The Musculoskeletal Syndrome of Menopause: A Conversation with Orthopedic Surgeon Dr. Jocelyn Wittstein

"Why do my joints suddenly hurt?" "Is this frozen shoulder connected to my hot flashes?" If you're a woman in your 40s or 50s experiencing mysterious joint pain, you're not alone—and it's not just aging. In this eye-opening episode of Medicine 3.0, host Catherine Isaac delves into the hidden connection between menopause and joint pain with Dr. Jocelyn Wittstein, orthopedic surgeon and sports medicine specialist at Duke Health. They uncover the surprising truth about the "musculoskeletal syndrome of menopause" that affects millions of women but remains largely unrecognized in clinical practice.

Understanding Musculoskeletal Changes During Menopause

As women transition through perimenopause and menopause, the decline in estrogen levels triggers significant changes in the musculoskeletal system that many women—and even healthcare providers—may not recognize as being connected to hormonal shifts.

Dr. Wittstein explains that these changes fall into three main categories:

1. Increased Inflammation: Women experience more painful, inflamed joints and an accelerated rate of arthritis development. A prime example is frozen shoulder (adhesive capsulitis), which almost exclusively affects women aged 40-60.
2. Accelerated Bone Density Loss: During menopause, the rate of bone density loss increases from 1% to 2% annually, significantly raising the risk of osteoporosis and fractures.
3. Muscle Mass Challenges: With declining estrogen levels, it becomes more difficult to maintain and build muscle mass, leading to sarcopenia (muscle loss).

The Menopause-Arthritis Connection

Dr. Wittstein describes what she calls "menopause arthritis" as existing somewhere between mechanical wear-and-tear osteoarthritis and purely inflammatory arthritis. The combination of aging joints and increased inflammation creates a unique scenario where women have a 30% higher risk of developing osteoarthritis around age 50—a risk men don't experience until about age 80.

Estrogen receptors exist in the synovium (the tissue lining joints), and studies show that estrogen withdrawal increases inflammation while estrogen therapy can reduce joint pain and inflammation. Interestingly, Dr. Wittstein notes that even though 77% of women in the Women's Health Initiative reported joint pain, and hormone therapy reduced both the number and severity of painful joints, joint pain is not currently an FDA-approved indication for menopausal hormone therapy.

Frozen Shoulder: The "50-Year Shoulder"

Frozen shoulder deserves special attention as it disproportionately affects women during the menopausal transition. Dr. Wittstein explains that this condition:

• Usually occurs without injury or trauma
• Begins with aching that progresses to significant pain and stiffness
• Can take up to two years to resolve completely
• Is so common in menopausal women that some cultures have termed it the "50-year shoulder"

The condition is so strongly associated with hormonal changes that when Dr. Wittstein sees a man with frozen shoulder, she screens him for diabetes, as that's typically the only context where men develop this condition.

Treatment Approaches

For frozen shoulder, Dr. Wittstein emphasizes early intervention:

• Steroid injections into the joint can be "magical" when administered within the first three months of symptom onset
• Physical therapy may worsen symptoms if attempted during the painful inflammatory phase
• For severely "frozen" shoulders that limit daily activities, surgical intervention may be necessary

Dr. Wittstein also discusses the complex relationship between menopause and musculoskeletal health, emphasizing two factors under individual control:

1. Exercise: A balanced approach that includes:
   • Strength training (resistance exercises) to support muscle and bone health
   • Cardiovascular activity for heart and brain health
   • Impact exercises (like jumping) to stimulate bone density
   • Balance training to prevent falls
2. Diet: An anti-inflammatory approach focusing on:
   • Minimizing red meat, fried foods, and processed foods
   • Including at least 25 grams of fiber daily from whole grains
   • Consuming a variety of fruits and vegetables for their antioxidant properties
   • Incorporating omega-3 fatty acids from fish, walnuts, and chia seeds

Resources for Further Learning

For those looking to learn more about maintaining musculoskeletal health during menopause, Dr. Wittstein recommends:

1. The Complete Bone and Joint Health Plan - Dr. Wittstein's own book co-authored with registered dietician Sydney Nitskorsky, providing comprehensive guidance on nutrition and exercise for bone and joint health.
2. The Musculoskeletal Syndrome of Menopause - A medical paper co-authored by Dr. Wittstein and Dr. Vonda Wright, available through the journal Climacteric.
3. The Science of Joint Health: How to Keep Your Bones Strong for Life - Dr. Wittstein's recent appearance on Gabby Lyon's podcast (Episode 147).
4. The M Factor - A recommended film about menopause that provides additional context and education.
5. Ortho Info - A patient-friendly resource from the American Academy of Orthopedic Surgery offering guidance on various orthopedic conditions.

