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Duration:31:23
Uploaded:2015-06-18
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Next week's LIVE Show: https://www.youtube.com/watch?v=RRKGMBume70 - Don't forget to leave your questions about parasites in the comments for next week's show!

1a) Food Recommendation episode: https://www.youtube.com/watch?v=PhEwfaFLrd0
1b) Food Recommendation (free) poster: http://ow.ly/NaEJa
2) HCT Reddit: www.reddit.com/r/hctriage
3) Podcast: https://itunes.apple.com/ca/podcast/healthcaretriage/id999134849?mt=2

Facebook: http://www.facebook.com/healthcaretriage
Patreon: http://www.patreon.com/healthcaretriage
Twitter: http://www.twitter.com/hctriage

00:00 - We're LIVE!

00:32 - We have a poster from the food episode!

00:40 - We have a subreddit now!

02:32 - Maxine McCurdy - Do antibacterial hand soaps and sanitizers make your body less able to fight infections?

04:32 - Deborah Piens - I quit smoking 8/17/14 (Yay me). At what point do I get to call myself a non-smoker? Or will I always be a "former smoker"?

05:46 - Alex Shannon - Is there any good evidence that says that aspartame can affect hormone levels and blood-sugar? PS, you didn't address that question in the HCT episode about artificial sweetners

07:54 - John Harvey - What does the current research say about secondhand smoke? I've heard everything from "barely harmful at all" to "worse than smoking itself".

09:07 - Lisa Jones - Is coconut water as good as, or better than, water for recovering after athletic pursuits?

11:51 - Jay Fensom - CIRCUMCISION! Should it be done according to the research is it more healthy to be circumcised even when considering all of the complications. And what about female circumcision as well?

14:37 - Emily Barbian - About 2/3 of people who lose weight gain it all back over time. How can I prevent that?

16:55 - Mncdk - Is it ever too late to get vaccines, for instance MMR?

18:29 - nkicker - Does Vermont's trouble with adopting single payer universal healthcare for its residents spell doom for others states wanting to do the same thing?

21:01 - Thomas Beard - Oklahoma just passed a law requiring children under 2 years old be rear facing in car seats. Does this reflect evidence-based best practices?

24:29 - Sam Khan What is the best evidence on the long-term health effects of working night shifts (specifically among healthcare providers)?

25:09 - marztha - In people who've previously been diagnosed with vitamin D deficiency, what's the best way to prevent a relapse? Do store supplements work? Any foods to focus on eating? How much sun should someone try to get?

26:00 - okapian - Are there any long-term effects of quarterly whole blood donations? My parents are concerned and want me to stop donating, even though I have no major health issues.

26:30 - Zzyzx - Are there any health benefits for intermittent fasting? Any harms?

27:03 - M. Avery - Are the protective qualities of obesity a myth? I've seen some reporting that says overweight/obese people are more likely to survive stroke and heartattack.

27:56 - Jenna Van Sickle - Is there a rise in autoimmune diseases recently? If so, is there research that indicates why? Are there any lifestyle changes that help? Can we prevent kids from getting autoimmune diseases?

28:21 - Dom Thorrington Within the healthcare, medical, pharmaceutical and public health sector, which is the job you'd prefer to do if you weren't a Research Fellow/Paediatrician/YouTuber?
Aaron: I believe we're live! Yes! All right, our track record is improving. Let me get to the right page here. OK. We're going to assume we're going. We will start with some housekeeping issues while everybody else joins us.

First of all, this week on the Facebook page, which you should all be part of, by the way, facebook.com/healthcaretriage... but we asked you if the food episode had changed the way you're eating, or if you were just sort of interested, and we want to say how thankful we are, how many of you actually said it does, or it did change how you eat. If you haven't seen that episode yet, click on the link in the description. We've also got a poster from that episode, which you can download for free on the Facebook page, link will be in the description as well.

Um, secondly, we actually have a Reddit now for the show, which I had nothing to do with starting, but we're pleased to see the community did. I've actually already popped over there a few times to answer questions and, you know, just try to be part of it. If you haven't been, you should also check it out. We'll try to get the link for that down in the description below as well.

We've recently updated the document with all the questions that have been asked or answered, link for that in the description, so if you have a question and you don't get a chance to get it addressed there, it might have been answered already. If it has, you could save yourself some time and just go look for it. If you haven't, keep submitting your questions, we will absolutely get to them in the future.

