13 episodes

The External Medicine Podcast is a podcast exploring some of the most exciting ideas in medicine. Medical students Daniel Belkin and Mitch Belkin interview physicians, scientists, and outside-the-box thinkers for evidence-based, practice-changing knowledge. The podcast focuses on diverse topics not typically covered in medical education, including medical transhumanism.

The External Medicine Podcast The External Medicine Podcast

    • Health & Fitness

The External Medicine Podcast is a podcast exploring some of the most exciting ideas in medicine. Medical students Daniel Belkin and Mitch Belkin interview physicians, scientists, and outside-the-box thinkers for evidence-based, practice-changing knowledge. The podcast focuses on diverse topics not typically covered in medical education, including medical transhumanism.

    Stephan Guyenet, PhD: GLP-1, Semaglutide, and the Big Future of Weight Loss Therapies

    Stephan Guyenet, PhD: GLP-1, Semaglutide, and the Big Future of Weight Loss Therapies

    In this interview, Mitch Belkin and Daniel Belkin speak with Stephan Guyenet, PhD, about Glucagon-like peptide-1 (GLP-1) and Semaglutide. They discuss GLP-1’s mechanisms of action, Anthony Sclafoni’s experiments on food reinforcement and nutrient receptors in the small intestines. Finally, they touch on some exciting new weight loss drugs that may replace semaglutide and potentially even bariatric surgery.

    Who is Stephan Guyenet?
    Dr. Stephan Guyenet received his PhD in Neurobiology and Behavior from the University of Washington. Afterward, he completed a postdoctoral fellowship in the neuroscience of obesity. He is the author of the book The Hungry Brain. Dr. Guyenet is the founder & director of Red Pen Reviews, which publishes expert reviews of popular nutrition books with structured semi-quantitative evaluations. In addition, he is a senior researcher at GiveWell where he conducts cost effectiveness analyses on water quality interventions and malnutrition treatments in low income countries.
    What is GLP-1 ?
    Glucagon-like peptide-1 is a hormone produced by the intestines. It is an incretin, meaning it signals the pancreas to increase insulin secretion in a glucose-dependent manner. Initially, GLP-1 agonists were developed for the treatment of diabetes. In both animal and human models, it was discovered that GLP-1 agonists suppress food intake, which led to weight loss. This discovery spurred its use in obesity trials, including STEP 1. 
    Citations for Stephan Guyenet:
    @WHsourceThe Promise and Impact of the Next Generation of Weight Loss DrugsNEJM - Once-Weekly Semaglutide in Adults with Overweight or ObesitySafety, tolerability, pharmacokinetics, and pharmacodynamics of concomitant administration of multiple doses of cagrilintide with semaglutide 2·4 mg for weight management: a randomised, controlled, phase 1b trialDanuglipron (PF-06882961) in type 2 diabetes: a randomized, placebo-controlled, multiple ascending-dose phase 1 trialDiabetes Prevention Program - 58% reduction in progression from pre-diabetes to diabetes.Stephanguyenet.comMarch 2021 article in Works in Progress______________________

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    Daniel Belkin and Mitch Belkin are brothers and 4th year medical students.  The External Medicine Podcast is a podcast exploring nontraditional medical ideas and innovation. 

    • 1 hr 4 min
    Emily Oster, PhD: Breastfeeding Recommendations, Rising C-section Rates, and Other Controversies

    Emily Oster, PhD: Breastfeeding Recommendations, Rising C-section Rates, and Other Controversies

