MRI Body Composition to Guide Health and Longevity

One out of four people has a disease globally which is now the leading cause for liver transplants and it is driven by our dietary choices.  

We are being joined by Dr Mikael Forsgren , lead scientist at AMRA Medical who will discuss his work using MRI for body composition to better understand this disease. He received his PhD  at Linköping University’s Center for Medical Image Science and Visualization .

 #longevity #wellness  #Ketones #lifestylemedicine #younger #ketosis #biohacking #acetone #RobertLufkinMD #AMRA #MikaelForsgren #MRI



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Robert Lufkin 0:00
Welcome back to the health longevity secrets show with Dr. Robert Lufkin. One out of four people have a disease globally, which is now the leading cause for liver transplants, and is driven by our dietary choices. Today we are joined by Dr. Niko Forsgren, Lead Scientist at amre. Medical, who will discuss his work using magnetic resonance imaging for body composition. To better understand this disease. Michael received his PhD at Linkoping University Center for Medical image science and visualization. Before we begin, I would like to mention that this show is separate from my teaching and research roles at the medical school with which I’m currently associated. It is part of my continuing effort to bring quality evidence based information about health and longevity to the general public. Now, please enjoy this interview with Dr. Niccole Forsgren. Hi, Nicole, welcome to the show.

Mikael Forsgren 1:03
Hi, Robert. Thanks. Thank you for having me.

Robert Lufkin 1:07
Today, we get to take a dive into the use of magnetic resonance imaging, to do body composition analysis, as well as looking at things like liver fat, and then also understand some of the diseases that this is technology is being applied to, and also how we can use it to manage our own health and wellness in the lifestyle choices we take. But before we do that, let’s take a moment, Mukul and tell us a little bit about how you came to be so interested in this fascinating area.

Mikael Forsgren 1:50
I guess it started off more than 10 years ago when one of the founders of the company I work for now grabbed me as part of a bachelor project, and threw me in front of MRI scanner and asked me to assess and fix some issue they had with assessing, deliver. And then I continued on that technology side of MRI and started exploring and working on a bunch of different tumor based methods trying to replace a liver biopsy and eventually start to get to read more and more about the clinical aspects of all of these things. And working together with positions on these various research projects. I’m now almost fully transitioning into the clinical applications rather than focusing on the technology side. And I’m just trying to apply these skills that I have an MRI trying to solve real world problems.

Robert Lufkin 2:46
Great, great. Well, let’s take a moment and talk about some of the diseases that that before we talk about the technology, let’s talk about the diseases and see which diseases this technology, technology can address. And in particular, there is disease, that’s an epidemic that’s sweeping the world. It has a prevalence about about 25% and maybe even higher. And I’m not talking about COVID. Actually, I’m talking to something that that may be even more significant in the long term. And it’s largely attributable to the epidemics of obesity and metabolic syndrome. And in the United States. This disease is become the number one cause for liver transplants in some situations. So maybe you could speak to this and tell us a little bit about about this disease.

Mikael Forsgren 3:53
Yeah, so the disease that probably not that many people have heard of is non alcoholic fatty liver disease, or fatty liver disease for short for some people. So it’s a tightly connected with obesity. And as obesity is increasing, the prevalence of fatty liver disease also increases. So it’s tightly associated with metabolic syndrome and diabetes. So actually, if you have that, in honor colic, fatty liver disease, you’re more likely to have diabetes, or type two diabetes, you want to be more precise. And vice versa. If you have type two diabetes, you’re more likely to develop fatty liver disease.

Robert Lufkin 4:33
Let me take a moment and amplify that just a second. This disease is called non alcoholic fatty liver disease. And that’s sort of a strange name, having alcohol in there but I remember when I went to medical school and practicing up until about 1980, the main cause of fatty liver disease was alcoholism and drinking drinking alcohol and then In the 1980s, with the introduction of high fructose corn syrup, we began to see something different, which was a non alcoholic version of that. So, and that’s what we’re talking about now. And this non alcoholic version of fatty liver disease has surpassed the alcoholic version has now become by far the most common cause of fatty liver disease. Great.

