Guide to Alternative Medicines with Helene Langevin

What does science say about alternative medicines and health fads? Neil deGrasse Tyson and co-hosts Chuck Nice and Gary O’Reilly learn about the science behind alternative medicine with director of National Center for Complementary and Integrative Health, Helene Langevin, M. D.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Neil deGrasse Tyson?

  Coming up on StarTalk Special Edition, we're going to explore some of the innards of the National Institutes of Health and that branch of them known as complementary medicine. What is it? How does it work? What does it mean? Is it real? Is it fake? What role does science play in all of our decisions related to supplemental health? All that and more coming up on StarTalk.

• 0:30Neil deGrasse Tyson?

  Welcome to StarTalk, your place in the universe where science and pop culture collide. StarTalk begins right now.

• 0:43Neil deGrasse Tyson?

  This is StarTalk Special Edition. Today, we're going to explore the National Institutes of Health, the NIH, and their special program on what we once called alternative medicine, but now it's been sort of rebranded, renamed, rethought about as complementary medicine. Let me introduce Gary O'Reilly. Gary?

• 1:06Gary O'Reilly?

  Hi, Neil.

• 1:07Neil deGrasse Tyson?

  You are Special Edition Guy, right?

• 1:09Gary O'Reilly?

  Well, I'm part of a team. There's no I in team, so there's...

• 1:14Chuck Nice?

  Yes, but there is a me. There is a me in team.

• 1:18Gary O'Reilly?

  Thank you. I set them up. You make the funnies.

• 1:22Neil deGrasse Tyson?

  That was a low-hanging fruit there, Chuck. Chuck, good to have you, man. Always a pleasure. Yeah, so Gary, what have you done for us today?

• 1:28Gary O'Reilly?

  Well, we sat down and as you articulated just now, very similar thought process. And we came up with the idea that we all want to enhance our health, lengthen our lifespans while reducing illness and disability along the way. Well, most of us have that chance. We can't always do it on our own. And does anybody have our backs? Or? Sadly, are we at the mercy of celebrity endorsements and teenage influencers, those young youngsters?

• 1:59Gary O'Reilly?

  Actually, somebody does have our back, and it is the NIH, or if you prefer, as you said, the National Institutes of Health. Their goals include fostering fundamental creative discoveries, innovative research strategies, very important, for protecting and improving the nation's health. Now, all of that said and done, we'll get to the hows and whys once we start talking to our guests. So please, if you would introduce our guest, Neil.

• 2:26Neil deGrasse Tyson?

  All of you join me in welcoming our special guest today, Helene Longevar. She's a medical doctor, and she's Director of the National Centre for Complementary and Integrative Health, which is part of the National Institutes of Health, the NIH. And you're currently Chair of the Inter-Agency Pain Research Coordinating Committee. That has way too many words in it.

• 2:50Gary O'Reilly?

  Ouch.

• 2:51Neil deGrasse Tyson?

  Just so you know.

• 2:54Neil deGrasse Tyson?

  And you research specializes in connective tissue, its flexibility, and how that all relates to pain. I'm all into connective tissue because I used to dance and I used to wrestle, and my connective tissue felt it every time. So I'm going to totally get into this conversation. And you were formerly a professor in residence at the Harvard Medical School. So I'm very much looking forward to this conversation. Helene, welcome to Startalk.

• 3:23Speaker 03

  Thank you.

• 3:24Neil deGrasse Tyson?

  People might have heard of NIH, but they don't really know what it is, or what it's supposed to do, or how it functions. Can you give us just a brief overview, so that we're all on the same page about what to expect from the organisation?

• 3:37Speaker 03

  Well, yes, my pleasure. NIH is the leading federal agency that's responsible for funding medical research.

• 3:44Speaker 03

  And so what NIH does is it really funds medical research, covers the whole spectrum from basic biology, really understanding how living things function, how they can function in health as well as disease, and then applying this knowledge to really provide the best treatments to enhance the health of all people. So that's the mission.

• 4:07Neil deGrasse Tyson?

  And so government money funds this organization, correct? And with a huge number, I think you're better funded than NASA, I think.

• 4:16Speaker 03

  Health is important, so is yes, of course.

• 4:18Neil deGrasse Tyson?