If you haven't already subscribed to the podcast, you should. This show, Healthcare Triage Live, is now being released as a podcast. It was one of our stretch goals, or milestones, as they are called, at Patreon.com, and we hit that thanks to generous support, and so we are releasing the non-very graphic-intensive live show as a podcast. You could listen to this on the go, anywhere you like. It's at iTunes, it's at SoundCloud, it's got an RSS feed if you use something else, so go ahead. We're going to be adding the last two weeks shortly, and I'll add today's episode later today. Awesome. Links will also be in the description down below.

Speaking of milestone goals, they're there because we had some many great patrons from Patreon.com. Patreon.com/healthcaretriage, it's a great way for you - our viewers - to help support the show, make it bigger and better and get awesome things like the podcast. So! Let's get started and have lots of fun.

Oh! Mark is back, which reminds me, because he would always tell me - this is not medical advice! Nothing I say here should be taken as medical advice: don't start any new treatments, taking any new pills, doing anything crazy. ALWAYS before you decide to do something medical, you talk to a licensed professional - like a doctor - about what you're going to do. This show is not medical advice. But this show is awesome and full of lots of good information, so let's start:

Question number one from "Maxine McCurdy - Do antibacterial hand soaps and sanitizers make your body less able to fight infections?"

So, first of all, I'm going to quickly plug - without being judgemental - the fact that we have an episode already done on antimicrobials and things like the FDA's ban of some of them in soaps like that. So, absolutely go watch it.

It's not quickly cut and dry on "make your body less able to fight infections." The truth of the matter is it probably doesn't do much good at all for the vast majority of people. The actual washing of soap and water is already so good that adding in the antibacterial component in most trials doesn't actually do any good. When they do studies about whether people actually get the stuff off their hands or whether they actually fight infections, the antibacterial component of the hand soaps and sanitizers doesn't do much.

That being said, the alcohol-based sanitizers do work in many settings, and there's no problem with using those, but that's mostly just the alcohol killing it - it's not an antibacterial or antimicrobial component. But there are settings where those sanitizers don't work as well. For instance, when hands are wet, they don't work as well, which is why you shouldn't be using those in the kitchen when you're washing your hands or have lots of water around, because the hand sanitizers aren't as good there.

There are also some reports of people using those hand sanitizers so much that they wind up killing some of the good bacteria on their hands, which leaves them more likely to get secondarily infected with viruses and things and actually get things like warts. So, you can overdo it.

But your general question about today - "make your body less able to fight infections" - no. When you're using them appropriately, they don't. But having said that, it's going to be harder and harder to find antibacterial soap in the future because the FDA has pretty much said that the companies can't be using that stuff. So, if you've got a stockpile of it, more power to you. Otherwise, it's gonna go away probably in the future, and that's really not a bad thing.

Next question comes from "Deborah Piens - I quit smoking 8/17/14 (Yay me)." And I agree, yay for her. "At what point do I get to call myself a non-smoker? Or will I always be a 'former smoker?'"

You know, it depends on context; if you're talking about for health purposes, there will always be some risks that probably are increased for you because you were a former smoker: some risks of possible lung disease or cancer - which certainly are less now that you've quit, but - will probably be higher than somebody who never smoked at all. That's just life.

Having said that, if you're just asking about for friends and things like that, I mean, you've almost made it a good year - that's pretty good! You know, six months to a year is pretty much what studies would say are the "quit rates." And so, you're getting there, and you should keep going.

People who are a part of Alcoholics Anonymous and things like that would say that you never fully quit this stuff, it's just how long have you refrained from the last time that you indulged or used. But you've almost gone a year - that makes you in a small crowd. Awesome. And if you wanted to tell people that you're a nonsmoker at this point, your friends and family, by all means - who's gonna stop you.

Next question, "Alex Shannon - Is there any good evidence that says that aspartame can affect hormone levels and blood-sugar? PS, you didn't address that question in the HCT episode about artificial sweeteners." Well, I appreciate the fact that you watched the episode on artificial sweeteners - one of my favorites. I'm actually gonna cover that in the future in other places that I write for.