The Takeaway

This episode highlights how the musculoskeletal impacts of menopause remain underrecognized despite affecting millions of women. Dr. Wittstein's expertise sheds light on why women experience particular joint, bone, and muscle challenges during this life stage and offers practical strategies for maintaining musculoskeletal health through the menopausal transition and beyond.

By understanding these connections and taking proactive steps with exercise, nutrition, and appropriate medical interventions when needed, women can better navigate the musculoskeletal challenges of menopause and maintain mobility and function for years to come.

Episode Timestamps

For easy reference, here are key moments from the conversation:

• 02:33 - Definition of musculoskeletal syndrome of menopause and its three main categories
• 05:27 - Explanation of menopause arthritis vs. other types of arthritis
• 10:07 - Dr. Wittstein's explanation of frozen shoulder
• 12:14 - Why frozen shoulder predominantly affects women
• 24:03 - Treatment options for frozen shoulder (steroid injections)
• 31:41 - Discussion about muscle loss during menopause
• 33:11 - Connection between muscle mass and bone density
• 39:42 - Explanation of hip bursitis and prevention strategies
• 45:21 - Anti-inflammatory diet recommendations
• 48:41 - Resources for further learning about musculoskeletal health

Listen to the full episode of Medicine 3.0 with Dr. Jocelyn Wittstein to learn more about managing musculoskeletal health during menopause.

‍

Buffalo Chicken Loaded Sweet Potato

A simple, high-protein meal made for busy days.

If you're looking for something fast, flavorful, and packed with protein—this Buffalo Chicken Loaded Sweet Potato is your answer. With minimal ingredients and almost no hands-on time, it's the kind of recipe you can throw together with pantry and fridge staples. Perfect for a weeknight dinner, quick lunch, or even meal prep.

Ingredients

Here’s what you’ll need to make one serving:

• 1 medium sweet potato
• 1 cooked chicken breast, shredded
• 1–2 tablespoons buffalo sauce (adjust to your spice preference)
• 2–3 tablespoons plain nonfat Greek yogurt
• Garlic powder, salt, pepper, and parsley
• Feta cheese (or your favorite cheese)
• Optional: chopped green onions for garnish

Instructions

1. Bake the sweet potato
Wrap the sweet potato in foil and roast at 400°F for 40–60 minutes, or until fork-tender. (You can microwave it in a pinch, but the oven gives a better texture and flavor.)

2. Prep the chicken
While the sweet potato is roasting, shred your cooked chicken breast. Mix it with buffalo sauce, Greek yogurt, and a sprinkle of garlic powder, salt, and pepper. Stir to combine.

3. Load it up
Once the sweet potato is cooked, slice it open lengthwise and fluff the inside with a fork. Pile on the buffalo chicken mixture, then top with crumbled feta, fresh parsley, and green onions if you have them.

Why You’ll Love It

• High in protein
• Minimal ingredients
• Comforting with a healthy twist
• Easy to double for meal prep

Pair it with a side salad or steamed greens for a balanced, satisfying meal.

Ready in under an hour with only a few minutes of hands-on time—this is comfort food, simplified.

#EasyDinner #HighProteinMeal #BuffaloChicken #HealthyComfortFood #MealPrepMadeSimple #BionicHealth #RealFoodRealLife

‍

When in Doubt, Make a Bowl

Let’s be real—trying to cook a new recipe every night can feel like a full-time job. It’s time-consuming, expensive, and honestly, not always sustainable when life gets busy. That’s why when I’m short on time or energy, I stick to my go-to strategy: I make a bowl.

Instead of reinventing the wheel each week, I focus on batch prepping a few core ingredients—a couple of proteins, some carbohydrates, and a mix of veggies and sides. With those basics ready to go, I can mix and match ingredients into quick, well-rounded meals that are both nourishing and satisfying.

One of the easiest proteins to prep and build around? Chicken breast. Here's how to bake it:

First, prep your chicken:

For each of these, bake boneless, skinless chicken breasts at 400°F for 25 minutes with a little olive oil, salt, and pepper. You can shred it, slice it, or cube it depending on the dish.