  Yeah, I am jealous. Don't be jealous, Neil. Let me.

• 4:25Neil deGrasse Tyson?

  Because I don't know that it was always funded more than NASA. And then like I remembered it passed and kept going. And what do you do that pharmaceutical company, the business world, doesn't do? I mean, we always hear that there's a new medicine that comes out from some big pharmaceutical company. And so do you guys make medicines or do you fund that research? Where does your, where does the, it's not just in your building there in Washington.

• 4:53Chuck Nice?

  I'd like to know how my tax dollars are being used. That's what I'm saying.

• 4:58Speaker 03

  Well, we cannot overestimate the importance, right, of having a rigorous research that is objective. But what I mean is that this is research that is peer reviewed, where the research projects themselves, as well as the science, and even after the research is being conducted, is monitored carefully for its objectivity. So this is not influenced by, for example, commercial bias or, so that's why this is so important to have. It's a source of, it's an agency that monitors the quality of the research, the rigorous nature of it, and also how the results are disseminated. So it's really an important function.

• 5:39Chuck Nice?

  Sounds to me like you're part of the deep state.

• 5:45Speaker 03

  It's certainly part of the state and we do go deep in the science.

• 5:50Neil deGrasse Tyson?

  There you go. There you go Chuck. There's your answer.

• 5:53Chuck Nice?

  There's your answer there.

• 5:55Neil deGrasse Tyson?

  And what I like is if you look at any of the papers that are published in the websites controlled by the NIH, something I don't see every day in my field because we just don't have this susceptibility. At the end of each of those papers, and correct me if I'm wrong, Helene, that there's a disclosure on whether the results of that paper will influence the person's financial status or where the sources of money comes from so that the reader can, it doesn't mean it's necessarily a biased paper, but you want to be able to put your sensitivities, your skepticisms in the right place.

• 6:35Neil deGrasse Tyson?

  In my field, if I do research on a black hole or Pluto, you know, I don't have to really disclose my sources. Nobody benefits from any of it in astrophysics. So I take it for granted that we're mostly immune from, not that we don't have bias, but it doesn't have the kinds of bias that are so importantly disclosed in your journals.

• 6:57Speaker 03

  There's all kinds of biases and the important thing is to first of all disclose them and then manage them. And so that's what NIH does really well.

• 7:05Chuck Nice?

  And do you ever take a collaborative tact in your approach to research? So is there ever something where you're joining research that is already underway as opposed to just reviewing it?

• 7:18Speaker 03

  All the time. So team science is now becoming so important, especially in our field, in the field of complementary and integrative health, because it is a science that by definition involves more than just one organ or one system. It involves the whole person as, you know, as we really have become to understand that health is something that is complex. And so you need all kinds, you need teams of people to do this kind of research. It's very, very important.

• 7:48Neil deGrasse Tyson?

  So Gary, take us into your laundry list that you had set up for today.

• 7:52Gary O'Reilly?

  We did come up with this idea of a laundry list and I think it's, it kind of fits the bill quite nicely. What if we said? Something that on the surface sounds like it should be really good for us and healthy, like multivitamins. And you know what? What if I took more? Wouldn't that be even healthier? Did your research go into that field of how this is positive and how this may be negative?

• 8:15Neil deGrasse Tyson?

  That's so fundamental. As you know, Helene, we have this mindset, I don't know if it's a nation or just being human, that if a little bit of something is good, then more of it must be better. So let's just chug it. And so if you can shed some light on that, that would be delightful.

• 8:31Speaker 03

  This is a very, very important question. More is better is almost kind of the mantra of our current society, right? And what we're finding out is in medicine is actually might be the other way around a lot of times. Is that if when we when we study, for example, the effect of a vitamin and we assume that if you take this vitamin in the form of like, say, for example, fruit and vegetables where the vitamin is naturally present, you might eat an apple or a bunch of grapes or something like that. You're not going to eat, you know, five kilograms of grapes, right?

• 9:11Chuck Nice?

  Turn those grapes into French fries and you got a deal.