Mikael Forsgren 5:26
Yeah, exactly. And it’s also expected to be a leading cause for liver transplantation. It’s not there yet. But since the disease is increasing, and thankfully, we’ve been managed to cure Hepatitis C, it’s probably one of the most prominent causes of liver transplant in the future. Luckily, it’s a fairly slowly progressing disease. And not everyone will progress to the end stages. But it’s Rachel print 30%. So it’s a huge number of people who actually are suffering from it or have it.

Robert Lufkin 6:06
And and what this is a deposition of fat in the liver. Is that right away? It’s called fatty liver disease. Is that right?

Mikael Forsgren 6:16
Yeah, exactly. It’s typically defined by having excessive amounts of fat in the liver. And that’s sort of usually seen as a benign face. And then you go into something called nourish, which is still satiety. So you have an ongoing inflammation also, within the liver coupled with cell death and scar tissue formation. That’s sort of the more damaging phase of the disease, which can eventually progress further into something called cirrhosis, where you have excessive amounts of scar tissue throughout the liver. And eventually, you would need a liver transplant to cure that because the liver is more or less input replaced by scar tissue to a very, very large extent at that point.

Robert Lufkin 7:00
So so how is non alcoholic fatty liver disease linked to obesity or metabolic syndrome? What is the relationship to that?

Mikael Forsgren 7:14
So it all connects to me, it’s probably the same. So the different manifestations of the disease in different organs. So it gets challenging just to focus on delivery need to look in, have a holistic view and see the entire body as the deliver dries, metabolism to a large extent throughout the body. So the body is affected to large things by the liver, and you also have a cross talk between the muscles and the liver. And that crosstalk itself is also further influenced by obesity, inactivity and excessive amounts of fat. So there’s a lot of different players in the body that interacts to sort of influence this disease and its progression. And there’s still a large, large number of unknowns in how this disease progresses and how to cure it. So it’s a huge amount of effort going into finding cures and treatments for this disease.

Robert Lufkin 8:15
And there’s certainly genetic components and and environmental components. Is this similar to the Flog gras, that when animals are induced to have very fatty livers for for as as a something to consume? Is that is that a similar type phenomenon? Or is that a different mechanism?

Mikael Forsgren 8:42
It’s a good question. I think my gut feeling would be yes, that’s similar that you have an excessive amount of food intake and very, very little little activities or too much energy going in. And the liver is very good at storing energy. So it’s doing short term so

Robert Lufkin 9:01
think it’s a good guy. I’ve heard Yeah, I’ve heard people if you want to make foie gras, you feed the darker the goose basically a corn slurry wheat and that’s been known for for hundreds of years and the corn slurry of course is high in fructose, which is what the liver converts to fat and not surprisingly high fructose corn syrup has begun to dominate our diet since the 1980s when non alcoholic fatty liver disease suddenly appeared on the scene so many people suspect a link there but like you say it’s complicated and the etiology and and risk factors are still being worked worked out on this. How does you mentioned the fatty liver disease also, the manifestation of the overall metabolic syndrome involves other parts of the body such as overall total body composition and, and we hear the term sarcopenia. What is that?

Mikael Forsgren 10:10
So for starting the more earliest stage of disease, we have done some research that was published some time ago, on general population, we looked at people with high levels of liver fat and low alcohol consumption. So the definition of non alcoholic fatty liver disease. And we could see that by looking into the Skewness in body composition. So, if they have high amounts of abdominal fat that is visceral fat, or the bad fat, if you will, that’s sort of within your intestines and your organs, coupled with high muscle fat infiltration that’s sort of associated with having a metabolic disease. And then if you copy that with either high or low liver fat, be so in that same research that if you have high amounts of liver fat, you’re more likely to have type two diabetes. But if you have actually high visceral fat, muscle fat with low liver fat that was more coupled to having coronary heart disease. So it’s interesting to start to look into the skewness, and how these different ectopic fat compartments interact together to really see how various metabolic comorbidities come into play into the fatty liver disease spectrum. And that sort of the earliest stages of the disease now go into the sarcopenic. area. So when you come towards the end stages of the disease, the body delivers, cannot really successfully maintain a working metabolism in your body. So they actually starve every so little when you sleep in between the meals, which then makes the muscle take a hit that they themselves need to lose energy by breaking down. So in that aspect, you have a slow, slow decrease in muscle mass coupled with also with the increased muscle fat infiltration due to the disease due to things affecting the muscle, slower muscles, and then increase muscle fat. And actually, if you look into those with end stage liver disease studies, those who had come to cirrhosis and put them need potentially a liver transplant, depending on the definition, but almost up to 70% of those have some stage of sarcopenia. So it’s highly prevalent when it comes to photos and stages, that you have a severely depleted or worse muscle composition.