    In this interview, Mitch Belkin and Daniel Belkin speak with Brown Economics Professor Emily Oster about the studies behind breastfeeding recommendations, the dramatic increase in the U.S. C-section delivery rate over the last half century, and how she approaches analyzing studies. 
    Who is Emily Oster?
    Emily Oster is the Royce Family Professor of Teaching Excellence and Professor of Economics at Brown University where she studies health, behavioral, and development economics. She received her PhD from Harvard University and taught at the University of Chicago Booth School of Business. She is the author of three popular books on pregnancy and parenting: Expecting Better, Cribsheet, and The Family Firm. 
    References:
    In our podcast, we reference the following papers, ideas, and talks:
    The 2007 TED Talk on AIDS in Africa by Professor Emily OsterA paper in which Professor Oster argues that the the increased ratio of men to women in Asia could be explained in part by Hepatitis B infection (2005)Another paper in which she retracts the claims of her previous paper (Hepatitis B Does Not Explain Male-Biased Sex Ratios in China) (2008)The Term Breech Trial - Lancet (2000)Door-to-Balloon timeAmy Finkelstein paper on Source of Geographic Variation in Healthcare spending: evidence from patient migrationJudith Rich Harris Argument - The Nurture AssumptionProfessor Emily Oster’s Parent Data SubstackErrata:
    In the introduction, we accidentally say Academy of Pediatrics at one point when we meant to say American Academy of Pediatrics.In the introduction, we state that one reason for C-section delivery is “protracted vaginal delivery”. We meant to say “protracted labor” defined as the arrest of cervical dilation prior to vaginal delivery.______________________

    Follow us @ExMedPod, and sign up for our newsletter at www.externalmedicinepodcast.com/subscribe

    Daniel Belkin and Mitch Belkin are brothers and 4th year medical students.  The External Medicine Podcast is a podcast exploring nontraditional medical ideas and innovation. 

    • 1 hr 3 min
    Katherine Flegal, PhD: The Obesity Wars and the Politicization of Science

    Katherine Flegal, PhD: The Obesity Wars and the Politicization of Science

    In this interview, Mitch Belkin and Daniel Belkin speak with Katherine Flegal about the relationship between BMI and excess mortality. Dr. Flegal's publication of two papers in JAMA led to substantial controversy among obesity researchers. They discuss the data regarding the U-shaped mortality curve, the history of BMI, as well as the politicization of science.
    Who is Katherine Flegal?
    Katherine Flegal is an epidemiologist and former senior scientist at the CDC's National Center for Health Statistics. She is one of the most cited scientists in the field of obesity epidemiology. After receiving a bachelor's from UC Berkley, a PhD from Cornell, and an MPH from Pittsburgh, she worked in the biostatistics department of University of Michigan prior to working at the CDC in the National Center for Health Statistics.
    Dr. Flegal worked on the National Health and Nutrition Examination Survey (NHANES), which is a comprehensive data set of nationally representative cross-sectional data from the US that combines interviews, physical exams, and laboratory tests along with demographic, socioeconomic, and dietary data. Her 2005 analysis of the NHANES data set and her 2013 meta-analysis demonstrated that people who are “overweight” (defined as a BMI between 25 and 30) have significantly lower all cause mortality compared to people who are “normal weight” (BMI 18.5 - 24.9). In addition, her publications showed no significant difference in mortality between people who have a BMI of 30-35 and people who are normal weight.
    References
    The Obesity Wars and the Education of a Researcher: A Personal Account (Progress in Cardiovascular Diseases, 2021)
    Excess deaths associated with underweight, overweight, and obesity (JAMA, 2005)
    Association of All-Cause Mortality With Overweight and Obesity Using Standard Body Mass Index CategoriesA Systematic Review and Meta-analysis (JAMA, 2013)

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    Follow us @ExMedPod, and sign up for our newsletter at www.externalmedicinepodcast.com/subscribe

    Daniel Belkin and Mitch Belkin are brothers and 4th year medical students.  The External Medicine Podcast is a podcast exploring nontraditional medical ideas and innovation. 

    • 57 min
    Karl Friston on Understanding Schizophrenia using the Free Energy Principle

    Karl Friston on Understanding Schizophrenia using the Free Energy Principle

    In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Karl Fristonabout his proposed free energy principle and how it applies to various psychiatric and neurological disorders including schizophrenia, depression, autism, and Parkinson’s. They also touch on the disconnection hypothesis of schizophrenia, how theories of schizophrenia have evolved over the last two centuries, and the relationship between schizophrenia and autism.

    Who is Karl Friston?