So, does it affect hormone levels and blood sugars? Well, the reason I didn't cover it is because there's no good evidence that it does. If there was good evidence that it had that kind of dangerous effect, I would have included it in that episode. It is, of course, impossible to cover every bit of research that's been done on a lot of these things because there's tons and tons and tons of studies. And the collective research does not show that aspartame in the general population does affect things like hormone levels and blood sugar.

You can find tiny studies that can show sometimes some laboratory levels or things or things being affected, but of course, those have to be trans-, especially in animals, but those have to be translated into human beings, and we just don't see that. And so, the general consensus of the collected body of evidence is that aspartame is safe, and it doesn't affect things in a negative manner, it doesn't cause cancer, it doesn't cause neurobehavioral or neuropsychiatric problems, and it doesn't cause endocrine issues either.

And of course, if you want to point to the fact that A study can show a problem or that there's a potential issue - of course as always as I say - you need to weigh the benefits and the risks. Is it worse or is it better than sugar? No. Added sugars have huge negative connotations for the general public. And so, if you're gonna drink a sweetened beverage - which many, many people do - if you had the choice between an artificial sweetener and sugar, I would choose the artificial sweetener, because again, you're looking for barely-proven or no risks versus very-known risks from sugar.

And so, when you weight those two things, I've told you the way that I would come down, and I put my money where my mouth is: that's what I drink, when my kids are drinking soda - when we let them have it - it's caffeine-free diet soda. I'm much more comfortable with that than I am with them getting lots and lots of added sugars.

"John Harvey" asks, "What does the current research say about secondhand smoke? I've heard everything from 'barely harmful at all' to 'worse than smoking itself.'"

Okay. It's not worse than smoking itself. Now, on the other hand, it's not "barely harmful at all." There's a decent amount of evidence - and I grant you, this is not randomized controlled trial evidence, because it would be completely, completely unethical to randomize people to be subjected to secondhand smoke to see if they get damaged - it's never going to happen. So, we will never have that type of study, which means we have to go off of the epidemiologic evidence that we can get.

And the collected body of evidence says that secondhand smoke is not harmless. It's not worse than smoking itself, but it's not harmless, and it does carry some risks with respect to pulmonary or lung functions or some disease, and so you want to avoid it. Just avoid it. And again, it's always, "What's the benefit; what the harm?" Well, it's hard to imagine a benefit here. It's very easy to manage harm. So, I would put it between the two things you've heard: It is certainly worse than "barely harmful at all," it is certainly better than "worse than smoking itself." But it is in between there.

"Lisa Jones" asks, "Is coconut water as good as, or better than, water for recovering after athletic pursuits?" I'm always amazed at people's interest in this, because the vast, vast, vast majority of people are not exercising so strongly that their bodies are at risk for some danger if they don't immediately correct themselves with some kind of amazing concoction. It's not like you've burned off all the sugar in your body, or killed off all the electrolytes, or sweated everything out.

Your body is incredibly capable of managing the electrolyte and sugar composition in the short term from participating in some athletics. People have run marathons and done all kinds of other stuff. They have been incredibly active, working all day outside, and the human races functioned just fine before the creation of Gatorade [major U.S. brand of electrolyte drink]. There are probably some incredibly hard-core athletic people who are engaging in such extreme athletic competition that they might need to replenish themselves over time, but for even most of them, water is gonna do just fine.

So, if you want, you can try to use a lot of this other stuff like Gatorade or sports drinks and stuff like that - they're also usually full of sugar, which you probably don't need - but fine if you want.

Okay, so you're asking about coconut water, whether that's good as or better than - I have no idea, literally. I can't imagine that anyone has ever studied this, and if they did, I can't imagine that there could be possibly any kind of real-world outcomes that we could see. They could probably do some studies in their laboratory values and show that "this electrolyte went up slightly higher than that electrolyte," but it's all meaningless when we talk about real-world outcomes. Because it's not as if you got a hundred or a thousand people together and said, "Hey, run for an hour," and they were otherwise going to drop in the streets if they didn't get coconut water and/or regular water immediately. They were all fine before and after. So, the likelihood of coconut water making a big difference over regular water is incredibly small.