Then comes the flavor. Here are 5 ideas:

• Balsamic Veggie-Packed Bowl:
  
  • Chicken breast
  • Roasted vegetables: broccoli, onion, brussel sprouts, and zucchini. Season with salt, pepper, and Italian seasoning, and roast at 375 for 20 minutes.
  • Top with fresh edamame and balsamic glaze
  • Serve over your choice of base.

• Chicken Fajita Bowl:
  
  • Chicken breast
  • Roasted or sautéed bell pepper and onions with fajita seasoning
  • Top with salsa, black beans, cheese, fresh avocado, and nonfat plain Greek yogurt.
  • Serve over your choice of base.

• Buffalo Chicken Bowl:
  
  • Shredded chicken breast
  • Buffalo sauce
  • Nonfat plain Greek yogurt
  • Lime juice, salt, and pepper
  • Mix all ingredients, top with chopped green onions. Optionally, add fresh coleslaw on top, like this one.
  • Serve over your choice of base.

• Mediterranean Lemon Feta Bowl:
  
  • Chicken breast
  • Tomato and cucumber salad (chopped tomato, cucumber, red onion, olive oil, red wine vinegar, salt and pepper, fresh herbs)
  • Feta cheese
  • Squeeze of lemon
  • Dollop of hummus
  • Serve over your choice of base.

• Chicken Salad Bowl:
  
  • Shredded chicken breast
  • Nonfat plain Greek yogurt and dijon mustard
  • Lemon juice
  • Chopped celery, bell pepper, red onion, and grapes
  • Sliced almonds
  • Parsley, dill, salt and pepper.
  • Mix together all ingredients and serve over your choice of base.

For your base, here are some options to choose from. Find what works best for you and your family!

• Roasted sweet potato
• Russet or baby potatoes
• White or brown rice
• Cauliflower rice
• Quinoa or lentils
• Leafy greens for a salad-style bowl

Why do these bowls offer a great option for a quick and easy meal to use your batch prepped ingredients?

• Flexible – Adapt to what you have in your fridge
• Efficient – Prep once, eat many ways
• Balanced – Easily incorporate protein, fiber, and healthy fats. These are a great way to introduce vegetables in a more unique and flavorful way!
• ‍Satisfying – Endless flavor combinations

Which bowl will you try first?

The Science of Sarcopenia: How Muscle Mass Predicts Healthy Aging

When it comes to healthy aging, we often focus on heart health, cognitive function, and managing chronic conditions. But what if the secret to maintaining independence and vitality as we age has been hiding in plain sight? According to Dr. William Evans, Professor of Human Nutrition at UC Berkeley and pioneer in the field of sarcopenia research, muscle mass might be the most critical factor in determining how well we age.

In a recent conversation with Bionic Health's Dr. Jared Pelo, Dr. Evans shared groundbreaking insights about why muscle truly is "the currency of aging" and how this knowledge can transform our approach to preventative healthcare.

What is Sarcopenia and Why Should You Care?

Sarcopenia—a term coined by Dr. Evans himself—refers to the age-related loss of muscle mass. While this might sound like a concern only for bodybuilders or athletes, Dr. Evans's decades of research reveal it affects virtually every aspect of health as we age.

"Of all the things that are affected as we grow older, muscle affects everything," Dr. Evans explained. "And it's remarkable to me that so little attention has been paid to it."

This oversight might explain why, despite sarcopenia affecting millions of older adults, many healthcare providers—even internal medicine physicians—don't recognize the term. Only geriatricians consistently understand its significance.

The Measurement Breakthrough: Beyond DEXA Scans

For years, the difficulty in accurately measuring muscle mass has hampered research and clinical progress in addressing sarcopenia. Traditional methods like DEXA scans measure "fat-free mass" or "lean body mass," which can be misleading.

"Among older people, muscle is only half of fat-free mass," Dr. Evans pointed out. This explains why measurements using these methods often don't correlate strongly with functional outcomes like mobility and fall risk.

The game-changer? Dr. Evans and his colleagues developed the D3 creatine dilution method—a non-invasive, accurate way to measure functional muscle mass. This innovative approach involves:

1. Taking a small capsule containing deuterated creatine (about 3% of the amount found in a hamburger)
2. Collecting a urine sample on a special filter paper
3. Lab analysis that determines precise muscle mass and percentage

This method has now been validated in thousands of individuals, from premature infants to older adults, and is being incorporated into major longitudinal studies like the Framingham Heart Study.

The Muscle Mass Threshold: What's Your Number?