Robert Lufkin 12:36
So what is the definition of sarcopenia? Is a decreased muscle mass below a certain criteria?

Mikael Forsgren 12:44
So there are a few different definitions there. There’s no not really a strong consensus exactly how to define it. But but most will say that it’s a combination of loss of muscle mass and function. And then you can measure that by various way. So I think that’s everyone would agree that it’s combination of muscle mass loss and functional depletion.

Robert Lufkin 13:10
Okay, yeah. And before we leave the liver and get into the muscles, I just want to interject one last thing. There’s an we’ll put this in the show notes. There’s a great interesting work done by Robert Lustig looking at liver metabolizing alcohol versus liver metabolizing fructose, and it has many of the same overlapping pathways and many of the same damages as his result is resulting in fatty liver with both of them. And he’s quoted as saying that fructose is like, consuming fructose is like consuming alcohol. As far as the liver is concerned. It’s just it’s like alcohol without the buzz sort of, or without the intercranial effects necessarily, although, with young children, I think we both know that consuming fructose can have a buzz to as far as the sugar rush with that, as well. But let’s look, let’s look at at sarcopenia and body composition. What are some of the approaches? Before we get into the magnetic resonance imaging? What are the current approaches? What are the alternative approaches for body composition? What are some of their limitations?

Mikael Forsgren 14:32
So a few different ways ways of assessing body composition. And it also depends on what you want to measure. What level of detail you need that service, of course, magnetic resonance imaging that we’ll touch upon later, but you also have something called DEXA, which is a extension of a modality that’s actually used to measure bone density but can also To some extent, assess the amount of lean tissue in your body. So I can see that the limitation there is the country really differentiate compared to digging, digging to see if there’s felting infiltration in the muscles or see which compartment you have fat in, because you just see straight through a body. So everything is sort of packed together there. Then you can also use CT. So CAT scan, typically don’t do whole body scans due to the radiation. But you can do like single slices, and can pretty much do similar quantification is can you be used with MRI. But with MRI can do a whole body instead. Sorry about body composition, I guess it’s also bioimpedance scales, where you stand on a weight and then you have an electric electric current going for your body, the different phases, and then you measure how the signal is affected by traveling through the body. And then based on that data, you then look, go into a lookup table and see how the body likely is composed based on that. So on a general level, you can have some air circulation, the problem there is that it’s affected by the fire, for instance, I see this or edema, which have been towards end stages of diseases and a bunch of other things. And also, since it’s a you estimate body composition based on that signal, so it’s not a direct measurement. So but it all depends on what level of detail you need for your application. Yeah,

Robert Lufkin 16:49
yeah, so the so a scale basically, that we’ve all used would just tell us our weight, and then we might, you know, compare our height with it and get some sort of index there. But it’s very crude, and doesn’t localize at all. Next we’d have DEXA or bioimpedance type measurements, which could give us a sense of fat and, and a sense of the body compositions, but it’s not localized into three dimensional space. And the quantification is really limited. So the highest level then we have where we want 3d anatomy, and it actually can measure muscle volume and fat volume and differentiate between body fat and visceral fat subcutaneous fat and visceral fat. That would be an imaging test. And we really the only two imaging tests available are CT Computed Tomography. And that, as you said, of course, uses radiation. So we don’t want to do that for a test that we’re going to apply many times or even that we expose the whole body to necessarily, especially when something like magnetic resonance imaging is available that can basically do everything and CT can as far as body composition, and there’s no no radiation penalty at all. With magnetic resonance, you can get it done really pretty much as often as you want. And, and that’s the approach you’ve taken right with, with a company you’re working with, with magnetic resonance imaging for body composition. So so how does that work? And one of the one of the advantages you found?