So, what do you even mean by "better than?" Is it some kind of laboratory value that really doesn't matter in the scheme of things? Maybe. For real-world outcomes, I would have a hard time imagining that any of this is necessary. Water's fine for the vast majority of people. You'll see a lot of research that says like, "Chocolate milk is as good as as other energy drinks," because it's got protein and it's got some sugar and it's got - I don't know - good flavor. They're all fine.

Somebody made a gif last week of me going like, "You're worried about the wrong things," - you're worried about the wrong things. Worrying about "what is the primary beverage for fine-tuning your body after participating in some athletics," - they're all good, they're all fine, don't stress over this.

"Jay Fensom," aaw, "CIRCUMCISION! Should it be done according to the research is it more healthy to be circumcised even when considering all of the complications. And what about female circumcision as well?"So, we get this question almost every week, and I've not done an episode on this, so I've nothing to point you to other than "keep watching Healthcare Triage Live."

It's a huge debate. If you're weighing benefits versus harm, there are some studies which seem to point to the fact that if you are circumcised, the risk of catching certain STDs - including HIV - is lower. So, that would be a benefit. But that's a relative benefit; in terms of absolute risk reduction, it's very, very small. There are some people that would argue about penile cancer and whether or not it might reduce the risk of that as well. Again, absolute risk reduction, incredibly, incredibly tiny - we're talking about male circumcision, here.

The reason that most people get circumcised is cultural and/or religious, and there the benefits are obviously greater than the absolute risk reduction, it's very meaningful to some people - that is why they circumcise. There are other people who think that that's a bad thing, because we're doing it to infants when they don't have a choice, and they may come to regret it later on. There's good research, however, that shows that the vast, vast, vast majority of people - or males -don't seem to have a ton of regret one way or the other. There are probably some - greater than zero - but most don't regret it or really get angry about the fact that they have. Most of the upsetness comes from the people who are not circumcised, who think that we shouldn't make other infants get circumcised.

Again, if you're talking about health reasons, slight bit of evidence pointing to a health benefit. Is it enough to overcome the ethical concerns that other people have? Not so much that we would say, "We should tell people to get circumcised," but enough that we should say, "If you want to get circumcised, there is some evidence for it; it seems like you could justify having health insurance pay for it."

With female circumcision, none of these thing I just said seem to be true. There no known health benefits that I know of, there's no known good reasons to do it, it definitely seems to reduce sexual pleasure, it seems like it is something that people regret far more post hoc than male circumcision. And so, all of the arguments that I just made for male circumcision do not apply for female circumcision. It's very hard to find huge advocacy groups which are supporting that. In fact, it's way easier to find people who are trying to end its practice right now. So, no. No, I don't think you see anyone supporting female circumcision.

Also, I should say, because "female circumcision" is usually "taking off the clitoris," which would be like saying, "Let's take off the head of the penis, not the foreskin" - totally separate things. And so, the idea that we call them both "circumcision," they are not; they're not in any way related in that way.

"Emily Barbian" asks, "About 2/3 of people who lose weight gain it all back over time. How can I prevent that?" That's such a great question, and it's not as easy to say.

So, the problem is that people who lose weight oftentimes do it by huge, drastic changes to their diet which are unsustainable over the long term. And so eventually - as with all diets - it leads to some sort of slowing of your metabolism. And the problem is that eventually people bail on the diet completely, their metabolism is slowed, they go back to their old eating habits, and therefore, their weight goes shooting back up. The way you prevent that is by making long-term sustainable changes to your diet.

I used to weigh about easily 30 pounds more than I-, maybe about 30 pounds more than I do right now. It was not that I went on a crash diet and immediately changed what I ate and refused to eat any certain foods; we made huge changes - my wife and I both - have this story - we made big changes to just our life: We started really eating many more vegetables, we started eating the way that we-, we stopped eating a lot of, you know, ordering in food, we started cooking a lot more - well, my wife started cooking a lot more, she started changing her cooking habits and what she actually would cook, we reduced a lot of the-, we stopped huge amount of rice and potatoes and bread and things that were more-, we stopped a lot of the processed foods, we started earing many-, along the lines of the food recommendations episode - which is also a good episode you should go watch.

And that led to sustained behavioral change - long-term - so that my weight has pretty much stuck. Now, my weight still fluctuates up and down a bit, but I don't even ever approach what I used to be, so it's a new set point.