One of the most practical insights from Dr. Evans's research is the identification of muscle percentage thresholds associated with mobility:

• For men: When muscle mass falls to 25% or below, the risk of mobility disability increases significantly
• For women: The threshold is around 20%

These percentages provide clear targets for maintaining independence. Interestingly, similar thresholds have been observed even in conditions like Duchenne muscular dystrophy, where maintaining a higher percentage of muscle relative to body weight may help preserve walking ability.

Why Muscle Loss Happens (And What to Do About It)

As we age, several factors contribute to muscle loss:

• Declining hormones (testosterone, growth hormone, and even estrogen)
• Increasing insulin resistance in muscle tissue
• Reduced physical activity
• Inadequate protein intake

"The RDA for protein (0.8g/kg/day) was established in healthy young people and assumed to be the same for older people," Dr. Evans explained. His research shows this amount is insufficient for maintaining muscle in older adults—he recommends nearly double this amount.

But the most powerful intervention? Resistance exercise.

"We did a study years ago where we did resistance exercise in 90-year-old people... and in 10 weeks, we were able to triple their strength," Dr. Evans shared. This groundbreaking study, published in the New England Journal of Medicine more than 30 years ago, demonstrated that it's never too late to build strength.

Even more encouraging: resistance exercise makes muscle more efficient at using dietary protein, helping compensate for lower protein intake.

Beyond Mobility: The Surprising Benefits of Muscle

The benefits of maintaining muscle mass extend far beyond strength and mobility:

• Cognitive function: Physical activity, particularly strength training, is strongly associated with preserved cognitive function and reduced risk of dementia.
• Metabolic health: Muscle mass is strongly related to insulin sensitivity, potentially reducing diabetes risk.
• Fall and fracture prevention: Adequate muscle mass significantly lowers the risk of falls and subsequent injuries.
• All-cause mortality: Higher muscle mass correlates with reduced risk of death from all causes.

The Future of Muscle Health

The emergence of GLP-1 agonists for weight loss has sparked renewed interest in muscle preservation, as weight loss invariably causes some muscle loss—potentially problematic for older adults.

"Many of the drug companies are interested in maybe an agent that will preserve muscle mass," Dr. Evans noted. "I think there'll be a lot of new potential drugs that are being developed in this space."

Meanwhile, Dr. Evans's team is working to make their muscle measurement test available to consumers within the next year, enabling individuals to track their muscle mass and take proactive steps if it falls below optimal levels.

Taking Action Today

While we await these exciting developments, Dr. Evans's research points to clear actions we can take now:

1. Incorporate resistance training at any age—it's never too late to start
2. Consume adequate protein (aim for approximately 1.6g/kg/day)
3. Stay active daily with walking and other activities
4. Monitor functional fitness with simple tests like walking speed or chair stands

The Bottom Line

Dr. Evans's research offers a powerful reminder that muscle truly is "the currency of aging." By prioritizing muscle health through resistance training and proper nutrition, we can maintain independence, metabolic health, and cognitive function as we age—aligning perfectly with Bionic Health's mission to enable optimal health for all.

As preventative healthcare evolves, measuring and maintaining adequate muscle mass may become as routine as checking blood pressure or cholesterol levels. The research is clear: muscle matters, at every age.

‍

Sheet Pan Chicken Fajitas: Quick, High-Protein & Packed with Flavor

When life gets busy, you need meals that are simple, nourishing, and seriously delicious—and these sheet pan chicken fajitas check every box.

This easy, one-pan recipe is perfect for meal prep or a quick weeknight dinner. It’s high in protein, loaded with fiber-rich veggies, and full of flavor thanks to Siete’s bold fajita seasoning. Pair it with your favorite toppings, and you’ve got a balanced meal that supports your health goals without sacrificing taste.

Ingredients

• 1 lb sliced chicken breast
• 1 small white onion, thinly sliced
• 2 bell peppers (any color), sliced
• 1 serving fajita seasoning
• Drizzle of olive oil

Instructions

1. Preheat oven to 400°F.
2. Line a baking sheet with parchment paper or foil.
3. Spread chicken, onion, and bell peppers evenly on the sheet pan.
4. Drizzle with olive oil and sprinkle the seasoning evenly over everything.
5. Bake for 25 minutes or until chicken is fully cooked and veggies are tender.

