Health, Fitness,Dite plan, health tips,athletic club,crunch fitness,fitness studio,lose weight,fitness world,mens health,aerobic,personal trainer,lifetime fitness,nutrition,workout,fitness first,weight loss,how to lose weight,exercise,24 hour fitness,

12/01/19
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16:22 ,
A new home urine test for prostate cancer could revolutionize diagnosis -- according to new research. As well as diagnosing aggressive prostate cancer, the test predicts whether patients will require treatment up to five years earlier than standard clinical methods. It also means that men don't have to come into the clinic to provide a urine sample -- or have to undergo an uncomfortable rectal examination.

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16:22 ,
Some men with advanced prostate cancer who have exhausted all other treatment options could live for two years or more on immunotherapy, a major clinical trial has shown. Researchers found that a small proportion of men were 'super responders' and were alive and well even after the trial had ended despite having had a very poor prognosis before treatment.

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16:22 ,
A study in fruit flies has identified serotonin as a chemical that triggers the body's startle response, the automatic deer-in-the-headlights reflex that freezes the body momentarily in response to a potential threat. Today's study reveals that when a fly experiences an unexpected change to its surroundings, such as a sudden vibration, release of serotonin helps to literally -- and temporarily -- stop the fly in its tracks.

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10:32 ,
White blood cells, which release a toxic potion of proteins to kill cancerous and virus-infected cells, are protected from any harm by the physical properties of their cell envelopes, find scientists. Until now, it has been a mystery to scientists how these white blood cells -- called cytotoxic lymphocytes -- avoid being killed by their own actions and the discovery could help explain why some tumors are more resistant than others to recently developed cancer immunotherapies.

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10:32 ,
A new study found there were more than 67,300 calls to US Poison Control Centers regarding exposures to natural psychoactive substances. The study looked at calls from January 2000 through December 2017, which totaled an average of 3,743 exposures each year, or approximately 10 calls every day.

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10:17 ,
Computer scientists have developed two algorithms that will improve earthquake monitoring and help farmers protect their crops from dangerous insects, or monitor the health of chickens and other animals. The algorithms spot patterns in enormous datasets quickly, with less computing power and lower cost, than other methods and have been used to improve earthquake detection, monitor the insect vector Asian citrus psyllid, and evaluate the feeding behavior of chickens.

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10:17 ,
Researchers have developed a novel diagnostic method for the rapid on-site measurement of antibodies from patient samples. Now they have applied this new method for the diagnostics of celiac disease, with promising results. These results may prompt the development of similar tests for the diagnostics of other autoimmune disorders.

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10:17 ,
People with visual impairments use social media like everyone else, often with the help of screen reader software. But that technology falls short when it encounters memes, which don't include alternate text, or alt text, to describe what's depicted in the image. To counter this, researchers at Carnegie Mellon University have developed a method to automatically identify memes and apply prewritten templates to add descriptive alt text, making them intelligible via existing assistive technologies.

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10:17 ,
Portland State University Chemistry Professor Rob Strongin led a research team to study what happens when additives are put into vaping products. Specifically, they studied the chemical reaction that takes place when cannabis is consumed using a vape pen or dab rig. 'What's inhaled is actually different than what's listed in the ingredients,' Strongin said.

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09:52 ,
Researchers used quantitative pupillometry to detect pupillary changes in high-school athletes after they sustained a high-acceleration head impact. These pupillary changes, indicative of changes in brain function, were evident even when the athletes had no discernible symptoms.

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07:47 ,
Little is known about the origins of manikins -- small anatomical sculptures thought to be used by doctors four centuries ago -- but now advanced imaging techniques have offered a revealing glimpse inside these captivating ivory dolls. Researchers using micro-CT successfully identified the material composition and components of several ancient ivory manikins, according to a new study.

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07:47 ,
Scientists have determined that La Crosse virus (LACV), which can cause inflammation of the brain in children, affects brain cells differently depending on their developmental stage. A new study shows that uncommitted neural stems cells generally survive LACV infection, while LACV often kills neurons. The study also shows that neurons infected by LACV can be rescued by interferon, a powerful antiviral protein.

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00:16 , ,

In this interview, Dr. Ed Le Cara, a chiropractor with a Ph.D. in sports medicine, shares his knowledge about blood flow restriction (BFR) training — a form of training that I believe is one of the greatest innovations in the last century. He’s also a certified athletic trainer and a strength and conditioning coach and one of the leading educators on BFR in the US.

“I combine all those backgrounds into the treatment plan and approach that I use with my patients,” Le Cara says. “One of the frustrations I’ve had — I’ve been in practice for about 20 years — was that very often patients would see me while they’re in pain, and once the pain is gone, give up on their previous exercise regimen.

But with my understanding of exercise and exercise physiology, I knew that once they were out of pain, they still had not gotten their body to the capacity they needed in order to meet the demands their sport or their life was imposing on them. Otherwise, they wouldn’t have gotten injured in the first place.

A lot of times it’s because they run out of insurance visits and that only got us through the point of where they’re decreasing in pain. Or they think that once they’re out of pain their injury is healed.

It was very frustrating for me to see people consistently injure themselves over and over again, and I wasn’t given enough time to really, truly increase their body’s capacity for the demand of sport, life or whatever they’re applying on it that was causing injury.

Then in about 2012, a good friend of mine, who at the time was the director of sports medicine at FC Dallas, said, ‘Hey. You’ve got to really check out this thing called BFR training.’ I had never heard of it … I looked at these different databases that I had access to.