• 9:14Speaker 03

  Yeah, but there's not too many vitamins, though, in French fries, or at least some of them are, yeah, it's sort of like, let's stick to vegetables for now. So if you take a vitamin pill, for example, you may have a lot more of that substance than you would normally consume in the course of your diet. Is that good? Is that bad? Research is starting to show quite convincingly that taking large amounts of anything is not a great idea unless you want to use it as a drug. Now, that's what drugs do, right? Drugs are substances that you take in relatively large amounts in order to really influence a metabolic pathway that's gotten diseased, for example. That's what drugs do, right?

• 9:58Speaker 03

  Like, say, for example, your cholesterol is too high. You could take a drug that will lower your cholesterol. What it does is it binds the molecule of the pathway and it pulls it down so that it actually collects, corrects your cholesterol. But the problem is that drugs are very strong and they can do other things too. Because that pathway is not just control your cholesterol, it might control other things. So drugs are strong. And as opposed to taking something in the form of a fruit or vegetable or something like that, where the same substance may be very, very small, that is more likely to interact with your body naturally, the way your body normally works and support the function of the body. So there's a big difference.

• 10:42Speaker 03

  And I think we tend to think that by taking more of something, we're going to have a better effect, when in fact, sometimes it actually doesn't. And in fact, it could have negative effects.

• 10:51Gary O'Reilly?

  Are we seeing a sort of mantra emerging that we need to go back to what we used to do, which is not go through a processed pill, processed tablet, but go into the vegetables, the fruits, and absorb the vitamins in a more natural way with our bodies in a bio? Food is medicine. Food as medicine. Who'd thought about that?

• 11:13Speaker 03

  There's certainly a lot to that. It's by taking substances in the context of your diet is certainly a lot safer as opposed to taking supplements that may give very, very large amounts of something when we don't really know if it actually is beneficial. And in some cases, we know it's not. For example, taking large doses of vitamin E have been shown to cause, to predispose to cancer. And since then, people have really backed off in how much over vitamin A, same thing. Vitamin D even. We used to think that vitamin D was you had to take a lot because you want to make sure you're not deficient. Well, now we're showing, we're finding that actually is not so beneficial to take very large doses.

• 11:54Neil deGrasse Tyson?

  What does that do? Too much vitamin D, what is that?

• 11:57Speaker 03

  Well, it's not so much what it does that's bad, but it actually, what we used to think is, but you needed to increase your dose of vitamin D in order to protect against osteoporosis, for example, in women. Where now we're finding that actually, no, it doesn't really do that much to take very large doses. As long as you're not deficient. And so correcting the deficiency is important, but adding to that is probably not that beneficial.

• 12:24Neil deGrasse Tyson?

  Okay, pause for a minute. Wait, pause. So in my field in astrophysics, when there's something that we don't know very well, it's because like we haven't been there yet, all right? What's really going on on Pluto? Well, let's send a mission there to find out. What's going on in the center of a galaxy? Let's get a bigger telescope and then we find out. We as humans have been here for you in the lab like forever. And we've had vitamin D since whenever it was discovered. So how is it that we can go from some earlier thinking about the role of vitamin D to some emergent thinking and have that emergent thinking be different? That has to mean the early experiments were not done properly,

• 13:08Neil deGrasse Tyson?

  or they had bias, or the sample size wasn't big enough. Why aren't we self-aware of that at the time and to put in the uncertainties so that people don't pivot their life on some medical research that might one day in 10 years show up wrong?

• 13:26Chuck Nice?

  What we did now was we took a spaceship and we shrunk it down and put it inside of a syringe. Then we shot it into somebody and we were able to do the exploration necessary to find out.

• 13:37Neil deGrasse Tyson?

  Okay, Chuck, that's a movie, okay?

• 13:40Chuck Nice?

  I thought that was a documentary.

• 13:45Speaker 03

  In answer to your question, it is frustrating for some people because they think, oh, you said this now before and now you're saying something else. But science, just like anything, doesn't go in a straight line, right? Part of good science is to design a hypothesis. You have an idea, you have a hypothesis. The hypothesis is based on what you previously knew. And then you say, let's test that. And then you test it and find out if it's right or if it's wrong. So it could be that when we decided to test larger and larger and larger amounts of vitamin, that was a hypothesis. And it took a long time for us to figure out that, well, you know, maybe that's actually not as useful as we thought. Now we're just, we're gonna go back to, you know, testing perhaps smaller amounts of this compound.

• 14:30Speaker 03

  It's still very important. It's just the dose may need to be different.