Serving Suggestions

Serve your fajita mix over:

• A bed of white rice, brown rice, cauliflower rice, or quinoa
• Mixed greens or shredded lettuce
• Top with sliced avocado, plain Greek yogurt, salsa, and a sprinkle of shredded cheese

Why You'll Love It

• High in protein
• Great for meal prep
• Balanced with fiber, healthy fats, and flavor
• Minimal cleanup

Fuel your body. Save time. Enjoy the process.

‍

Optimize Your Fitness Journey with Performance Testing

In this insightful episode of the Medicine 3.0 podcast, Bionic Health advisors Kelly and Anna dive into the world of performance testing and how it can revolutionize your fitness journey. Whether you're a seasoned athlete or just beginning to incorporate exercise into your routine, establishing a baseline through comprehensive testing provides invaluable data to guide your path toward optimal health.

Why Performance Testing Matters

Performance testing gives you a clear picture of where you stand across multiple fitness domains. As Anna explains, "We recommend it to get a baseline of where our members are at currently in their fitness. They get percentiles, and that's helpful to get a knowledge of where they're at and where they should go."

This data-driven approach transforms abstract fitness goals into tangible metrics that can be tracked and improved over time. By establishing these baselines, your Bionic Health team can create truly personalized recommendations tailored to your specific needs.

What to Expect During Testing

The comprehensive performance testing protocol at Bionic Health includes:

• VO2 Max Testing - The gold standard for measuring cardiorespiratory fitness, conducted on a stationary bike
• Strength Assessments - Including bench press and leg press for maximal strength evaluation
• Muscular Endurance Tests - Push-ups and dead hang measurements
• Hand Grip Strength - An excellent indicator of overall body strength
• Mobility Assessments - Evaluating shoulder, hip, ankle, and knee mobility
• Vertical Jump - Measuring power, which tends to decline most rapidly with age

Many members feel nervous about performance testing or believe they need to "train before they train." Kelly and Anna emphasize there's no need to worry—the purpose is simply to establish a starting point. "There's really no pressure to get any certain score right off the bat," Anna reassures. "It's just getting more information that's valuable for how to improve looking forward."

The Science Behind VO2 Max

The VO2 Max test measures how efficiently your aerobic system uses oxygen during maximal exertion. This data helps determine your personal heart rate zones for training, allowing for more precise workout programming. As Kelly explains, the test also provides insights into metabolic flexibility—your body's ability to switch between different energy sources during exercise.

Tracking Progress Over Time

Most members who return for follow-up testing see significant improvements across multiple metrics, particularly in VO2 Max and bench press strength. The recommended retesting frequency is every 6-12 months, allowing sufficient time for meaningful changes to occur while keeping you accountable to your fitness goals.

Beyond the Numbers

Performance testing isn't just about achieving high percentile rankings—it's about optimizing your health for longevity and quality of life. As Anna notes, "A lot of our members join Bionic with the goal of aging comfortably and being able to do the things that they love long-term."

Even members who regularly strength train often discover opportunities for improvement in their programming. The testing process frequently reveals needs for more strategic progressive overload or better balance between different fitness domains.

Take the First Step

If you've been hesitating to schedule your performance testing session, Kelly and Anna have one clear message: don't wait. The valuable information gained from these assessments will help you work more efficiently toward your goals, whether you're just starting out or looking to optimize an existing routine.

"Performance testing is valuable for all of our members," Anna concludes. "It gives a lot of valuable information on how to improve in all of these different areas... we can really work with you one-on-one to slowly add in training or adjust to your specific goals."

Ready to establish your fitness baseline? Contact your Bionic Health advisor today to schedule your performance testing session.

Podcast Timestamps:

00:08 - Introduction and welcome
00:58 - Overview of performance testing benefits and protocols
03:53 - VO2 Max testing explained
09:53 - Using heart rate data for personalized training zones
12:50 - Strength and grip testing protocols
16:25 - Importance of mobility for healthy aging
18:55 - Vertical jump testing and power assessment
20:06 - Plyometric training discussion
23:55 - Recommended frequency for retesting
25:19 - Balancing different training modalities
26:42 - Final thoughts and encouragement for members
29:05 - Closing remarks

‍

Fighting Heart Disease Like Cancer: A Conversation with Dr. Mike McConnell

In this episode of the Bionic Health podcast, Dr. Jared Pelo sits down with cardiologist Dr. Mike McConnell to discuss a revolutionary approach to heart disease prevention. Dr. McConnell, who authored the book "Fight Heart Disease Like Cancer," shares his expertise on early detection, risk assessment, and proactive treatment strategies.