    Dr. Karl Friston is a professor of neuroscience at University College London and an authority on brain imaging. He is the 20th most-cited living scientist with over 260,000 citations for his works. After studying natural sciences at Cambridge, he completed his medical studies at King’s College Hospital in London and worked for 2 years in an inpatient psychiatric facility on the outskirts of Oxford, where treated patients suffering from schizophrenia.
    Dr. Friston has developed a number of statistical tools for analyzing data from the brain, including statistical parametric mapping (SPM), voxel-based morphometry (VBM) or dynamic causal modeling (DCM). His mathematical contributions include variational Laplacian procedures and generalized filtering for hierarchical Bayesian model inversion.

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    Follow us @ExMedPod, and sign up for our newsletter at www.externalmedicinepodcast.com/subscribe

    Daniel Belkin and Mitch Belkin are brothers and 4th year medical students.  The External Medicine Podcast is a podcast exploring nontraditional medical ideas and innovation. 

    • 1 hr 15 min
    Fructose and Fat Storage: An Evolutionary Perspective with Rick Johnson, MD

    Fructose and Fat Storage: An Evolutionary Perspective with Rick Johnson, MD

    This conversation was recorded on June 24th, 2021. In this interview, Mitch Belkin and Daniel Belkin speak with Dr. Johnson about fructose and its relationship to fat storage. They discuss uric acid as a cause of kidney inflammation and essential hypertension, how glucose intake can trigger endogenous fructose production, and the relationship between salt and obesity. Finally, they touch on the evolutionary history of uric acid metabolism and the potential role for fructokinase inhibitors in treating metabolic disease.

    Who is Rick Johnson?
    Dr. Johnson is a Professor of Nephrology at the University of Colorado School of Medicine. He is one of the world’s leading experts on fructose. His research focuses on the role of fructose and uric acid in obesity, diabetes, hypertension, and kidney disease. He has over 700 publications, in journals including JAMA and the NEJM. He is also the author of two books for a general audience, The Fat Switch and The Sugar Fix.

    References
    Uric Acid levels predicts future hypertension
    Uric acid and its relationship with pediatric hypertension 
    Randomized Trial - Allopurinol on hypertensive adolescents 
    Endogenous fructose production and kidney inflammation
    High salt diet and endogenous fructose production in mice
    How osmolality of soup increases blood pressure 
    Fructose, Uricase, and the Back-to-Africa Hypothesis 
    Books:
    1. The Fat Switch
    2. The Sugar Fix
     ______________________

    Follow us @ExMedPod, and sign up for our newsletter at www.externalmedicinepodcast.com/subscribe

    Daniel Belkin and Mitch Belkin  are brothers and 4th year medical students.  The External Medicine Podcast is a podcast exploring nontraditional medical ideas and innovation. 
     

    • 1 hr 6 min
    Medical Conservatism, Myocarditis, and Physician Advocacy with John Mandrola, MD

    Medical Conservatism, Myocarditis, and Physician Advocacy with John Mandrola, MD

    This conversation with Dr. John Mandrola was recorded on July 11th, 2021. In this interview, Daniel Belkin and Mitch Belkin speak with Dr. Mandrola about a 2019 article he co-authored entitled The Case for Being a Medical Conservative. They discuss concerns about vaccine-induced myocarditis in children, vaccine mandates, and whether the AMA and other physician organizations should take sides on controversial political issues. 
    Who is John Mandrola?
    Dr. John Mandrola is a practicing cardiac electrophysiologist and a regular columnist for theheart.org on Medscape. He hosts the fantastic “This Week in Cardiology” podcast and is a blogger at drjohnm.org. He completed his medical training in Internal Medicine, Cardiology and Electrophysiology at Indiana University. 
    References:
    The CAST trial 
    RECOVERY Trial
    Medscape – Cardiology
    Medscape – General Medicine
    Blog
    Substack
    This Week In Cardiology Podcast
    Twitter: @drjohnm

    ______________________

    Follow us @ExMedPod, and sign up for our newsletter at www.externalmedicinepodcast.com/subscribe

    Daniel Belkin and Mitch Belkin  are brothers and 4th year medical students.  The External Medicine Podcast is a podcast exploring nontraditional medical ideas and innovation. 

    • 53 min

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