• 14:34Neil deGrasse Tyson?

  There's a combination of the research results as reported and the press interface to those results that brings it to the public.

• 14:42Speaker 03

  Yeah.

• 14:43Neil deGrasse Tyson?

  So somewhere in there, if they say this amount of vitamin D is good for you to clear your deficiencies, more might be better for these reasons, we think, but it's not fully tested yet. We need more studies. And that's what I would expect it to say for you to now say the more studies show that it's not working as intended.

• 15:05Speaker 03

  Yeah, I mean, it doesn't cancel everything. You know, vitamin D is still important. It's still important to not be deficient. And so people who are not, for example, don't are not exposed to enough sunlight, for example, in the winter, you know, people who live in northern climates, etc. It's very important to say, okay, let's just make sure either you eat food that are rich in vitamin D, like oily fish, for example, or take a supplement that gives you the amount of vitamin D that would normally be in your diet if your diet is not sufficient, but not boost.

• 15:39Neil deGrasse Tyson?

  I'd take two vitamin D three pills. Does that make a vitamin D six? Just one?

• 15:45Speaker 03

  No, hopefully not.

• 15:55Speaker 04

  I'm Kais from Bangladesh and I support StarTalk on Patreon. This is StarTalk with Neil deGrasse Tyson.

• 16:09Gary O'Reilly?

  Are we in the middle of a battle here between the advertising budgets of Big Pharma and the supplement makers and science? At the moment, it seems like the advertising budget has the bigger muscles and is winning.

• 16:24Speaker 03

  Advertising is just one way that people get information, right? From ads, you can also get information from other places like the social media. You can also get important information from the NIH, right? Places like that where science or from scientific papers, etc. That's what we try to do at NCCI is really, very importantly, educate people about what we know and what we don't know. And when things change, like this information about vitamins, we make sure that people know about this. So yeah, it's, it's, there are a lot of places for information.

• 16:56Chuck Nice?

  Also, I think that for pharma particularly, they're pretty regulated in terms of the claims that they are able to make about their products in the advertisement.

• 17:07Neil deGrasse Tyson?

  FDA regulated, right?

• 17:08Chuck Nice?

  The FDA causes them to not only govern tightly that what they say about the product itself, but more importantly, they have to list anything that could go wrong, which is why at the end you get this disclaimer that says things like, "In certain cases, may cause death," you know, and you're like, "Did I just hear that right? Wait, so get rid of this hangnail? I gotta risk death and cancer? Wait a minute."

• 17:35Speaker 03

  That's it. I mean, drugs, like I was saying earlier, drugs are strong. Drugs can correct an abnormality when you have, say, somebody has a serious disease. The drug becomes very important to correct the abnormality. There are some risks and side effects to the drug, but you need the drug in that case. The thing is, though, other kinds of treatments, like the kinds of treatments that do not involve drugs, that are more what we call non-pharmacological, generally a lot safer, although we can talk about that, too. I mean, there's ways, you know, not to overdo things, even if they're not drugs, but as long as done in the right way, can be very effective treatments without involving the risks of drugs.

• 18:14Neil deGrasse Tyson?

  But you're a person on the street and you walk by a store that says "Health Supplements", and you go in, and there's hundreds, maybe even thousands, of bottles of stuff, and the bottle itself will not necessarily make a health claim because they're riding on what you might have heard about it in some back alley magazine that is telling you that it cured something in some faraway land. And so you go in there looking for it, and you buy it, and none of it is FDA-approved. So what is your recommendation to people who seek some kind of solutions in their lives through these non-approved medical supplements?

• 18:57Speaker 03

  Well, first, they can seek some guidance from, for example, our website. At NCCIH, we have a website that's dedicated to this. And we have, you can look up a substance if you're not sure. What does this substance actually claim to do? Is this actually verified? Because in some cases, there is science, but in other cases, there isn't. So on our website at NCCIH, we have a very nicely inorganized page where you can look things up. And that would be a very good way for people to not waste their money.

• 19:30Chuck Nice?

  They're not cheap, too.

• 19:33Speaker 03

  They're very, you can spend a lot of money on these things.

• 19:37Chuck Nice?