I was overwhelmed with how much research was already out there. My previous experience with different types of modalities that I use in the clinic or different exercise appliances, there was not a lot of literature. Or we had to try to apply literature that was already existing towards what we were trying to do …

This was totally the opposite. Over 650 studies at the time had been done. It had been utilized for years, [it was] validated and reliable … It was almost too good to be true. To get strength or hypertrophy in four to six weeks was like, ‘There’s no way.’ Physiologically that was impossible. And to not be causing muscle damage associated with that? I was a very big skeptic to say the least when I started.”

What Is BFR?

BFR involves exercising your muscles while partially restricting arterial inflow and fully restricting venous outflow in either both proximal arms or legs.1 Venous flow restriction is achieved by using bands on the extremity being exercised.

By restricting the venous blood flow, you create a relatively hypoxic (low oxygen) environment in the exercising muscle, which in turn triggers a number of physiological benefits, including the production of hormones such as growth hormone and IGF-1, commonly referred to as “the fitness hormones.”2

It also increases vascular endothelial growth factor (VEGF), which acts as “fertilizer” for growing more blood vessels and improving their lining (endothelium). BFR, originally known as KAATSU training, was developed over 50 years ago by Dr. Yoshiaki Sato. Now 73 years old, Sato is still in excellent shape and a true testament to the value of this approach.

Between 1996 and 2015, Sato, along with exercise physiologist Naokata Ishii and Dr. Toshiaki Nakajima, a renowned cardiologist at the University of Tokyo Hospital, performed a variety of groundbreaking research, proving the benefits of KAATSU.

Much research on BFR has also been done in the U.S. in recent years, but it didn’t really catch on until 2010, when Steven Munatones from the KAATSU Global Company was granted permission by Sato to bring the technology to the U.S.

BFR — Low-Intensity Exercise With High-Intensity Rewards

BFR provides many benefits through a variety of mechanisms. As noted by Le Cara, you’re essentially tricking your brain and body into thinking that it’s doing high-intensity exercise, yet you’re doing low-intensity exercise. He explains:

“High-intensity resistance training is defined as somewhere between 65% and 90% of someone’s one rep max (1RM), depending on what resource you’re looking at. Low-intensity exercise is around 20% to 35% of your 1RM.

If you look, you can even see behind me some of the modalities that I use in my clinic. I’m using resistance tubing and resistance bands. I’m using dumbbells no heavier than about 20 pounds. I’m able to take these light weights, apply something to occlude the blood flow and allow patients’ bodies to think that they’re doing very high-intensity exercise when they’re not.

The advantage to this is that I don’t cause any damage to the tissue if I do it appropriately, whereas normal exercise and training at high intensity does. These patients cannot tolerate more damage to their tissue because they’re already injured.

We use the same exercises that we do in rehab, very light load, but we’re able to mimic high-intensity exercise, which, outside of the physiology that occurs, is really the game-changer. That’s what allows us to see quick adaptations.”

In the video, Le Cara demonstrates the basics of how the BFR cuff works.

“I have this cuff and I place it on my limb. Now, I inflate this cuff … to a certain percentage of what’s called my limb occlusion pressure (LOP). I’m reducing the amount of arterial flow into this arm, but I’m totally restricting any venous return.

What happens is that fluid that should be returning to my heart under normal circumstances is not. That means there is extra fluid hanging out down here that never gets back to my heart that can’t be involved in cardiac output. Cardiac output is the amount of blood that’s being pumped to the body.

The other part of that equation is the heartrate. Heartrate times stroke volume is equal to cardiac output. And so, if I reduce the stroke volume, my heartrate has to jump up in order to keep the same amount of blood flow going out to the working muscles.

That’s where, really, physiologically, we see the stress induced on the aerobic capacity system, and why these exercises raise your heartrate so rapidly and give you this sense of having to work very, very hard to do very light loads.”

Aerobic Improvements With BFR

Aside from helping you grow bigger muscles, BFR training also improves your aerobic capacity and cardiovascular endurance. One of the simplest ways of using BFR is to simply walk with the cuffs high on your thigh for 15 to 20 minutes. According to Le Cara, you can improve your aerobic capacity in as little as four or five weeks doing this.

“I had a patient who had experienced stroke. He could walk about four or five minutes at a time without feeling like he was going to fall, and had fallen a few times. Of course, we know that when we have this increased risk of falling, we have increased risk of fracture and further problems down the line.

He was asking for a way to be able to do two things: He wanted to be able to go quail hunting with his buddies … [and] he wanted to be able to take the dog out for a walk with his wife. That’s what he did every night of his life until this happened. It was really having a negative effect on him psychologically.”

Le Cara had the man walk on a treadmill with the cuffs on his legs for one minute holding on to the handles, and one minute unsupported. Over the course of four or five weeks, he was able to build up to where he could walk for 20 to 25 minutes without feeling like he was going to fall.

“That’s just one of many examples. But that was very profound because he was so limited in what he could do. He really needed something to help him translate from the rehab setting to life,” Le Cara says.

“When I put the cuffs around both legs and go for this walk, not only do I improve aerobic capacity, but [researchers] have also seen increased … hypertrophy of the thigh.

They’ve also seen increase in strength at the knee … If you can increase your strength with just walking for 15 minutes a couple times a week, then that’s also going to translate into a decrease in fall risk.

Things that have been measured, like the ‘sit to stand’ test, ‘timed up and go’ test … also improve. We’re seeing increases in strength and aerobic capacity at the same time with a very simple exercise like walking, which normally does not cause positive adaptation.”

