[music] From NJPBS Studios, this is NJ Spotlight Newt with Prayana Vanossi.

Hello and thanks for joining us on Joanna Gagas, Prayana Vanossi is off.

Tonight we take a closer look at your health and how to protect yourself and your family this summer.

One of the things we'll look at is something we all need but many of us don't get enough of.

Yep, sleep.

One expert explains how going to bed on time can actually change your life expectancy.

And later for some it's a miracle drug.

Others are seeing side effects.

We look at the health benefits and risks of using GLP1s for rate loss.

But first summer heart health will discuss what you need to know to protect your cardiovascular health in the heat.

That's next.

Major funding for NJ Spotlight News is provided in part by NJM Insurance Group, serving the insurance needs of residents and businesses for more than 100 years.

The summer months mean getting outside more from swimming, walking, running, even yard work.

But all this activity coupled with the heat and sometimes poor air quality can take a toll on your heart.

In fact, for both men and women, heart disease is the leading cause of death among New Jerseyans and Americans.

So how can you protect your heart this summer?

Dr.

Brett C. Love is Chief of Cardiology and Jersey Shore Medical Center and Associate Professor and Vice Chair of Cardiology at Hackensack Meridian School of Medicine and he's here with some advice.

Dr.

C. Love, great to have you on the show.

We often think of the summer as really an optimal time together.

We get outside and to be active.

That's a good thing, yes?

Definitely.

But don't forget, you know, the heart doesn't take a summer vacation.

Then there are plenty of risks out there that people need to be mindful of.

Okay, let's talk about some of those risks that can come in particular with the warmer weather.

Yeah, I mean, we've all felt the warm weather and we've also seen felt and experienced those Canadian wildfires in that air quality.

And actually, when you put both of them together, we have seen and known that it really can be a detriment to your health.

In fact, for the 24 hours after when both of those events collided together, there was a 42% increase risk of heart attack alone, doubling the amount of heart attack deaths, and even 70% of increase of out of hospital cardiac arrests.

So that doesn't mean to scare you.

It just be, you need to be mindful of these risks, mindful of the risk.

People that were all at some element of risk and the people that are highest risk are the people that have chronic diseases elderly and the most vulnerable populations.

I want to take this kind of in chunks because we know that warmer weather comes with higher higher humidity.

We're going to talk about that in a minute, but I want to focus really on this wildfires issue because as we've seen, warmer weather unfortunately is correlating with more wildfires and many of us, even if we're not near the fire, are getting the impact of it and all that smoke.

So help us understand those increased risks that you just talked about.

Why?

What is actually happening in our bodies?

Yeah, well, from the wildfire standpoint, from poor air quality, you know, we typically either smell it or feel it in your lungs after you take a big deep breath, but what's happening on the inside is actually much more profound.

Believe it or not, the fine particulate that you inhale can sometimes not get filtered by your lungs and go into your bloodstream.

And those things are seen as far and objects, foreign objects, bring inflammation throughout your blood and can cause an increased risk of clotting.

So that is how the bear, the bad air quality affects the risk of heart attack.

When you put profound, extreme heat on top of that, you are really dealing with a double edge sort.

So heat in of itself is putting a strain on the heart.

Even if you're 12 years old, the difference is when you're 12, you can compensate and have a tremendous amount of reserve.

But when you're 82 with not perfect lungs, not a perfect heart and a lot of risks, you are definitely putting yourself in harm's way without really being mindful of even that it's happening.

Again, it's not to scare people, it's just to be knowledgeable.

And when all of these things actually do really occur at the same time, very poor air quality, very elevated temperatures, the American Heart Association and people like myself actually advise people to not do significant exercise because the benefits are just not there in the world.

And I just have to ask a someone who loves my outdoor summer walks and just found myself stuck inside, I jumped on the peloton instead.

But is it a bad idea to even be exercising inside?

How much of that particular matter is coming inside the house?

Yeah, the answer is really not.

I mean, your home and your air conditioning unit essentially is one of the best filters you have and you're not really going to get exposed to the point where you're putting yourself at risk.