So, the quick answer to this would be, "Don't go on a crash diet. Truly try to change your behavior in small, sustainable ways over the long term." And people that make those kinds of long-term lifestyle changes have probably a much greater success than those that say, "I'm gonna go on Atkins or Weight Watchers of Jenny Craig or something like that for six months, and let's see what happens." Because it's hard. It's really hard to make that kind of radical change over the short term and then keep it up for a long time.

"Mncdk" asks, "Is it ever too late to get vaccines, for instance MMR?"

Okay, so it is never too late to get a vaccine, but at some point it becomes sort of useless. Once you've already been exposed to herpes, getting an HPV vaccine is worthless - it won't do any good anymore. That's why we need to get you vaccinated before you get the disease. And since that's a lifelong disease, that's how it goes. Same thing goes with chickenpox; once you've been exposed to chickenpox, the varicella vaccine is worthless, it's just not even worth your time.

There are some diseases which we used to say, "Well, once you get to a certain point, you don't need as many," or "you don't need it because that's a childhood illness, and it doesn't affect adults as much." We're changing our thinking on some of those, because still we're finding that adults who get infected - even though it's not a danger to them themselves - they still can give it to babies. And so, we're re-upping people's MMR sometimes or certainly their DTaP - the ones for pertussis. That actually will help prevent them from getting pertussis and giving it to babies, which is a real concern.

So, "You should talk to your doctor," is the short answer. There are good recommendations on how people should catch up, and we're actually starting to booster people. Every time a woman gets pregnant now, there are recommendations to boost certain vaccines, even if they've had it many times before, because it prevents transmission to babies when they're born, and that's our biggest concern - protecting those who cannot protect themselves is one of the most important reasons to get vaccinated. So, lots of good reasons; talk to your doctor.

"Nkicker" asks, "Does Vermont's trouble with adopting single payer universal healthcare for its residents spell doom for others states wanting to do the same thing?" Great question.

Vermont tried to do a state-level, single-payer system very recently, which would've been interesting. But their single-payer system was also interesting in ways that Medicare, which is another single-payer system, is not. They were going to use a private health company - I think it was United Healthcare, but it could also be Blue Cross, I can't-, maybe was Blue Cross - regardless, a private health insurance was going to be the single payer. It was not government-run.

And they had a shot at that because that private insurer already covers 75, 80, 90 percent of the state, like, it's already the game. So, to create their single-payer system would've meant only, like, stretching it to cover everyone, and then getting a lot of money to help make the government pay for it. They were gonna do it through taxes and things like that.

It failed. Even though, ironically enough, there was a period of time when winning the primary for the governorship was sort of done by making sound of Vermonters, like "you are the most strident, ardent supporter for single-payer," so it's totally opposite of the United States. As a whole. But it didn't work; it didn't work because they couldn't make the numbers square without talking about tax increases, and even though their tax increases would've been small compared to how much people were paying for health insurance, saying "tax increase" is very politically difficult in the United States of America. So, it didn't work.

"Does it spell doom for other states?" I think it makes it hard, because if anywhere it was gonna succeed, it was gonna be a state like Vermont where, again, there was a lot of support for it already. But you know, every time I think there's doom in everything else, you gotta take in the fact that Medicare is a monstrous single-payer health care system, and at this point, the world of America thinks it would be "disastrous" to even talk about dismantling it in any way. It is one of those strange, bizarre, hypocritical quirks of American politics that single-payer is American as apple pie when you're 65, but it's "tyranny and the end-of-days" if you're 64. So. I don't know.

I have long since tried to stop second-guessing the politics of singl-payer health care in the United States, because none of it makes sense to me. It is awesome, again, for the elderly, and "the worst thing that could ever happen to America" for everybody else. So, I don't know. But Vermont is worth looking into; you should go read about it. I don't think we've ever done an episode on it; I've written a lot about it in my blog. You could go there.

Next question comes from "Thomas Beard - Oklahoma just passed a law requiring children under 2 years old be rear facing in car seats. Does this reflect evidence-based best practices?" This is a FABULOUS question.