BFR Improves Bone Density

Interestingly, BFR also improves bone density, thereby lowering your risk for osteoporosis. As explained by Le Cara, who is familiar with the medical literature on this, BFR improves osteoblast formation, or the formation of bone. It also helps prevent further degradation of bone density.

“There are many pathways associated with it, including capillarization and VEGF. But the primary thing I think helps the most is that when we inflate the cuff and we’ve got the swelling in to the limb, because the swelling is all around in all the tissue, you’ve got the bones surrounded, 360 degrees all around, [and] that creates a stress on the bone.

When we stress the bone, now the body has to respond by stimulating bone growth. So, I think Wolff’s Law comes into effect through that mechanism, in addition to the physiological adaptations that are occurring … It appears that hypoxia, or the decrease in oxygenation, also stimulates [bone growth].

There’s a stimulation of the vascular endothelial growth factor (VEGF) that occurs; numerous cascades that are happening. There’s something magical about creating an environment where there’s not enough oxygen and the body has to adapt due to that.”

Indeed, that “magic” was recently elucidated further with the award of the 2019 Nobel Prize in Physiology or Medicine3 for the discovery of how cells sense and adapt to the availability of oxygen, which involves responses in VEGF, hypoxia-inducible factor 1-alpha (HIF1A) and erythropoietin. In essence, by creating a hypoxic (low oxygen) environment, your body thinks you’re doing high-intensity exercise, and responds accordingly.

Wide Rigid Cuffs Versus KAATSU

While KAATSU specifies the use of narrow elastic occlusion bands, Le Cara has developed his own take on the technique using rigid, nonflexible wider bands, which is actually listed as a Class 1 medical device (blood occlusion device) in the U.S. He explains why he decided to veer from Sato’s already established parameters:

“When I’m experimenting with different modalities and I’m unsure of them, my first tendency is to go to the literature. What is the literature suggesting? What has been studied? What hasn’t been studied? When I went there, there was really a hodgepodge of different types of modalities being used to occlude blood flow.

Nothing was sticking out to me … There really wasn’t a resource … except for very expensive modalities [and], frankly, until I’m confident that something works, I am hesitant to spend the money.”

This is understandable, considering the original KAATSU equipment was rather large and had a price tag around $16,000. (However, as of October 2019 they have a unit that sells for only $8004 and is the one I personally use every day and endorse. Unfortunately, Le Cara has never worked with the KAATSU system, but has used numerous elastic and thinner bands.

“What I first did was based on the recommendation of my buddy who … had mentioned a certain type of band, and so I ordered those and started using them. What I first noticed was that exercise didn’t seem to be that hard. I was actually using the cuffs on all four limbs. It still wasn’t that hard …

When we have these cuffs [on] … it creates these little spaces in the cuff, and then the accumulation of metabolites distal to the cuff or closer to my hand can still escape. It wasn’t truly occluding arterial flow, so it wasn’t creating a hypoxic environment.

Now, my veins were sticking out like crazy. What we know is that because the veins are closer to the surface or more superficial, they’re much easier to occlude. The deeper pressure is what’s needed in order to get to the arterial flow to really create that hypoxic environment that we have already said is very beneficial.

Some of the other literature that came out [showed] that if we use a very narrow band, less than 5 centimeters, then it requires much higher pressures in order to occlude the arterial flow.

I wanted to use something that was wider so I didn’t need so much pressure, especially if I was going to use this with my compromised patients or people who maybe had … contraindications.

I wanted something that was as safe as possible. So, we developed something that was wider, that had that full diaphragm — the bladder that gets inflated with air …

When you have the little segmented bladder, when you inflate it, you really can’t find true LOP. I was never able to quantify with my patients what a safe and effective pressure was. We were using something called ‘arbitrary pressures or guessing what pressures we needed to use. With my patients’ safety, I don’t guess.

Realistically, I was what I like to call ‘undercooking’ people, not using enough pressure to occlude. I wasn’t getting the benefit I really wanted to see. We needed something wider.

We needed something that had that full diaphragm or bladder that could be inflated and that I could measure LOP using a Doppler to know exactly what each individual’s LOP was … [even] in different positions, like standing, sitting or lying down, depending on what position of exercise I was putting somebody in.”

The Case for Wide, Rigid Cuffs

So, to summarize, the reason Le Cara recommends using a wider rigid inflatable cuff instead of a narrower, flexible inflatable cuff, is because it traps and accumulates metabolites more effectively at lower pressures, thus reducing risk to damage beneath the cuff.

When using a flexible cuff, the muscle contraction will force the blood to return back to your heart. Even though the return flow is initially restricted, it doesn’t remain restricted once you do the contraction.

However, there are three concerns when using wide rigid cuff systems. The first is that wider cuffs will tend to limit movement during exercise. The second is that there appears to be an attenuated response to BFR benefits to the muscle and tissues under the cuff.5

Finally, although BFR improves hypertension in the long-term, there is a greater risk of eliciting an acute hypertensive response, especially in those who already have hypertension or the elderly that already have compromised vascular resilience.6 For these reasons it is likely wiser to choose narrow elastic bands like the KAATSU in these populations.

As with the KAATSU system, you would place the wide cuff proximal to the bicep, distal to the deltoid. With the wider band, the correct placement is essentially as close as you can to the armpit, right below the deltoid tubercle (the insertion point of the deltoid). On your leg, the cuff would go right below the greater trochanter; in other words, as high up on the leg, near your groin, as you can.