So we want everybody to move, we want everybody to get exercise, we just want to be mindful of the risks and when it is extreme, just be careful.

Okay, so you told us a couple things we want to get to.

We're going to talk about humanity.

We won't forget that.

But you said that heat itself can have an impact on the heart, even for 12 year olds.

How?

Why?

Yeah, what's happening inside without getting too granular is the heart is actually working harder during extreme heat, heat conditions.

So that is the new baseline when it's 102 degrees.

And the humidity index is very elevated.

So you're starting at a baseline that the threshold to overcome concern or harm is actually you're just much closer to that threshold.

So it is putting some element of baseline strain on the heart.

And again, most of the time we really have nothing to worry about.

But when all the moons align with your baseline risks, it just should not be minimized that that may be a time to either take a gentle walk.

When, by the way, it's early in the morning, late at night, the temperatures are dropping or just even to do what you did exercise a little bit inside, do some talistetics or just take a day off.

It's just not worth it.

Yeah.

And the humidity piece.

What are the concerns there?

Yeah, same kind of discussion.

You know, all of these are element of risks when you put them all together.

That's where we get into trouble.

Humidity of itself, it just has to do with air quality and humidity and just your ability to really, you know, gas exchange.

But all of these things put put taking in totality is the biggest concern.

You know, it's self-humidity alone won't really do tremendous amounts to you.

But again, just be mindful of all of these things colliding together.

And we all need to look out for each other, right?

The grandchildren need to look out for the parents and the grandparents and vice versa.

You know, it's it is really bi-directional.

Okay, so we really do want to be able to optimize these summer months.

What should we be doing for the eight to nine months out of the year before it's really warm and we want to be outside to make sure that we have good hard health?

Yeah, well, I tell everybody hydrate like it's your business and hydrate before you get thirsty, you know, thirst lags behind dehydration.

So really stay hydrated.

And that is a very challenging thing for people to do in and of itself.

It's also really hard to know like, what does that really mean?

What does that mean to me?

That may be something different to me than a 92 year old who's a hundred pounds.

The answer is what's the need?

What's the expenditure?

And the short answer, while not perfect, is you need to hydrate enough that you're going to the bathroom relatively frequently and it's relatively clear.

That's sort of the cheap man woman's version of knowing how hydrated you are.

And then in terms of physical activity.

Yeah, the answer is, is you really almost can't do too much moderate physical activity.

What I would hope that we learned from 50 plus years of data that approximately 150 minutes of moderate exercise a week would essentially save billion dollars of billions of dollars in healthcare expenditures annually and save countless lives and decrease the risk of heart attack, stroke, diabetes.

So it's really get up and go get out and move.

The more you can do the better, as long as you're hurting your body and being mindful of your orthopedic ailments.

Okay, really quickly just a minute left.

I know that there are different signs of risk of heart attack for men and women.

What should men look out for?

What should women look out for that maybe something's wrong?

Yeah, that could take an hour, but in a minute or less, the answer is we all need to be mindful that this is the number one killer in the Western world.

This is not an old man's disease.

Listen to your body, listen to your physician, know your numbers, right?

Lower your blood pressure, your cholesterol.

Know that most days you've got to move, treat, sleep, and stress like it's own cardiac risk factors, not just a little extra thing of the side, and just know that there are countless things you can do to prevent this disease from happening to you, and you really don't want to be a statistic.

You want to be proactive and prevent this disease from ever happening.

And again, with you put all your efforts together, there's a you could modify your risks by 80 to 90%.

It's just not easy to do, and you need to do much better efforts in actually tackling this disease.

And to know your numbers, you got to see a doctor.

Dr.

Brett C. Love, chair of car cardiology at Jersey Shore University Medical Center, part of Hackensack, Meridian Health.

Thank you so much for the advice today.

Appreciate it.

Thanks for having me.

About one third of Americans don't get the recommended seven hours of sleep a night, according to the CDC.

And for many, the struggle isn't just getting to bed on time.

It's sleeping well.

So how do you know when poor sleep is just a rough stretch or when it's something that needs medical attention?

I recently spoke with Dr.