  Speaking of spending a lot of money, this is very personal right now. And I don't mean to just derail the show, but I gotta ask. So there's these green powders now that are out, and you see them all over the place. And there are many different companies that make these green powders, which are kind of a dehydrated amalgam of many, many different vegetables, concentrated to a point where they're supposed to give you all that you need nutritionally in one little shake, and you drink it, and they cost a lot of money. So my question is, am I wasting my money?

• 20:14Speaker 03

  Well, for some people, they may think, well, you know, I'd rather do that than cook a meal.

• 20:21Chuck Nice?

  Oh.

• 20:22Speaker 03

  There's a lot of other benefits to cooking a meal that are not in that little powder, right? And so the effort, the time and effort that you might want to take to cook a meal, to buy the food, prepare it, eat it. A lot of people think, well, I don't have time for that. You know, I'm just gonna, you know, take the pill. First of all, as you say, it's expensive. Sometimes it can be more expensive than cooking the food. But it also doesn't provide you with all the benefits of the actual food. You know, there's so much that is in the food that we eat that is not in that little pill. So, you know, it's it's a shortcut. And I think that especially because these projects are not regulated, you don't know what else might be in there

• 21:08Speaker 03

  that you don't know about. And also, some of the substances might be so concentrated in there that you might have adverse effects from it. Because you don't know, you know, how much there is. So I would say generally, it's not a good idea.

• 21:22Gary O'Reilly?

  Wow. Seeing as we've gone back to the future with some of our thinking, um, and we are now thinking maybe non-drug related treatments, therapies, etc. Something that's been around for thousands of years, acupuncture. Where would you or the NIH stand on practices like acupuncture?

• 21:45Neil deGrasse Tyson?

  Yeah, one point there, Gary, I don't like asking or inquiring where someone stands on something. Because that implies that there's there's some their heels are dug in and it's not an open scientific process. So rather than think of stances, because anytime somebody says a stance, then that they're not giving up.

• 22:02Gary O'Reilly?

  What are the findings?

• 22:04Neil deGrasse Tyson?

  Yeah, what are the findings? That's the way to put this.

• 22:06Speaker 03

  Yeah, yeah.

• 22:07Neil deGrasse Tyson?

  And just to be clear, your entire branch of the NIH is entirely concerned with what has historically been called alternative medicine. And acupuncture has been, you know, front and center in that in that movement.

• 22:21Speaker 03

  Well, the first thing is actually we don't call it alternative medicine anymore. It used to be. Uh, now we we call it complementary. Because none of these therapies are meant to be used instead of uh, conventional medicine. They they're really meant to be used together.

• 22:37Neil deGrasse Tyson?

  Important semantic point, yes.

• 22:39Speaker 03

  As important, yeah, as appropriate, right? You wouldn't want to use acupuncture to treat cancer. For example, however, you might want to use acupuncture to help manage some of the symptoms that people have when they have cancer treatment, very importantly. Pain, for example, a lot of people with cancer have pain that is very difficult to manage. Ah, fatigue, problems sleeping, problems with stress. In fact, there's a very good study that has shown that there's a certain cancer drug ah that causes a lot of musculoskeletal pain in women with breast cancer. And when acupuncture was used in addition to the cancer treatment, it did such a nice job helping with the pain that a lot of the times the the women were able to stay taking their their medication,

• 23:24Speaker 03

  which a lot of times people have to discontinue this medication because the side effects are so serious. But acupuncture helped with that, so you can see it's really a complementary treatment.

• 23:35Gary O'Reilly?

  Yeah.

• 23:36Speaker 03

  That helps.

• 23:36Gary O'Reilly?

  That makes a lot of sense, you saying that, yeah.

• 23:38Neil deGrasse Tyson?

  Yeah, and where does the placebo effect show up here? Uh, that should be, it seems to me, a very big part of your uh budgetary explorations. Yeah. Because so much of people's expectations are just fulfilled in their own physiology. And uh, and maybe that's fine. I mean, I I if the placebo effect works, then maybe we should harness the placebo effect.

• 24:02Speaker 03

  I agree a hundred percent. So think about placebo as a healing response, as self-healing, because that's what placebos are.

• 24:09Neil deGrasse Tyson?

  Tell us afresh what a placebo effect is.