BFR Provides Full Body Benefits

Interestingly, BFR doesn’t just benefit the limb being occluded. The chemical cascade that occurs as a result of the restricted blood flow provides body-wide benefits. Benefits occur both distal and proximal to the cuff, i.e., on both sides. You also get crossover effects, so while you might be working your right shoulder, your left will also benefit.

“We use this in rehab a lot when [one] shoulder has been immobilized,” Le Cara says. “I have a patient who I’ll go see as a home visit tonight. She just had surgery last week … She’s not moving this arm.

But I can do things over here that’ll get the crossover effect. I can do things with her legs. She can walk with the cuffs on … She can do things for other extremities to try to maintain her muscle mass and maintain that capacity as an entity …

Within 10 days of disuse, we can lose about 30% of our muscle mass … We start losing aerobic capacity at about Day 7 and we start losing strength and size right around that Day 10. So, if I tell somebody to take four or six weeks off, they’re way in a hole.”

Risk Factors and Contraindications

BFR is a fitness modality that really everyone can benefit from. The elderly, especially, need to consider it, as it’s one of the most effective ways to prevent sarcopenia or age-related muscle loss. Once you lose muscle mass, your risk of developing complications from everyday activities skyrockets.

Again, one of the reasons why BFR is so well-suited for the elderly is because you use such light weights. You don’t even need to use any. According to Le Cara, research has shown it takes three sessions of BFR for your body to start adapting.

In Le Cara’s clinic, the first visit typically involves establishing the patient’s LOP bilaterally while sitting, lying and standing, and taking down a thorough medical history to make sure there are no contraindications.

While very safe when done properly, there are risks when using a rigid cuff system like the Smart Cuff System, the two primary ones being a hypertensive crisis that could contribute to a stroke or heart attack, and blood clots, which could be lethal. Factors that place you at increased risk include:

1. Recent blood stasis — Situations in which you’ve had blood occluded, such as during surgery. Most people who have just had surgery in the orthopedic setting are at a slight increased risk for clotting.

Another situation that can raise your risk is after long travel. If you’ve sat on a plane for a day, it’s best to wait a few days to normalize, as blood stasis and pooling can put you at increased risk for a blood clot. Being bedridden for a period of time is another scenario that would apply here.

2. Blood vessel damage — A crush injury on a limb would be a risk factor, for example, or a venous graft. Poor circulation can also increase risk, necessitating lighter pressure to start.

3. Cardiovascular risk factors — If you have heart problems, has your physician cleared you for high-intensity exercise? “If they’re cleared for high-intensity exercise, cardiovascularly, they are cleared for BFR,” Le Cara says.

For patients with high blood pressure, he recommends keeping exercises to nonweight-bearing, single-joint exercises. “If I do a squat with somebody, like an air squat, compared to somebody doing a long-arch quad exercise or a quad extension off the edge of a table, there’s going to be a big difference in what cardiovascular stress is occurring. I will keep that in mind when I’m dosing or choosing which exercises to do,” he says.

Next, Le Cara will evaluate the tourniquet risk itself, to determine whether there’s any risk involved with the occlusion apparatus that might damage a blood vessel. Examples might include bunching of clothing underneath the cuff, or the cuff width being too narrow, requiring higher pressure.

“I’m really concerned mostly about people who are showing signs of poor circulation,” he says. “In those cases, I would keep the number of exercises lower, like maybe one or two to start and see how they tolerate them. I’ll also make sure that I’m only using the amount of pressure necessary for the occlusion required that is both safe and effective.”

The Benefits of Cellular Swelling

Oftentimes, Le Cara will perform a cellular swelling protocol on the first visit, which is where the cuffs are inflated to a point where arterial flow is slowed to a trickle with no venous return. In this case, there’s no exercise involved. This creates extracellular swelling, which pushes fluid into the muscle cell.

Your body basically translates the cellular swelling as a signal that the cells are about to die, so a signal is sent to regenerate the cells through protein synthesis. “It’s a way to get people ready for the exercise or future exercise dosages,” he says, “yet, I’m still seeing benefit with that.”

The second visit typically involves performing one or two single isolated exercises. So, if you’re rehabbing a bicep, you might start by doing four sets of a bicep curl, the first set being 30 repetitions and the second, third and fourth sets being 15 reps each, with 30 seconds of rest in between, using a weight that is about 20% of your one-rep max.

The speed at which you raise and lower the weight should be quite slow. Le Cara recommends two seconds up and two seconds down. This will help create metabolite accumulation in the muscle and an acidic environment that triggers the recruitment of more motor units. The slow pace is also what creates muscle fatigue.

“We know when we take exercise to failure, there is more damage to the tissue. I want to get the tissue tired. I want to create metabolite accumulation. I want to recruit Type 2 muscle fibers. But I don’t want to cause more damage, especially in the rehab setting, because that tissue is already damaged. I don’t want to cause more damage.

After that, I might go to a second exercise. In this case, typically if it was a bicep, I would pretty much bet that most of the muscle fibers are exhausted. They’re fatigued. So, there’s no reason to hit that exercise group again. I would then go to probably a tricep exercise and I would do tricep in that same manner: 30-15-15-15-15, and then deflate.”

Sample Workout Protocol

If you’re injured, you’d certainly be wise to find a BFR trainer like Le Cara to guide you. But for the general public, this is really something you’ll want to learn to do on your own, for life. Le Cara describes what a typical home regimen might look like:

“I never do cuffs on all four limbs simultaneously. The reason is that I think you reduce stroke volume so drastically that you’re going to faint and feel sick. Primarily, I do cuffs on both upper or both lower extremities …

I don’t think you need more than about four, maybe five exercises a day, because by the time you’re done with five exercises, you’re done. You’ve totally fatigued all your motor units; you’re psychologically tired. You don’t need to do more than that.