Mikael Forsgren 18:32
It’s also good. Interestingly, we’re getting multiple MRI scans when you do your PhD. Yes. And Mr. Physicist, you typically go into the scanner all over the time for a colleague, so I guess all who has a PhD in physics, I spend days in the scanner. I haven’t seen any publication that no one has suffered from that. So that’s yeah, it’s a very, very safe modality, indeed. So what we do at the company, so it’s actually a spin off company from research. So bunch of researchers at the University of Leeds shopping, who started this company almost 10 years ago was actually inspired by Spurlock Supersize Me documentary, which came around that time, that his study and wanted to see if they could quantify the body composition efficiently, because the in the old days, he pretty much had to go slice by slice and quantify and they wanted to develop a more automatic way of doing that. So pretty much what to do is have a fairly brief MRI imaging session takes about eight minutes. Going from neck to Denise, and then that’s it in terms of procedure to hospital and then it’s all algorithms done doing quantification based on those images.

Robert Lufkin 19:58
So Just quick reference, we will link to Morgan Spurlock’s seminal documentary Supersize Me where, what was it, he went to a fast food restaurant, I think it was McDonald’s for a month and survived barely on McDonald’s only food. And I think I think he saw his metabolic parameters, he had frequent blood tests and all decreased over that time. But we’ll we’ll link to that as as as well. So I just wanted to put that in there and, and continue them.

Mikael Forsgren 20:39
So now actually, that that’s sort of that was the day it was actually took, like, 15 medical students and gave them similar treatment. That’s, that’s burlock. But then we did also MRI was that, back in those days, we didn’t have that technology. So that studied them, made them develop the technology to do this whole body MRI accuracy assessment. So that was only done focusing on deliver in terms of fatty infiltration, etc.

Robert Lufkin 21:10
Now, you mentioned that to do this body composition, with magnetic resonance imaging, you scan from the neck down to the knees. Why were the maybe tell our audience why those choices were made? Why? Why wouldn’t you scan from the top of the head to the toes.

Mikael Forsgren 21:30
Because you don’t have that much fat in your head, but you have some fat, but it’s mostly around your neurons in your brain, and doesn’t know that many things that happen up there. So we wanted to focus on the central pieces of the body. And it’s always like it’s you have to decide how quickly want to have it done and how easy it is to get it moving on other systems and have it sort of being scalable. So this was one way you’re doing it very, very efficiently and rapidly in a standardized manner. And also, since you don’t have big fatty deposits or muscles in your head, that’s because we want since we don’t want to do it quickly, we can’t have very, very high resolution. So it’s difficult to find these small small muscles in your head. During this rapid acquisition that takes just eight minutes, of course, you can use the same technology going into small muscles, which we typically do in like your muscular disorders. But that’s a whole different type of sequence, which takes much longer time in the smaller for specialist like clinical trials, etc.

Robert Lufkin 22:49
So the key here is it really would be the abdomen for your visceral fat and subcutaneous fat. And of course, course the key structure the liver. And then by extending down to your thighs, you get large muscle masses, and presumably, you know what happened, what’s happening in your thighs is happening in your calves. So it’s not really necessary to do the calves and and the brain, like you say, doesn’t add anything. So you’re really hitting the the high impact areas with this with this study? And what have you found? What are some of the results that you found with this technology.

Mikael Forsgren 23:28
So as I mentioned a little bit earlier, we could see that when we look into the sort of the skewness of body compensation, if you will. So looking into how these different compartments are against each other, we could see that if you have high amounts of visceral fat with high amounts of muscle fat that was linked to having metabolic disease. And in the same research also saw that if either high or low liver fat, you have more likely type two diabetes or coronary heart disease. So that was published back in 2018 2019. It’s actually picked up by National Geographic who made a special edition in 2019. On the future of medicine, where they work further in that case, and actually, they coined the phrase, it’s not the fat it’s goats ad, which is quite a good one just described like because after the same BMI that was shown that researcher the same BMI, but different risk for metabolic comorbidities, pending your Skewness in your body composition or your ectopic fat compartments.