Rethinking Heart Disease

Dr. McConnell challenges the traditional view of heart disease as simply a "plumbing problem" where arteries gradually get clogged. Instead, he frames it as an active biological process more similar to cancer, where growths develop in the arteries that supply blood to the heart. These growths can remain asymptomatic until a blood clot forms, potentially causing a sudden and catastrophic event - as happened with Dr. McConnell's own father-in-law.

"We're in this amazing era of tools, both for prevention from a lifestyle perspective and from a medication perspective that we can really stop this," Dr. McConnell explains. "We shouldn't be having people who have blockages and need stents or bypass surgery or having heart attacks."

Early Detection and Screening

The conversation explores various screening methods for heart disease, including:

1. Risk Assessment Scores - Evaluating factors like age, gender, cholesterol levels, blood pressure, diabetes status, and smoking habits
2. Coronary Calcium Scans - A rapid CAT scan that detects calcified plaques in arteries
3. CT Angiograms - More detailed imaging that shows both calcified and soft plaques
4. Retinal Imaging with AI - An innovative approach using eye scans to detect cardiovascular risk

Dr. McConnell highlights the importance of early screening, especially for those with a family history of heart disease. He also discusses how these imaging tools can help motivate patients to take their risk factors seriously and adhere to treatment plans.

The Essential Eight for Heart Health

The American Heart Association's "Life's Essential Eight" provides a framework for heart disease prevention:

1. Blood sugar management
2. Cholesterol control
3. Blood pressure regulation
4. Regular physical activity
5. Healthy diet
6. Avoiding smoking
7. Maintaining healthy weight
8. Getting adequate sleep

Dr. McConnell adds two more important factors to this list: limiting alcohol consumption and managing stress.

Combining Lifestyle and Medication

While lifestyle modifications are important, Dr. McConnell acknowledges their limitations. He advocates for a combined approach:

"The more you can do with lifestyle, the less you need medication. So that's sort of part of the bargaining or discussion that we have," he explains.

Dr. McConnell notes that only about one in three eligible people in the US are taking cholesterol-lowering medication, even though guidelines would recommend it. He sees tremendous opportunity in increasing awareness and proactive treatment.

Looking to the Future

Dr. McConnell shares exciting developments in heart disease prevention, including using AI to analyze retinal images for cardiovascular risk assessment. His company, Toku, is working to bring this technology to market, which could potentially identify at-risk individuals during routine eye exams.

"Not everybody's day to day, unlike me, most people are not thinking about their heart disease risk every day," he says. "Why not when you're making contact with optometry, ophthalmology, getting an eye exam, that there's an opportunity to say, look, your retina looks like you have some increased risk."

For those interested in learning more, Dr. McConnell's book "Fight Heart Disease Like Cancer" and website (FHDLC.info) provide additional resources and guidance.

As Dr. Pelo notes at the conclusion of their conversation, following Dr. McConnell's advice on screening and prevention could save countless lives - perhaps the greatest impact a physician can have.

Timestamps:

00:00 - Introduction and welcome
00:22 - Dr. McConnell's background and career journey
03:09 - How Dr. McConnell decided to become a physician
05:35 - Framework for understanding heart disease
09:18 - Personal stories motivating heart disease prevention
10:30 - Heart disease screening approaches and risk assessment
14:58 - The "Life's Essential Eight" for heart health
19:11 - Retinal imaging for cardiovascular risk assessment
24:03 - Expanding heart health screening through eye exams
27:08 - Using imaging to motivate patients
30:05 - Balancing lifestyle changes and medication
33:39 - Advanced imaging: CT angiograms and soft plaque detection
40:15 - Where to find more information
41:22 - Closing thoughts

Member Spotlight: Alex Ladan on Finding Personalized Health Support After Competitive Athletics

In this Member Spotlight, we talk with Alex Ladan, former gymnast and current clinical researcher in women's health, about her journey with Bionic Health and how personalized health coaching has transformed her approach to nutrition, stress management, and overall wellness.

From Competitive Athlete to Health Researcher

Alex Ladan's relationship with health and fitness began early. As a former gymnast, she was accustomed to being considered "healthy" simply because she was athletic. "Growing up as an athlete, I was always just considered healthy," Alex explains. "I was never given true information about anything. It was like checking the box—you went to your physical, great job, how's gymnastics going? And that was it."