Carol Ash, a pulmonologist at the DeBora Heart and Lonsend Center about these issues.

Dr.

Ash, thanks for talking to us today.

Let's be honest, many of us, maybe most of us don't get the right amount of sleep.

Can you just tell us what is the right number of hours that a person should get in a night?

Well, Joy, this is such a great topic because sleep is so critical for well-being and health and most of us need, it's a range seven to nine, but most of us shouldn't be getting less than seven hours of sleep.

And unfortunately, for many of us, there's so many demands, you know, people who have non-traditional work schedules that interfere with our ability to get the hours we need, and also not just the amount in the hours, it's the timing of sleep that is critical as well.

That timing, I want to understand that better.

I've heard, you know, this reference to the shift worker, and I know there's some new data around, and research around the shift hour workers, which is really focused on when you're sleeping.

So let's start there.

What is a shift worker, and what kind of defines those hours of sleep?

Well, traditionally, Joanna, we're meant to be awake during the day and sleep at night.

So typically anybody who is up working at night and anyone who's getting up at 4 a.m.

in the morning is technically considered a shift worker.

And that schedule, you know, I was in healthcare for many years, and that's what we did, right?

Like first responders, the military, everyone in healthcare, and lots of other individuals who that's normal for them.

But study show, it's not what we're designed to do.

So when you open your eyes in the morning and expose yourself to light, that sets a clock in your brain that sets everything in your physiology, the rhythms that are necessary to make sure that you're fully awake during the day and able to fall asleep and get restful sleep at night.

And even your meal time, your body needs to know where it is in 24 hour day.

And when they're not aligned.

So if you're a shift worker and you're eating meals at 3 o'clock in the morning, which is what typically most people will do.

That's a problem as well.

So, you know, we're starting to understand the amount at the time.

So critical for our health.

Okay, what about folks who are shift workers or who do struggle to sleep?

Can you make up sleep at other times during the week or during the day?

How does that work?

Well, you know, there's no way around that there's going to be people that are working those night shifts.

But what you want to do is is when you can make sure you're practicing good sleep habits.

So you want to resume sleep.

Observe that sleep time.

Make sure when you get off work, you go right home.

It's common for a lot of people to try and say, "Let me get a few errands in before I get home and get to bed."

It's really not what you want to be doing.

So the best you can to re-duplicate, you know, what a traditional day would be like is in your best interest.

And then you want to encourage, you know, friends and family not to interrupt that sleep time, really guard that as best you can.

And when you are heading off to work, you don't want to be heading off to work with sleep debt, right?

It's very difficult for people that are shift workers sometimes to get that full amount of sleep and keep a regular schedule.

And there's lots of tactics to really help shift workers.

And employees are now getting smarter on how they can help employees such as things like nap rooms, right?

And recognizing that sometimes it is necessary for shift workers to take a nap at night while they're at work.

Okay.

So further, the rest of us who are not shift workers or who don't struggle to sleep at certain times, how important is a consistent sleep schedule from night to night?

Like, what if I have a long weekend or what if somebody you know is traveling and their sleep is disrupted?

What's your advice in terms of how consistent sleep should be?

Consistency is probably the most important critical ingredient for getting a good quality sleep and your well-being.

So what I tell patients, if they're going to do anything, try to get up the same time every single day.

Because awakening in the morning and exposing yourself to light at the same time every day is what sets that internal clock in those rhythms.

And we might not think that what we did a week ago, or several nights earlier is really impacting your health, but it can.

So I'll say to my patients and family and friends, get up the same time every day, even on the weekends.

Don't sleep in more than an hour.

Because if you do, you're going to reset that clock in your brain.

And you're essentially causing a form of social jet lag.

And so on the weekends, you're better off if you've created sleep debt to take a nap.

No more than 20 or 40 minutes, but that can offset any sleep that you may have created.

And you know, there's a lot of demands on us.

So it's never going to be perfect.

So you'll have a few bad nights.

It's okay.

Just get back on track.

Yeah, that's good advice.

I have to give a shout out because I just love this routine.