Robert Lufkin 24:36
Yeah, that’s a that’s a key point that That bears repeating I think yeah, for a given weight, depending on how the fat is distributed into various body compartments, which is what the body composition MRI can show. For given the same weight you can have two people and one is very healthy metabolically and one is very unhealthy metabolically and you wouldn’t be able to tell from looking at them or from their, their, their weight as measured by a bathroom scale. And along the same lines, I think it’s worth repeating too, that metabolic health and all these these problems with the liver and and wellness, it’s not just a problem of patients with obesity. In other words, in fact, as we’ve talked about, on other episodes, you can have people who are clinically obese, but they’re metabolically healthy. And, and you can have people who are thin, but are very metabolically unhealthy with all the risk factors and all the increase incidence of diseases and life expectancy associated with it. So it’s not enough, unfortunately, just to say, well, I don’t have a problem with my weight, I don’t have a problem with metabolic disease. And, and of course, and then in the, the paper a few years ago that everyone quotes, you know, over 80% of Americans have at least I have metabolic disease is defined by at least one of the five criteria for metabolic syndrome. So this is truly pandemic. But this body composition analysis will allow us to zero in on which patients have metabolic abnormalities, they’re how long does the scan take? What is the experience for a patient when they come in for one of these studies.

Mikael Forsgren 26:41
So it depends if you’re appending, this to an already prescribed MRI scan, for other reasons, then it only adds about six to eight minutes, roughly. But if you are going to scan only for this analysis, then you have to add also the time of getting into the to the scanner, in and out so but you could easily do it if within 20 or 30 minutes, if you’re doing only an examination for this. Having someone going into the scanner room, going into the scanner of the images and then go out. So it’s very efficient. And there’s no contrast enhancement or any things have to put on the body. It’s just into the scanner, take vividness and then you’re done. So it’s very, very quick in that aspect.

Robert Lufkin 27:28
So let’s scan with the body coil, then pretty much and correct. And I’ll just use this to be open. And also, as you said no contrast injections for so no, none of those intravenous injections that sometimes we add for Magnetic Resonance scans. But in this case, not not doing that at all. And is where’s the scan that available? Currently, we have a international audience to this program. So I what countries is available in now? And how do people would go about requesting one of these scans.

Mikael Forsgren 28:09
So currently, our scan is actually supported by at least 80% of the MRI scanners available from the me major manufacturers. So it’s a very good footprint and aspect. In terms of the medical device, for health and wellness, we have one medical device available in the European Union with a CE mark. And now we’re working on an updated one, which we expect to get clearance in the US by the first quarter of next year. The same goes for you getting this new device cleared, actually just got the clearance from Canada for that same device. So things are moving to get this available to people. So far, we’ve been involved quite heavily in major multicenter clinical trials with the same technology, which to now bring it to to the health and wellness area.

Robert Lufkin 29:04
Yes, we’re hoping to have one of these available in the Los Angeles area where I’m based and in q1 2022. What about the clinical trials? What are some of the some of the clinical questions that you’re finding this technologically technology useful to address?

Mikael Forsgren 29:25
So in some scenarios, they have been used to pretty much try to see So do we have any unforeseen effects somewhere in your body? Can we look into that or can we see any other good impact? One of the very good example is in our neuro muscular disorder. studies that were done that recently came out with fulcrum therapeutics are one of those rare diseases and we were I’m showing were very good results with our technology. So it’s, you can apply it to a bunch of different diseases and different aspects of the disease, since it ultimately it describes the manifestation of the disease on your body. So depends on the mode of action of the treatment and which questions you want to answer. So it’s, it can be used to do quite a lot, which also makes it kind of hard when you’re talking about it, because it’s like a blue ocean thing.