So, we put kids in rear-facing car seats up to one year of age, or we used to, because it's safer. Because that way, their heads don't rocket forward when they get into car accidents; their necks don't work so well, so being in a rear-facing car seat is safer. Here's the thing: Being rear-facing is ALWAYS safer. That's why astronauts take off in rear-facing seats. I don't know if you ever looked at the movies or seen Apollo and all that-, they take off in rear-facing seats because- ... [to OffScreen] I think they do, don't they? At least they used to, or they used to land or fly-, whatever it was.

A lot of times, astronauts do use rear-facing seats. Why? Because that is safer! Because if you have a sudden acceleration, that's safer. We don't do it for cars because, of course, it's impossible to drive; you can't be in a rear-facing seat and drive. But  maybe we should-, it would theoretically be safer for everyone but the driver to be in a rear-facing seat. No one will do this because it's uncomfortable. So we weigh the risks and the benefits and we say, "Yeah, there probably is an absolute risk reduction in putting people in rear-facing seats, but we're not going to do it." So, we don't.

We used to make the cutoff at one year of age; now they want to make the cutoff at two years of age. Is that safer? Sure! Just like it'd be safer to put everyone in a rear-facing car seat. But the question is, does that make it more likely that people won't car seats correctly, or does it make it like it's a huge cost? And that is debatable.

Ther American Academy of Pediatrics, I think, actually now recommends that everyone up to two years of age be in a rear-facing car seat. I know almost no one who complies with this. Because it's hard. If you have a child between the ages of one and two, it is hard enough to buckle them into that car seat without it being rear-facing and everything else. And so I know people who say, in general, it's easier to put them in the front-facing car seat because they'll at least comply and do it. And that benefit is so much greater than not putting them in a car seat, that they will do that rather than still try to do the rear-facing seat. Because squeezing bigger kids into those rear-facing car seats and trying to hangle and wrangle-, it's so hard they won't do it at all. So - [loud sustained background noise]

The truck is-, I'm sorry, it's very loud, and when we're taping the show, I stop for the truck, but what are you gonna do other than keep going.

So anyway, is it evidence-based? It's evidence-based in the sense that it is harm reduction. But if we're talking about "total, overall", like, does it lead to better outcomes, are more people likely to comply, stuff like that? Questionable. And so, this is one of those like-, we did talk about this in an episode with the AAP one-point man, you know, tried to put out a mandate that every child in an airplane had to be buckled into a seat, and people did a quick calculation and figured out that that would get people to drive instead of fly. And driving is so much less safe than flying that mandating this kind of thing, putting them in car seats on planes, would likely lead to more kids getting injured and killed. [shrugs]

Would they be safer in the car seat? Probably, yes. Is that good evidence-based practice because it's going to reduce harm overall? No. Same thing applies here. Is it better in the instance? Maybe. Yes, I can say yes. Is it better overall? I don't know.

We're gonna do one more question for the end, here. So the next question was "Sam Khan - What is the best evidence on the long-term health effects of working night shifts (specifically among healthcare providers)?"

So, if you're asking about the effects for the people themselves, I don't know that that's been studied well. If you're asking about the effects of sleep deprivation and changing people's cycles, that has consequences, and obviously being sleep-deprived is a danger to them as they drive home, when risks go way up. It's also a danger to people who are being cared for by those people, because their risks go up as well. And so, being sleep deprived is a problem.

I'm gonna try to do a few more speed rounds before we end here.

"Marztha" says "In people who've previously been diagnosed with vitamin D deficiency, what's the best way to prevent a relapse? Do store supplements work? Any foods to focus on eating? How much sun should someone try to get?"

If you've been diagnosed with vitamin D deficiency, you should have a prescription from your physician, and insurance should pay for that, and that's how it should go. There's no reason to buy store supplements; if you truly have vitamin D deficiency, get it diagnosed, get treated - it's a treatment. If you're "self-treating," you're "thinking you have vitamin D deficiency," then everything goes off the rails. Because more people think that they're deficient than are, supplements - as we've shown you before in many episodes - rarely carry what you think they do, and supplementing people with vitamin D when they're not deficient, doesn't work, doesn't do anything. So, don't do it. Except you should, of course, talk to your doctor.

"Okapian" says, "Are there any long-term effects of quarterly whole blood donations? My parents are concerned and want me to stop donating, even though I have no major health issues."

There really aren't, that I know of. And people really need that blood. So, if you're able to, and your doctors are okay with it, it's a really, really awesome thing to do. And so I would say talk to your doctor, and if your doctor says it's safe, it really is an amazing generous and thoughtful and awesome thing to donate blood.