But if you've ever seen Joe Koi and his whole routine on sweep apnea and his near death experience, I really think he brought this into the conversation, head of the general conversation about those who do struggle with sleep apnea.

How do you know if you have sleep apnea or if you're struggling during your sleep, some folks can't monitor that on their own.

Well, if everything is working well, you would be getting up the same time every single morning, even without an alarm clock and feeling awake and refreshed and ready to take on the day.

And your brain knows what to do.

So if you keep that consistent schedule, there's one thing that will help you drift off to sleep when you're supposed to.

So I'll say on my patience, you know, if you need eight hours of sleep, which is what most of us need, and let's say you get up at eight o'clock in the morning, then hormones will help you transition.

You'll start to feel sleepy at 11 o'clock at night.

But if you're finding it's taking more than 30 minutes to fall asleep or if you're continually waking up at that night or waking up very early in the morning, you want to consider that maybe you're one of those 70 million Americans with a sleep.

Sleep Disorder, there's there's 80 different sleep disorders.

For people have sleep at me, what they typically will experience is they may find that their sleep is fragmented.

They may be getting up at night to get to go to the bathroom.

Believe it or not, sleep at me will strain the heart in an effort to protect itself.

It will cause you to release a hormones.

So you'll frequently get up at night to go to the bathroom.

You may be experiencing acid reflux or just waking up feeling short of breath.

And if you're tired during the day, that's another sign that something's wrong with your sleep, especially if you're getting the amount of sleep that you need at night and despite that, you're still waking up feeling exhausted.

So most congested they they go just a little bit of time left.

I want to ask you how much do you think folks should rely on a sweep tracker versus going to the doctor.

Well, sleep tracker is great to reinforce good habits.

There's plenty of them out.

And really that's where it starts that with good habits, but sleep trackers cannot make a diagnosis.

So if you have sleep apnea or if you have maybe one of those other 80 sleep disorders, you really do need to reach out to a health care professional and get a diagnosis.

There's things that can be done.

There's all kinds of therapies or CPAP for sleep apnea and now the new weight loss drugs just really revolutionizing sleep and helping people to get the rest they need.

All right, great advice for us.

Dr.

Carol Ash, pulmonologist at the at the DeBora Heart and Lung Center and of course should just shout out that your patients do not pay for their treatment there.

All of that is provided to them.

But thank you so much.

Appreciate your time today.

Thank you Joanna.

You may know them as ozampic or wagovie, but we lost drugs that fall into the GLP one category are growing in popularity.

GLP one stands for Glucogen like peptide one and it's a hormone that regulates appetite and blood sugar.

But there's still a lot of questions about how they work, who should take them and what side effects they may have.

Lucky for us we have a doctor to call on to answer those questions.

I recently spoke with Dr.

Kierthanaakis of Arapu who's the director of the Center for Metabolic Health and Weight Management at the RWJ School of Medicine at Rutgers University.

Dr.

it's so great to have you with us.

I want to better understand how does a GLP one work in the body.

Can you just break that down for us a little bit?

Yeah, no, that's a great question.

So the first GLP that's been approved is semically tied.

It's glucagon-like peptide-1 receptor agonis.

So it's essentially a molecule that goes and binds at the GLP one receptor and then causes all of these downstream effects.

Notably it's impact on appetite, it's impact on inflammation, it's impact on weight loss, all of these things and slowing down the way food moves through GI tract.

All of those things are impacting weight, and metabolic risk in such a positive way.

You say it's positive, I know there are some concerns about side effects, although overwhelmingly they are becoming more popular and more and more medical professionals are recommending them.

I do want to understand who is the best candidate, if we're talking about swelling down digestion, if we're talking about slowing down appetite.

Yeah, so I always like to think of, you know, when we think about medications, we have to follow guidelines and FDA-based indications.

So right now, it is a, it's preferred therapy in certain populations, populations with patients with type two diabetes, right?

These agents are first line alongside other agents, especially in those patients who have our high risk for cardiovascular disease.

They're also approved for sleep apnea, fatty liver, specifically those with scar tissue from the fat and the liver.