Robert Lufkin 30:32
So, so many applications well for, for our audience, interested and health, longevity, and in particular, the lifestyle choices that we can make to influence those things. This could be a very powerful technology. And anytime we evaluate a new test, or a tool to apply in this area, the first question we always ask is, can the lifestyle changes that we make choices that we make, and the changes that result be seen by this test? And I would say, you know, of course, people have people routinely changed their their body fat, their overall weight, but also their body composition, and arrangement of fat decreasing visceral fat, and versus subcutaneous fat can be can be done with a number of the interventions that our audience has been looking at, if you’ve seen that as well.

Mikael Forsgren 31:36
Yeah, we see changes in a number of different compartments, often can see changes increases in liver fat, because it’s a hot topic in since everyone’s trying to really solve the fatty liver disease issue. But since that’s coupled and with the entire metabolism, you see also changes in other compartments, such as the, the visceral fat compartment. And since we can do with a very, very high precision accuracy, you can find very, very small changes, or actual changes that you can measure over time.

Robert Lufkin 32:14
Yeah, it’s, it’s been a revolution. To me, or to my understanding, since I’ve gotten involved with lifestyle choices into just how much of a dramatic impact simple lifestyle choices like diet or exercise can have on our entire body. I mean, not only liver fat people can can lower their liver fat and reduce their fatty liver disease or, or lose weight or change their body composition from a metabolically unhealthy form to a metabolically healthy form. Just by just by lifestyle, things certain avoiding certain foods and, and all and, and, and even brain volumes, I was blown away to see hippocampal volumes in the brain on MRI, when it’s lost as a biomarker for Alzheimer’s disease can be increased over a period of months, and it can be seen dramatically on the imaging. So it’s, it’s it’s amazing the effects that the lifestyle can have on these quantitative measurements. But it’s also on the other side of the coin. It’s very powerful having a technique like body composition, where you can quantify something, apply the lifestyle, and then a few months later retest it, it’s a very strong motivational factor for the patients when they can see their liver getting healthier or their body their visceral fat decreasing, or their hippocampus growing back and increasing in their brain back to normal size. It’s it’s really very, very remarkable. The the so if they, if patients want this for wellness, they can request it themselves through through their local imaging center and get in touch with those and then obviously, if it’s if it’s done for a medical indication, then their their health care provider, their physician would request it or order it from again the hospital and locally imaging center. Is that correct?

Mikael Forsgren 34:24
Yeah, so currently, we will probably be out of pocket for the the patient or the person who is interested in seeing that this point in time, but there will be other options available at later stage.

Robert Lufkin 34:42
What are you familiar with the price range just the ballpark on? I know I’m sure it varies greatly around the world, but

Mikael Forsgren 34:53
no, I’m mostly focusing on the science things I’m not sure exactly what the cost the price is, to be honest,

Robert Lufkin 35:05
we’ll try and get some numbers if we can, and put them in the show notes update that. So with your expertise in body fat composition, and liver, fat and naphthyl, D and MRI, how has this knowledge informed your personal choices about lifestyle? Knowing what you know, what do you what do you do for exercise or diet or any particular choices there or sleep or anything like that.

Mikael Forsgren 35:40
So I actually kind of did a analysis, previous technology, almost a year ago, slightly more, and found actually had very, very high levels of visceral fat, which I did not expect. So that did not really match what you would see looking into the other traditional measures like waist circumference, weight, or whatnot. So I actually had very high levels of visceral fat, which made me quite startled, and then started looking to the other parameters. So that, yeah, but my muscle fat was very, very low. So it was good. liver fat, really, really low. So that was fine. High levels of pasta volume, which I expected since I do exercise quite a lot. So but the Mr. adipose tissue was actually quite high. And so that really triggered me into doing some changes. But just as trying to get sick, well seen that you need a holistic view on the body composition. Also, you need a holistic view on your life composition, if you will, to really get a working effect. So

Robert Lufkin 36:45
why why is the visceral fat so dangerous, as the taneous fat.