This experience ultimately led Alex to pursue kinesiology in undergrad, followed by a master's degree in sports science at UNC Chapel Hill. Now working in clinical research focused on women's health, Alex brings a unique perspective to her own health journey.

Why Bionic Health?

When Alex moved to North Carolina for her master's program, she faced challenges many young adults encounter: managing her own healthcare appointments for the first time while balancing a rigorous academic schedule.

"It was my first time moving away from home, which came with making my own doctor's appointments and keeping up with my health," Alex shares. "I really liked the flexibility of Bionic, but I also really liked the advisor portion of it."

What particularly appealed to Alex was Bionic's comprehensive approach that went beyond what traditional providers typically addressed: "It brought in the body composition piece, the exercise piece, all of the things that I feel like my traditional provider was never asking me about or never really understood because I was a gymnast and I was active, so that was good enough."

Evolving Goals and Personalized Support

One of the most valuable aspects of Alex's Bionic Health experience has been working with her advisor, Anna. Their relationship has allowed Alex to address changing priorities over time—from managing nerve pain and anxiety to developing sustainable nutrition practices and preparing for her upcoming wedding.

"I feel like my goals change every time I meet with her," Alex laughs. "I think originally I was experiencing some nerve pain, and I wasn't sure if it was related to physical activity or high anxiety levels."

Through regular check-ins with Anna, Alex gained important insights about stress management. "She helped me a lot with recognizing that from an outsider's perspective, like, 'Yeah, actually, this is not a normal level of stress.'"

Making Nutrition Personal

For Alex, nutrition was a complicated area due to her gymnastics background. "I was hyper-fixated on food for my entire upbringing," she explains. After years of not thinking consciously about nutrition during college, Anna helped her develop practical approaches to meal planning.

"She helped me a lot with understanding the importance of planning my meals before work...things that are maybe so small and mundane but ended up being really impactful for me."

Rather than following a one-size-fits-all approach, Alex and Anna crafted strategies that worked for her specific preferences. For instance, with meal prep, Alex notes: "I don't like to feel like I'm eating the same thing over and over again. I can prep fruits, vegetables, and starches, but I have to prepare my protein each day. Otherwise, mentally, I just don't feel like it's fresh."

Meaningful Progress Beyond Numbers

The true value of Alex's Bionic membership has been in the gradual, sustainable changes that have significantly improved her quality of life:

• Improved Energy Levels: By tracking her sleep and adjusting her alcohol consumption, Alex noticed dramatic improvements in her energy throughout the week. "I used to feel like I'm dragging my feet on Monday and Tuesday. But now I actually look forward to Sundays because I look forward to prepping my meals, and then I feel more energized going into the week."
• Better Work-Life Boundaries: With Anna's guidance, Alex transformed her morning routine. "I would wake up and immediately start mentally clocking into my job. Now I take more time in the morning for restorative activities, listening to a podcast during my commute instead of thinking about work."
• Personalized Approach to Protein: Rather than tracking all macronutrients, Alex focused specifically on protein intake. "It's actually funny that you asked specifically about protein because that is really the only thing that I keep track of each day."

Working Through Barriers, Not Around Them

One of the most valuable aspects of Alex's experience has been identifying and addressing barriers to her goals. For example, when discussing resistance training: "I remember myself being like, 'Well, this is the reason why that's not going to work.' And then we talk through it...recognizing what the barriers are is so, so key."

Alex appreciates the collaborative approach: "It's never just Anna being like, 'You need to do this, and if you don't do it by the next time we meet, then you failed.' It's more fluid and a conversation."

Advice for Health Professionals

As someone with a background in health and fitness, Alex offers valuable insight for other professionals who might think they already know enough:

"It is so hard for me to stay consistent with a routine of exercise and nutrition when I get really busy. This helps to have something consistent. Maybe in the periods where I'm falling through the cracks with my own nutrition and exercise, I have somebody there consistently."

Looking Forward

As Alex approaches her one-year anniversary with Bionic Health, she reflects on how her goals and motivations have evolved: "What I would have said at the beginning and what I would say now is so different—why I'm still a member has changed so much across time."

With her wedding approaching later this year, Alex continues to work with Anna on maintaining a healthy perspective amidst wedding culture pressures. "I told her upfront, 'I feel like this is going to become an issue, and it hasn't yet, but I can feel it starting.' And just having her to talk through that and talk through the things that maybe I'm seeing on the internet and to help get ahead of it has been really helpful."

