. Matson also discussed fasting, and intermittent energy restriction and how it promotes autophagy, which is often described as the body’s innate recycling system. Dawn asks if Steve can elaborate a little on this process.
18:02: Dawn mentions that Steve has written about muscle quality and body composition and the risk of metabolic diseases and functional decline. She asks about the relationship between muscle quality, body fat and health.
19:17: Dawn asks if Steve can talk about how the age-related loss of muscle function and mass often lead to sarcopenia, and how this condition effects the individual and society.
20:31: Ken asks for Steve’s thoughts on the group of people who could be classified as having “pre-sarcopenia.” Ken mentions his interest in this group given that dietary and exercise intervention can still make a huge difference in their lives.
21:35: Dawn brings up the point of how testosterone tends to decline as men age, which is associated with a number of adverse health problems, including: cardiovascular and metabolic disease, sexual dysfunction, and mood disorders. Dawn asks about Steve’s study on the effects of testoste...
Next Episode
Episode 70: David Sabatini on the discovery of mTOR and its role in disease, longevity & healthspan
Peter Attia, who was our very first guest on STEM-Talk, describes David Sabatini’s discovery of mTOR as one of his two favorite science stories.
Today, Dr. David Sabatini joins us and gives us a first-hand account of how his research into rapamycin in 1994 as a graduate student led him to the discovery of mTOR, which we now know is a critical regulator of cellular growth.
Our interview with David delves into his continuing research into mTOR, which has led to promising opportunities for the development of new treatments for debilitating diseases such as cancer, diabetes and neurological disorders. He also discusses mTOR’s role in healthspan and lifespan.
David is a molecular cell biologist who, according to Reuters News Service, is on the short list for a Nobel Prize. David is on the faculty at MIT and heads up the Sabatini Lab at the Whitehead Institute.
In today’s episode, we discuss:
• Rapamycin, a macrolide antibiotic discovered in the soil of Easter Island
• David’s discovery of mTOR while a grad student at Johns Hopkins
• mTOR’s role as one of the major growth pathways in the body
• mTOR’s role as a nutrient sensor
• How mTOR inhibiton has become one of the hottest topics in longevity research
• mTOR’s role in diseases, especially its connection to cancer
• The role of RAG GTPases as key mTOR mediators
• Protein intake and downstream mTOR activation
• Research into ketogenic diets effect on longevity and healthspan
• Whether David would take rapamycin as a means to enhance his longevity
• And much, much more
Show notes:
[00:03:32] David talks about growing up in New York and having parents who immigrated to the United States from Argentina.
[00:04:00] Dawn asks what David was like as a kid.
[00:04:59] Dawn asks David about his decision to attend Brown University.
[00:05:56] David talks about his decision to become a scientist and the time he spent in the lab of Al Dahlberg
[00:06:53] Ken mentions that after his time at Brown, David headed off for Johns Hopkins to work in Sol Snyder’s lab, a professor known particularly for the work he and his colleagues did on the opioid receptor. Ken asks what drew David to Sol’s lab.
[00:08:25] David talks about how as graduate student at Johns Hopkins in the M.D./Ph.D. program, he began trying to understand the molecular mechanism of rapamycin, a macrolide antibiotic discovered in the soil of Easter Island. Rapamycin was known as a potent antifungal, immunosuppressive with anti-tumorigenic properties. That research led David to the major discovery in 1994 of the protein to which rapamycin binds, now referred to as the mechanistic target of rapamycin, or mTOR.
[00:11:46] Dawn asks David to give a high-level definition and overview of what mTOR does.
[00:13:44] Dawn asks why the “m” in mTOR went from standing for “mammalian” to “mechanistic.”
[00:14:11] Ken mentions that we now know mTOR is one of the major growth pathways in the body that is responsible for growth in both a positive sense and a pathologic sense. He goes on to mention that mTOR acts as a major switch between catabolism and anabolism, and asks David to explain why both of these processes are essential for survival.
[00:16:10] Dawn asks how the two different mTOR protein complexes, mTORC1 and mTORC2, differ with regards to their activation and downstream function.
[00:17:40] Dawn asks David about his decision to join the faculty atMIT and embark on a research-focused career there, starting his own lab at the Whitehead Institute rather than following the clinical path arising from his M.D.
[00:20:50] Ken asks about how nutrients and other inputs are sensed and integrated by the mTOR complexes, given how one of the most fascinating aspects about mTORC1 is its role as a nutrient sensor.
[00:23:46] Ken asks why both nutrients and growth factors are required to activate mTORC1.
[00:25:54] Dawn mentions her interest in the connection of mTOR to aging, mentioning that mTOR inhibition through rapamycin or its analogues is currently one of the hottest topics in longevity research. She asks why mTOR inhibition appears to be life-extending?
[00:30:38] Ken asks what the risks are of excess catabolism, when inhibiting mTOR pharmacologically, in terms of both health and longevity.
[00:32:09] Dawn asks if there is data in humans suggesting that suppressing mTOR will extend longevity and healthspan, either pharmacologically, genetically or through diet and fasting.
[00:34:23] Dawn asks where mTOR is made, both in terms of the individual cell, as well as specific tissues in the body.
[00:35:02] Ken asks if there is a significant difference between the mTOR signaling in organs like the liver, skeletal muscle, and the brain.
[00:37:07] Ken asks if tissue specific inhibition of mTOR is possible.
...
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