"Zzyzx" asks, "Are there any health benefits for intermittent fasting? Any harms?"

There are people that show that intermittent-, there are studies that can show that it works - like other things - to reduce-, it can actually help you lose weight or maintain a weight. Now, in long-term studies, that's not so, but that's fine. Any harms? Not that I know of. This is one of those that, like almost anything nutrition, if it works for you and you feel good about it, your doctor's fine with it - fine. Would I start preaching it to everybody else? No way. It's just what works for you doesn't necessarily work for everyone else. That's fine.

"M. Avery - Are the protective qualities of obesity a myth? I've seen some reporting that says overweight/obese people are more likely to survive stroke and heart attack."

You know, it's hard to really say "protective qualities of obesity." There's probably a range of weight, and it is true that we are trying - many of us - to achieve a weight which is probably not where a set point natural is. And then, therefore, trying to achieve that low weight probably doesn't produce much more benefit. But "obese" people are way above the 95th percentile and above; they are probably not getting protection. So, those are two separate things: about what we qualify as "overweight" - what we qualify as a BMI above 50% - and "obese. And I'm not sure that I would go as to say "there are protective qualities of obesity," and certainly lots of negative consequences have been associated with obesity. So, it's not something we should probably shoot for.

"Jenna Van Sickle - Is there a rise in autoimmune diseases recently? Is there research, any lifestyle changes that can help? Can we prevent kids from getting getting it?"

You know, with so many things, we see sometimes a rise in diagnosis; that's often because we're getting better at picking it up and because we're broadening the definition. I don't necessarily know that there's an uptick in a sense like, we should be concerned that people are getting sicker over time.

"Dom Thorrington" last question, "Within the healthcare, medical, pharmaceutical and public health sector, which is the job you'd prefer to do if you weren't a Research Fellow/Pediatrician/YouTuber?" Awesome question.

...I don't know. That's a really good q-, you hit me. Um, there's no other health care job I'd want. I wish I could tell you that being an active pediatrician is something I really look like that's I wanna do, and it's not. I do a very little bit of being an actual pediatrician in a clinic, and it's enough - that's not where I'd want to go.

So, for medical/pharmaceutical - you know, there's research in pharmaceuticals, but I'm not really a basic scientist. I guess if I had to pick some job, I think it would be interesting to work in public health in the sense of trying to set better government policy and enact it might be appealing, but not as much as doing what I do; I love what I do, that that's why I do it. And so, I guess something government-y or public health-y might appeal to me at some point, but at this point, being a research fellow, a research guide pediatrician YouTuber - it's the perfect job. That's why I do it.

All right. We're gonna wrap it up. Next week, we're gonna do something different, so get ready. As per your suggestions, we're going to do a themed live show. So, for next week, we're gonna address questions about parasites, because if you don't know, it's parasite-month on regular Healthcare Triage, we've already had episodes on bed bugs and lice - more to come. There was a Mental Floss that just went up today! It's a tie-in crossover that I'm starring in that does 14 facts about parasites that you might-, whatever, myths or facts about parasites. So, you should go watch the Mental Floss, you should go watch the regular episodes. And as part of all kind of parasite month, we're gonna address questions next week on a themed episode of Healthcare Triage Live.

We can't get to enough of them here, so go to the questions a day before the show - next Tuesday - to have some time to put in comments, your questions about parasites, because we will need to research some of them. I like to think I know a lot of stuff about medicine, but I am positive I don't know everything there is to know about parasites. But I will work very hard to find out the answers to your questions, to have them ready to go. So, go start putting them up next Tuesday in the comments for the next video, we'll start getting links up, and whether you've a question that relates to any of the videos we put up, put it up there. If you have another parasite you'd like us to talk about, put it up there, put it in the comments of next week's live video.

Patreon.com/healthcaretriage, think about becoming a patron. Facebook.com/healthcaretriage, join our facebook page - it's awesome. Reddit, I don't know what the link is, so I'm just gonna say, "Reddit" or "Healthcare Triage page."

OS: [unintelligible]

A: "Reddit.com/r/HCTriage." Very easy to do. That's it for everyone, bye, see you next weekend, 11:30 a.m.

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