My personal opinion is that if you can lift 65% (or more) of your 1RM … do it. And use BFR as a supplemental [exercise]. For example, I might feel like my upper body is not as strong as I would like, or my calf is not as big as I would like …

I [would then] do my normal exercise, and two or three times a week, I would do what I call a complementary BFR session — one or two exercises to the area that you want to focus on, but I would do it after you’re already done with your [regular strength training] exercise.

You only need to do it two or three times a week because [that] … has been shown to be as effective for strength and hypertrophy as five time a week … If you can’t lift that type of a load [65% of your 1RM], you should be doing BFR five days a week …

If I’m not doing high-intensity [conventional strength training] exercise, then what I do is alternate. I’ll do upper body one day and lower body another day.

I’ll do aerobic on my lower body days … I walk for 15 [minutes] and then do three or four exercises for my lower extremities, with the thinking that the more dynamic exercises you do, you’re going to get this fatigue factor going …

I’m looking at 45 to 60 minutes of exercise. I’m going to be really tired. I’m going to get an aerobic training effect. I’m going to get an isolated and integrated body approach. I’m going to get a pain reduction. I’m going to get my brain stimulated.”

Building Bulk

Toward the end of the interview, Le Cara also discusses how to optimize your muscle growth once you’re used to the system and are ready to take it to the next level. One key take-home from that section is that the higher the pressure used, the better the results.

This is likely due to the highly hypoxic environment created. That said, as a general rule, you don’t want to exceed 50% LOP in the upper extremity and 80% LOP in the lower. The primary variable that will influence your ability to “bulk up” is the weight used.

Starting at 20% of your 1RM, Le Cara suggests increasing the weight you use by 5% every two weeks, until you get to 35% of your 1RM. As a general rule, your rate of perceived exertion should be around 8 out of 10 after you’ve completed the 75 reps (30+15+15+15). If the exertion feels too light, add more weight. If too hard, lower it.

More Information

Again, one of the biggest benefits of BFR outside of rehab is the prevention of sarcopenia. I’m particularly motivated because both my parents developed sarcopenia and likely passed away sooner than they would have, were it not for their frailty.

You can also review my comprehensive BFR article that goes over additional details not discussed in this interview and additional training videos.

Every assistive care facility needs to provide BFR training. Most have exercise therapists, and they really need to understand and embrace this modality. It’s such a simple way to improve people’s quality of life. Once you lose the ability to stand up from sitting in a chair, it’s a rapid decline to death.

There’s an enormous body of science backing its use. All that’s really needed is for people to learn it. You can find information about Smart Cuffs certification courses on SmartToolsPlus.com.

In 2020, Smart Cuffs will be offering more than 250 live trainings across the world. “I have a really great cadre of instructors who are really passionate about the subject. We are going to be spanning the globe, spreading the word,” Le Cara says.

There’s also an online course for rehab professionals. His personal website, EdLeCara.com is another resource where you can find information on BFR and a listing of live presentations.



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00:16 , ,

Dr. Mercola Interviews the Experts

This article is part of a weekly series in which Dr. Mercola interviews various experts on a variety of health issues. To see more expert interviews, click here.

Hemp has been outlawed in the U.S. since 1938. Thankfully, the latest Farm Bill signed into law at the end of 2018 makes it legal. In this interview, board-certified clinical nutritionist and expert on phytocannabinoids, Carl Germano, discusses the exciting implications of this change.

Now, there's a difference between cannabidiol (CBD) products made from hemp and those made from marijuana. While many mistakenly believe hemp and marijuana are interchangeable, they're actually two different plants.

"Both are considered Cannabis sativa by genus and species, but that's where the similarity ends," Germano explains. "Hemp has been cultivated for many reasons for the past few thousand years — food, clothing, fiber and fuel. The plant itself contains naturally occurring active compounds called phytocannabinoids, of which CBD is just one of them.

Marijuana, on the other hand, has been cultivated for its primary phytocannabinoid, tetrahydrocannabinol (THC). While it has recreational value at small levels, it does have medicinal value.

Nevertheless, many decades ago, hemp got dumped into the definition of marijuana. Hemp was unjustly placed into the Controlled Substances Act (CSA), which kind of hampered its access, its ability to have U.S. farmers grow it, or to have even medical or academic institutions study it.

We've been in the Dark Ages for decades. Thanks to Israel and Europe, who've championed all the research, we've [discovered] the cannabinoid system in the body called the Endocannabinoid System (ECS).

Trump did sign a Farm Bill that finally deregulates hemp. It takes it out of the CSA … It gives the rights of farmers to grow it. It will open up the doors for academic and medical institutions to study it. It will give consumers access to [what is] probably the most important botanical we have on this planet."

Why Whole Hemp May Be Better Than Isolated CBD

The hemp plant contains over 100 different phytocannabinoids, of which CBD is one. And while hemp has now been taken off the CSA, CBD is still under the jurisdiction of the U.S. Food and Drug Administration (FDA), which is responsible for the labeling of supplements and enforcing the Dietary Supplement Health and Education Act (DSHEA).

"With the passage of the Dietary Supplement Health and Education Act (DSHEA), you have several things against CBD. First, CBD was not in commerce prior to 1994, so it could not be grandfathered as a dietary supplement, yet hemp oil has been in commerce prior to 1994, so we're OK there.

Secondly, DSHEA states that if you want to submit a new dietary ingredient application, you can do so and petition the FDA for an ingredient to be classified as a dietary supplement.