And then anyone who's had a cardiac event, someone has had a heart attack or stroke to decrease the risk of these redeveloping.

And so there are certain populations where this medication can be super helpful and the benefits definitely outweigh any of the risks.

Now that's not to say that there aren't certain patients that we should be very cautious in, right?

Anybody who has a family or personal history of medulary thyroid cancer or this disease called multiple endocrinomyoplasia type 2.

Anyone who's trying to get pregnant is pregnant or breastfeeding.

We want to be very cautious with these medications.

They're contraindicated in those missions.

Let me ask you this.

We have heard some of the side effects in some cases, those bowel blockage.

In other cases, we've seen something called ozemic face where you get sagging skin and sagging muscles, muscle loss.

I know is another one.

At what point does the benefit outweigh the risk?

And is there any mitigating factor to how to minimize some of those risks?

Yes, and I think it's really important to note that it's like any medicine, right?

There's risks and benefits.

There's always side effects of any medications.

And so not any different.

The biggest side effects are all GI, nausea, vomiting, diarrhea, constipation.

About 40 to 70% of patients will have those side effects.

That's a lot of patients will develop that.

But most patients have very transient or short lasting symptoms that typically their body gets used to over time and they shouldn't have an issue.

However, I will say that's it's really important they see a physician who's trained in administering these medications so that we can prevent these side effects from happening and then control them if they do.

And the same thing with those epic phase, right?

This muscle mass loss, this idea that anytime you lose weight, whether that's through diet and exercise, through these medications or surgery, 25% of that weight loss is from muscle.

I mean, only way to prevent fats or slow that down is to be sure that someone is eating appropriately and moving appropriately.

So you need some of that muscle.

So what does that look like?

So what does that eating appropriately look like?

Just kind of quickly, where can you laundry list?

Yeah, absolutely.

So, you know, just a over general, we say in terms of protein, you want to be consuming at least one gram per kilogram, at least.

And it's hard for a lot of people to do even that.

And then we want to talk about fiber, right?

So that we're allowing good gut motility.

That's 25 grams a day at least.

And then we want to be sure that people are doing resistance training.

This idea that they're working their muscles.

And then they're also consuming the proteins that together, they're going to build more muscle in their body.

Yeah.

And that's something we can.

Interesting.

Let me let me jump in here.

An interesting positive side effect that we've we've been reading about is this impact potentially on people who struggle with addiction.

And that these medications can actually reduce or even perhaps eliminate addiction.

What is the science behind that is that evidence based yet?

So there are a lot of ongoing studies about the role of these medications and patients with alcohol abuse, history, and we are seeing very positive results in the preliminary data.

Now the science is still being understood.

We think that there's probably a role in the dopamine receptors in the brain that affect the reward pathways.

It's similar to how someone, you know, was having those pathways activated by food was having those pathways activated by a particular substance.

So it might be impacting both of those, but I think it's still we're still waiting on more data about the science behind it all.

I have also seen that some folks are micro dosing this that they're taking very small doses and maybe it's someone who's not struggling with obesity, but just wants to lose a little bit of weight.

Is that advisable?

Are medical professionals overseeing that type of treatment?

So it is not FDA approved.

And so right now most physicians aren't recommending it.

However, you know, we all know the other patients that come to see me that are doing this.

Yes, and I'll tell them the same guidelines as that we don't have data on what happens if someone who doesn't have an elevated BMI or all of these metabolic conditions, what that does to the body.

We don't know.

And so there is a risk that you are running that you may develop long-term side effects to these medications that we just don't know yet.

Now there are patients who can't tolerate full dose.

And so sometimes they take a lower dose for a longer period of time.

So that's something that we will recommend.

But typically microdosing at this time most providers are not routinely recommending it.

Right, still obviously a lot more to learn and study as this medication becomes more widespread.

But thanks so much for shutting some light on it for us.

Dr.

Kierthana case of a rapu with the RWJ School of Medicine at Rutgers University.

Thank you.

Thank you for having me.

That's going to do it for us.

I'm Joanna Gaggis for the entire team here at MJ Spotlight News.

Thanks for being with us.

We'll see you next time.

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