Mikael Forsgren 36:52
So you can hardly find any links for subcutaneous fat for disease other than if you lose quite a lot of subcutaneous fat, and you’d like to kick the can or about have a very severe end stage event. But visceral fat is coupled with quite a lot of risk for developing disease. But as I looked at an entire database, with individuals with having the same combination with high visceral fat, but low muscle fat and low liver fat, the propensity for having diabetes, coronary disease was just a few percent. So that really made me feel good. Got it, this is nothing to be alarmed by now, but I better get that value down before anything happens. So that’s the beauty here, you can really start to see things that you can actually attack before they go become a actual disease. So nine months later, I was down 10 kilos, and maintained that since by just not that drastic changes, actually. we’ve skipped all of the highly processed foods, and all of those sugars because those are big, no no’s and then also just going so every morning is always oatmeal. And whole grain and sourdough breads, and going back to the old cultural wheat varieties like Emmer and spelt. So and then portion control, smaller plates eat less food, and small changes like that, that can still be sort of sustainable changes can’t come, because I figured it’s kind of hard to do big drastic changes. Because that’ll be hard to maintain in the long run. So we’re starting just doing small changes that we can maintain and sort of have a snowball snowball effect, adding more and more stuff, because it was not a critical event, but we wanted to have a working solution to get it down.

Robert Lufkin 38:56
Yeah, that’s, that’s been very powerful with with people rather than going on a quote, diet that, you know, people will stay on for a matter of days or weeks, and then end the diet rather than that make a gradual change that’s that we don’t really think of as a diet, but just it’s the way we eat whatever we eat, and that becomes the normal for us. And that is sustainable, by definition in the long term. So that’s that that’s great. Any Do you do any intermittent fasting? With that?

Mikael Forsgren 39:29
I actually try that. Prior to doing all of us I actually tried it during my PhD years, for a few months. By during those two days of calorie restriction, I really couldn’t be sharp mentally. So it had too much of an impairment on my other aspects of life. So I did not continue that. But it was a interesting experience to try out. But for me, it was challenging but same for others, it’s been working. So it’s also everyone slightly different. So different things work for different people. Yeah, it

Robert Lufkin 40:09
shows the importance of whether it’s diet or supplements or fasting, these lifestyle choices all have to be personalized, because the effects are so different. Any any supplements or devices that you use to follow your health?

Mikael Forsgren 40:26
Well actually use the traditional scale. So almost 10 years worth of data to track back and see the impact of your big holiday events. We’ve been binge eating, and then the holidays, everybody also goes to show me looking scary. So we’re sort of slightly above where it should be, but probably not that bad. But then when you did that, PCP scan, getting the thing, the exact malice or the visceral fat is like, whoa. So I still now have a cut point. And I don’t want to move over in terms of weight. But, again, it shows that need more data. But other than that, of course, I have a cellphone smartphone, you have a step counter a built into that one, which I try to look at now and again. And really, if there’s too much, we’re hard, intense work periods where there’s not mood enough to really step up. And but the good thing is, I have a two year old son who really loves biking. So once or twice a day, he’s up on the back of my bike, can we go for a ride for half an hour, 40 minutes, it’s a good solid exercise and also having a small son, which is quite active. It’s a good exercise by itself. Absolutely. Absolutely. Well,

Robert Lufkin 41:47
Michael, tell us, how can people follow the work you’re doing? Is there a website they should go to or social media?

Mikael Forsgren 41:56
Yeah, so we’re actually there’s a few colleagues also do this type of work with these measurements. So I’ve printed our the company’s LinkedIn page, and my medical limping LinkedIn page really highlights all of our research that we do, of course, I, on my personal LinkedIn page, also highlight the research I’m directly involved in but so following both you get posts specifically to me, and then all the other things that my colleagues work on. So we’re a team of clinical scientists, that are all involved in different aspects of trying to really dig into how body composition really relates to disease and outcomes.

Robert Lufkin 42:37
Great well, and we’ll link to all those in the show notes as well. Well, thank you so much, Mikko for spending this this hour with us and sharing the fascinating work that you’re doing. Thank you and look forward to let’s stay in touch and want to hear about all the great things in the future that we have to look forward to as well. Looking forward to it.

Unknown Speaker 43:04
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