Well, if you were to do that today, you would get rejected immediately because the other part of DSHEA states that if Big Pharma takes a natural ingredient and makes a drug that gets approved, it's hands-off to the dietary supplement industry.

GW Pharmaceuticals has two drugs using isolated purified CBD in it. Therefore, we've got several strikes against putting CBD on the front panel, calling it a dietary supplement, and I say, why bother? Because the story is much bigger than CBD, both clinically, scientifically and legally."

Hemp oil is a food that happens to have CBD in it. But while CBD may not be legally advertised on the label, CBD-containing hemp products can be labeled as having phytocannabinoids — the class of compounds to which CBD belongs. While CBD has gained the most attention, CBD alone cannot fully support your body's endocannabinoid system (ECS). You need the other phytocannabinoids and terpenes, which are very complementary to the phytocannabinoids, as well.

"Those of us in botanical medicine understand that the sum of all the parts of the plant is greater than any one single ingredient," Germano says. "Let's face it. There's more than one ginsenoside in ginseng. There's more than one curcuminoid in curcumin. There's more than one isobutylamide in Echinacea. There's more than one ginkgolide in ginkgo.

Well, there's more than just one phytocannabinoid in hemp. Back in 2011, Dr. Ethan Russo in the British Journal of Pharmacology1 … wrote about the entourage effect of all the phytocannabinoids and terpenes needing to be present to give rise to full clinical, meaningful benefit …

While CBD may be the most dominant phytocannabinoid in hemp, the others are there in minor in number, but they are not minor in the body as they all participate in nourishing, supporting the ECS, which is the bigger story."

Understanding Your ECS

While the discovery of the ECS is fairly recent, genetically it dates back over 600 million years.2 Cannabinoid receptors in the human body were discovered in the 1990s, which in turn led to the realization that we make compounds in our body — endogenous cannabinoids — that influence these receptors.

It was also discovered that the ECS orchestrates communication between other bodily systems, such as your respiratory, digestive, immune and cardiovascular systems. The ECS does this via receptors found in every organ, including your skin.

"Your ECS is like the conductor of the orchestra. The orchestra are our organ systems. We cannot be healthy, we cannot be well if our ECS does not function well," Germano says.

"Your body produces cannabinoids similar structurally to the cannabinoids found in cannabis. Your body feeds off of them. If you don't produce enough to feed every single receptor, various conditions and various illnesses will ensue."

Two Types of Endocannabinoid Receptors Have Been Identified

There are two primary ECS receptors: cannabinoid receptor type 1 (CB1) and cannabinoid receptor type 2 (CB2). While CB1 is typically thought of as being primarily in the brain and CB2 primarily in the immune system, both types of receptors are in fact found throughout your body.

One of the two cannabinoids your body produces is called anandamide — a nod to the word "ananda," the Sanskrit word for "bliss," as it attaches to the same CB1 receptors that THC attaches to. The other, 2-arachidonoylglycerol (2-AG), is found throughout your body.

"The ECS has been the subject of many scholarly textbooks … Quite frankly, this is something that should be taught from high school to college to medical school. Unfortunately, because of the stigma attached to cannabinoids … less than 13 percent [of medical schools in the U.S.] are teaching the ECS.

I say, 'Are you insane? This is like saying that for the next 70 years we will not teach the cardiovascular system, as if it never existed.' We now have to dismantle this medical travesty … The whole thing is about education. This is critical and crucial to our health and well-being.

We have to dismantle the stigma, and we have to start educating ourselves to understand that the ECS is probably one of the most important medical discoveries in quite some time. Understanding the enormity of this system and what it does and what it influences throughout the entire human body."

Low Endocannabinoid Levels Result in Ill Health

With age, our bodies tend to become less efficient in creating the compounds needed for optimal health, and this holds true for anandamide and 2-AG as well. According to Germano, these two cannabinoids can actually be used as biological markers for certain illnesses and conditions.

Endocannabinoid deficiency has been identified in people who have migraines, fibromyalgia, irritable bowel syndrome, inflammatory and neurological conditions and a variety of treatment-resistant conditions. Germano also cites a paper3 in Translational Psychiatry, which found low anandamide levels are a statistically positive indicator for stress-induced anxiety.

They've also discovered there's an intimate relationship between your ECS and your omega-3 status.4 As it turns out, omega-3 fats make your cannabinoid receptors more active, and are used as backbone structures to produce cannabinoids in your body.

"What do we see in people who have low omega-3 status? We see the same things we see in people who are endocannabinoid deficient: pain, inflammation, stress, anxiety, depression and so on. It is a perfect marriage between omega-3s and phytocannabinoids, which act like a multivitamin for the ECS.

But it doesn't stop there. Look at bones … the reason we give post-menopausal women estrogen is because it influences the cells that build up bone, osteoblasts, and the cells that break down bone, osteoclasts. What does this have to do with the ECS?

We now know that if you stimulate the CB1 receptors, you start to stimulate the brain-to-bone communication by slowing down the brain from releasing bone-breaking compounds, like norepinephrine. Then when you stimulate the CB2 receptors, it increases osteoblasts, the bone makers, and decreases osteoclasts, the bone breakers."

Top conditions associated with low cannabinoid levels include:

  • Pain, inflammation and inflammatory conditions
  • Stress, anxiety and insomnia
  • Ocular health
  • Bone health
  • Neurological conditions

"These are all conditions that can be suitably treated with phytocannabinoids," Germano says. "These are conditions that we see in people who are endocannabinoid-deficient."