Interested in learning how Bionic Health can support your health journey? Contact us today to learn more about our personalized approach to optimal health.

Interview Timestamps:

• 0:00 - Introduction
• 0:56 - Why Alex joined Bionic Health
• 3:02 - Initial health goals and expectations
• 5:54 - Meeting frequency with health advisor
• 8:02 - Stress management and physical symptoms
• 11:33 - Perspective changes as a Bionic member
• 15:08 - Insights from lab testing and body composition
• 16:50 - How Alex feels different since starting
• 24:34 - Advice for health professionals
• 34:15 - Conclusion

‍

The Science of Better Sleep: Inside Bionic Health's Comprehensive Sleep Module

In the latest episode of Medicine 3.0, Bionic Health advisor Kelly Joniak and Dr. Catherine Isaac dive deep into one of our most popular offerings: the Sleep Module. This conversation reveals the multifaceted approach Bionic Health takes to help members optimize their sleep quality and understand the factors affecting their rest.

A Comprehensive Approach to Sleep Health

Dr. Isaac explains that Bionic's Sleep Module stands out for its thoroughness, combining multiple data sources to create a complete picture of a member's sleep patterns:

• Sleep diaries: Members record morning and evening sleep habits, providing insights into sleep quality, bedtime routines, and daytime factors affecting sleep
• Wearable data integration: Information from devices like Whoop, Oura, Apple Watch, or Garmin is analyzed alongside self-reported data
• Specialized assessments: Evaluations for stress, depression symptoms, sleep apnea signs, and chronotype (morning/evening preference)
• Laboratory testing: Thyroid function, basic metabolic panel, hormone levels including progesterone for women
• Cortisol measurement: Both serum and salivary cortisol testing to understand stress hormone patterns throughout the day

Key Insights from the Conversation

Understanding Your Chronotype

Dr. Isaac discusses how knowing whether you're naturally a morning person, evening person, or somewhere in between can help you optimize your schedule and understand potential sleep challenges. This is particularly relevant when family members have different chronotypes, requiring thoughtful coordination.

The Truth About Sleep Supplements

The episode covers several popular sleep aids with evidence-based perspectives:

• Melatonin: Most beneficial for elderly populations with naturally declining levels, shift workers, and travelers—not generally recommended for routine insomnia. Dr. Isaac cautions that over-the-counter supplements often contain higher doses than necessary.
• Ashwagandha: May help reduce cortisol levels and has anxiety-reducing properties that can improve sleep onset.
• Magnesium: Dr. Isaac specifically recommends magnesium threonate for sleep as it's the only form that crosses the blood-brain barrier.
• CBD: May reduce core body temperature (potentially facilitating sleep onset), but insufficient research exists on its effects on sleep architecture.

Wearable Data vs. Reality

A fascinating discussion explores the discrepancies between wearable sleep tracking data and self-reported experiences. Dr. Isaac cautions against letting your wearable device "tell you how to feel," citing research showing how suggestible we are about our sleep quality.

Lifestyle Factors Affecting Sleep

The episode covers practical recommendations about:

• Caffeine consumption (ideally limited to 1-2 cups before 1-2pm)
• Pre-bedtime activities (with warm showers or baths recommended over screen time)
• The relationship between exercise, nutrition, and sleep quality

Why Sleep Matters (But Don't Stress About It)

Dr. Isaac strikes a thoughtful balance, emphasizing that while consistent quality sleep is important for health, occasional poor nights aren't cause for alarm. The research on sleep's health impacts primarily concerns chronic patterns over years, not occasional disruptions.

"I find that when I'm actually doing the review of the sleep data, I find that to be really interesting and I think to help provide important insights," Dr. Isaac notes, highlighting how the module helps members understand their unique sleep patterns.

Ready to optimize your sleep? The Bionic Health Sleep Module provides actionable insights for improving this critical aspect of health. Listen to the full episode for more detailed recommendations and reach out to our team to learn how this module might benefit your health journey.

Timestamps:

• 00:05: Introduction to the Sleep Module
• 00:31: Components of the comprehensive sleep assessment
• 05:06: Understanding cortisol patterns and sleep
• 07:17: Lab tests and what they reveal about sleep issues
• 10:13: Chronotypes and how they affect sleep patterns
• 18:07: Discrepancies between wearable data and self-reported sleep
• 24:55: Optimal sleep duration and impacts across life stages
• 30:46: Evidence-based supplement recommendations
• 38:41: Caffeine consumption guidelines for better sleep

‍