Running Dramatically Boosts Anandamide Level

While runner's high is typically attributed to the release of endorphins, running also dramatically increases anandamide in the body, and anandamide not only targets the CB1 receptor, but it also influences opioid and endorphin receptors. Not surprisingly then, the higher an individual's anandamide level, the better they report feeling.

"That makes sense, because anandamide hits the receptors in the brain that are involved in reward and mood," Germano says. "We also understand that the cannabinoids we produce are quite promiscuous.

They certainly touch the CB1 and CB2 receptors, but they [affect] other receptors as well, [such as] the 5-hydroxytryptamine (5-HT3) receptors, peroxisome proliferator-activated receptors (PPAR), gamma-aminobutyric acid (GABA) receptors, and receptors that control inflammation, pain, reward, anxiety and things of that nature."

A paper5 published in PLOS ONE also details how various nutrients (such as omega-3 fats), drugs, exercise, chiropractic care, massage and acupuncture influence the function of your ECS.

Your Endocannabinoid System — A Key Player in Inflammation

Curcumin, boswellia, fish oil and quercetin are all well-recognized anti-inflammatory nutrients, but none can compare to what cannabinoids can do, Germano says, especially when the full spectrum is used.

As noted in a 2014 paper6 in Current Opinions in Clinical Nutrition and Metabolic Care, the ECS is an emerging key player in inflammation, because it's intertwined with all of the inflammatory pathways, including the eicosanoid ones that omega-3 fish oils influence.

Germano also cites other research showing that targeting the ECS can ease both inflammatory and neuropathic pain, and describe how cannabinoids act as analgesics. According to Germano:

"You cannot contend with any inflammatory condition unless you're supporting the ECS. They can be used interchangeably; phytocannabinoids along with curcumin and boswellia and fish oils would be remarkable, as they are complementary to each other by doing different things.

Again, we must address the ECS in any inflammatory condition, whether it be irritable bowel syndrome or injuries — even inflammation in the brain, which is one of the hallmarks of all neurological diseases. In 2003, the United States government got issued a patent on the neuroprotective effects of cannabinoids.

At that time, while the government has been telling us that phytocannabinoids are like lysergic acid diethylamide (LSD) and heroin — [meaning they] have no medical value — they go out and get a patent on the medical value.

But that was followed up, and there are many papers that talk all about the anti-inflammatory effects in the brain and in the nervous system, of these cannabinoids … There is nothing else like supporting the ECS with phytocannabinoids."

Your Endocannabinoid System Also Plays a Key Role in Your Gut Health

You're probably familiar with the fact that there's a strong connection between not only your brain and your gut, but also your immune system. The importance of this triad in health and disease prevention cannot be overstated. Your gut not only is your largest immune organ, it's also your second brain, containing hundreds of millions of neurons.

"We now understand how the gut is involved with communicating with the brain and the immune system, because it has brain cells and immune cells in it," Germano says. In the middle of this trio is your ECS. It is actually the orchestrator of this tri-directional communication. According to Germano, researchers have also discovered the ECS controls:

  • Motility in the gut
  • Intestinal inflammation
  • Abdominal pain
  • Gut permeability
  • Tolerance to antigens

The ECS also reduces the activity of the stress pathways, including the hypothalamic-pituitary-adrenal (HPA) pathways. Anandamide, specifically, participates in the immunological response in the gut. What's more, there's also communication occurring between your endocannabinoid system and your gut microbiome (the bacteria in your gut).

Clinical Applications for Hemp Products

Again, a full-spectrum oil is actually far preferable to product in which CBD has been isolated. Germano cites a 2015 Israeli paper, which compared full-spectrum oil against isolated CBD, and found the full-spectrum oil was in fact clinically superior.

As for dosing, most of the literature demonstrates efficacy of CBD in the several hundred milligram range — but that is for "single magic bullet" isolated CBD. Preclinical studies and any clinicians are reporting that efficacy can be achieved with much lower doses when using a ful spectrum oil — some in the 10 to 25mg CBD range.

"Since CBD is the most dominant cannabinoid in hemp, when you extract oil from hemp, you do have much, much higher levels of CBD naturally in the oil as compared to the rest of the phytocannabinoid family. Providing 10 to 25 mg of CBD is the sweet spot for most conditions in the trade — especially when used with other synergistic ingredients …

People are responding quite remarkably, which [suggests] you don't need a lot to jump-start the body's ECS. Quite frankly, when we look at the bell-shaped curve with the isolates, the higher the dose, sometimes you decrease the effectiveness … When you use a full-spectrum oil and you're getting the other important phytocannabinoid and terpene components, this is superior, and I'll tell you why.

People have been focusing on CBD, which is the wrong message. It's the myopic message. Think about it, CBD does not attach to the CB1 or CB2 receptors. If anything, CBD supports the CB1 receptors by preventing the breakdown of anandamide in our bodies and anandamide hits the CB1 receptor.

What about the CB2 receptor that controls inflammatory cycling, pain signaling, insulin sensitivity and bone building? CBD does nothing for that, so we need something of a CB2 agonist. A perfect partner to CBD would be another phytocannabinoid called beta caryophyllene. Luckily, the family of other phytocannabinoids in a full-spectrum oil contains other phytocannabinoids that complement to what CBD is not doing as well.

We must get off this single magic bullet bandwagon. We must appreciate the full gamut of all these phytocannabinoids as a whole, and that they complement each other, because CBD is not the answer to support the ECS as a whole."

As with most things, too much can backfire. While CBD cannot kill you, using CBD isolate in too high amounts can reduce its effectiveness. Such problems are far less likely when using a full-spectrum oil.

"I don't foresee anybody really overdosing on the standard dosages that we're recommending," Germano says.

"Nor when we look at the data that's been published, up to 1,500 mg of CBD chronically administered over time show that it was well-tolerated, minimal to no adverse reactions on physiological function, psychological functioning and other parameters in the body, including blood pressure. So, CBD is quite well-tolerated in humans."

Hemp Oil for Sleep

Aside from inflammation and pain, another area where a full-spectrum hemp oil can be beneficial is to improve sleep and treat insomnia. Germano recommends using a full-spectrum oil in a dose that provides 25 mg of CBD.

"CBD at that range does a number of things. No. 1, it reduces excitability in the brain. It can reduce glutamate toxicity and any excitatory conditioning. Secondly, CBD is involved in various neurotransmitters that are involved with a normal sleep cycle.

While it has a calming effect and helps to establish a normal sleep cycle, it's not necessarily a sedative. You can use it with melatonin. You can use it with lavender. You can use it with chamomile and passionflower, what have you. I would do that towards the latter part of the day, at least an hour or two before bedtime. Lower doses of CBD are more stimulating, so to speak, and more upregulating."

How the New Law Can Improve Quality of Hemp Products

In the past, prior to the signing of the new Farm Bill, the leaf, flower and bud of the hemp plant could not be used in the production of CBD-rich hemp oil. The oil had to be pulled from the stalk and stem of the plant only — the less concentrated part. With the new law, all parts of the plant can be used, which will make processing easier and more economical, as the cannabinoids are more concentrated in the leaves, flowers and buds.

The law also makes it legal to grow hemp in in every state, so if you wanted to, you could grow it in your backyard. This is something I'm definitely considering, as you can easily juice the whole plant or add it to smoothies.

"Growing it for yourself would be wonderful," Germano says. "It is a weed. It has a short period of harvest. It grows very rapidly — July, August and September. Yes, the whole plant can be used rather than just extracting the oils from it. All the phytocannabinoids and lipids are found in the oils, but the leaf can be juiced and put into smoothies as well …

In terms of growing and processing it, it's a rather easy plant to grow, because it is a weed. When we talk about the raw plant, a lot of these cannabinoids are in their acidic form. CBD is in CBDA, cannabidiol acid, form. To convert it to its useable form, the acid has to be decarboxylated.

So, while you may benefit from a lot of the phytocannabinoids [in the raw plant], it's going to be reliant on your body's ability to process it from the acidic forms that are in there. Exposure to heat, light, moisture and air will decarboxylate a lot of them as well. The more you process it yourself, the more useable some of those phytocannabinoids will be.

[To process it], you can take the leaf, flower and bud. You can blend it and store it in the refrigerator. Over a day or two of exposure to heat, air, light and moisture, it'll decarboxylate to some extent and you'll benefit more from that. How much do you get? Appreciable amounts of CBD may be difficult with just juicing alone …

I don't want to misquote myself and say the wrong thing, but probably an ounce or two [of raw plant] would do the trick as a healthy plant beverage. Again, you don't need a lot to jump-start your body's ECS. It's not a numbers game. Small doses, you would definitely respond to."

How to Identify a High-Quality Hemp Product

If you're not growing your own, attributes to look for when shopping for a hemp product include:

Organic

Kosher-certified

Non-GMO

Verified pesticide and herbicide free

Full-spectrum phytocannabinoids

Grown from certified seeds and not hybrids with marijuana

"I look for companies that are doing the right thing also. That is, they don't mention CBD on the front panel or quantify it in the Supplement Fact box. Responsible companies talk about phytocannabinoids," Germano says.

"They talk about hemp oil. They talk about nourishing the endocannabinoid system. This is a superior story to just CBD. Those are the more reputable companies that are telling the right story, [and not just talking about] isolated CBD."

More Information About Endocannabinoid System

Germano has written a book about the endocannabinoid system called, "Road to Ananda: The Simple Guide to the Endocannabinoid System, Phytocannabinoids and Hemp." I am very proud to have written the forward to this book as it is a great resource. Definitely pick up a copy if you want to learn more about this fascinating topic.

"I'm ecstatic to announce that the person who wrote the introduction to the book is Raphael Mechoulam, the father of cannabinoid research and who was involved in the discovery of the endocannabinoid system.

He is well-known in the scholarly circles. There are certainly plenty of scholarly work out there, but we need to get this message, this story, which is enormous, out to the layman and practitioner out there who is really unaware still," Germano says.

"I've been in this industry for over 35 years. I'm a clinical nutritionist by trade. I have not seen any natural compounds this clinically relevant since the inception of this industry. I can tell you that targeting the endocannabinoid system, supporting it, will dominate medicine and nutrition of the next couple of decades.

There are also topical applications for phytocannabinoids, because, again, our skin is one of our largest organs. It also has five to 10 times more cannabinoids in it than we have in our brain. The CB1 and CB2 receptors are there as well.

There are three targeted areas for topical applications. One, obviously, is pain and inflammation, because the CB2 receptors are there that control that. That is something that will blow away any of these compounds in the marketplace today for topical pain relief.

Then we know that certain cannabinoids strangle the sebaceous gland for acne. Certain cannabinoids also influence age spot development and antiaging. [There are] some very interesting things going on in the topical application area.

When we look at the global picture of what is the subcutaneous endocannabinoid system doing, it's helping to maintain normal cell proliferation, differentiation and immune competence. Oncologists are going to be interested in that aspect."



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