• 24:12Speaker 03

  So the the classic way to describe a placebo, it's a fake treatment, right? Something that has no effect, that supposedly had like a sugar pill, for example, and that you take, thinking that you've taken a real treatment. And and there's a certain placebo response to that in a sense, it's just the fact of taking this this placebo substance. A lot of times, this helps people to get better. And it's very interesting because people used to think that it was a deception, but people have started to do what we call open-label placebos, where you actually tell the person, this is a placebo. And you compare that with taking no placebo, and people still can get better with these open-label placebos. Now, what's going on here, right?

• 24:57Gary O'Reilly?

  Positive mental attitude, doctor. That's what we used to call, back in the day, PMA. Yeah, you heal yourself.

• 25:03Speaker 03

  But some people think that there's something about the ritual. Of taking something and saying, I'm taking this pill. And this, I'm going, this is, this is something that I'm doing to help me get better. Which is what, when you do, when you take an open label placebo, you know you're taking a placebo. You're still taking it. And there's a therapeutic effect to that. We still don't quite understand what it involves. But it's a very, very

• 25:26Neil deGrasse Tyson?

  Why not? This is 2024, you're the NIH, you got a bajillion dollars a year more than NASA. Just jealous. And you don't, you cannot tell me how placebos work.

• 25:39Speaker 03

  Well, we have some idea. Uh, we know that there are pathways in the brain that, that have, for example, for pain. Right? We know that there are pathways in the brain that influence how much the pain bothers you. You may still have pain, but you may have a certain amount of stress or anxiety or suffering associated with the pain. And this involves some areas of the brain. The placebo, interestingly enough, when you take a placebo and you do studies using a functional MRI in the brain, you can see these pathways being activated by the placebo.

• 26:16Neil deGrasse Tyson?

  Wow.

• 26:17Speaker 03

  The pathways that, that, that interact, it's not just, I mean, you still feel the pain, but it's how you respond to the pain.

• 26:23Gary O'Reilly?

  Well, I would flimsily describe as changing your brain chemistry then.

• 26:27Speaker 03

  What, your brain mechanisms, yeah, are being affected by placebo, that's well done.

• 26:31Neil deGrasse Tyson?

  The brain changes though.

• 26:32Gary O'Reilly?

  Okay, so let's come out of the placebo for the minute. People have heard of the term acupuncture, but don't know how anatomically it's worked. Yes, it's pain management, but what systems is it connecting to? Cause it's just needles in your skin and what's that, the knee bone connected to the whatever the hell's going on here.

• 26:49Chuck Nice?

  And by the way, uh, sticking a bunch of needles in me sounds very painful.

• 26:53Neil deGrasse Tyson?

  I'm in pain, give me acupuncture.

• 26:55Chuck Nice?

  You stick needles? It's like, so you're in pain, let me stab you eight thousand times.

• 27:00Speaker 03

  Yeah, well, it, I mean, it, but it's funny what you're saying, distraction, actually, you know? Like if you, you know, with your, when your mom did, when you, when you, uh, you hurt your knee and you, you rub another part of your body, that's actually distraction, that actually works, you know? It's just a temporary distraction. But acupuncture does something more than that. It, it is, it does two things. That we know about. One is it stimulates sensory nerve information that can actually modify the mechanisms of not just pain, but other functions. What we call the autonomic nervous system in the body, which is the part of the nervous system that controls the internal organs, the gut, for example,

• 27:45Speaker 03

  the heart, the lungs, etc. That can be modified, believe it or not, by mechanical stimulation of points that are on the ear. And these are points we know now are linked to the nerve that connects to the organs. So this is a very, very, very interesting part. And people have been doing this for a thousand years. But now we're starting to understand that it has a connection to the nervous system. But there's another part of acupuncture, besides the nervous system, that's also important, we think, is that acupuncture can actually stimulate the connective tissue, which is a part of the body that is very important, but not very well understood yet.

• 28:27Speaker 03

  And that links the various different across the muscles, for example, of your body. And this may be the basis for these acupuncture points that people use to do acupuncture.

• 29:00Gary O'Reilly?

  We've heard about it. People have done it. There are challenges. And it can be extended from ice baths into cryogenic chambers, where athletes with lots of money can spend thousands and thousands of dollars to spend X amount of minutes in there. What are our findings here for ice baths?

• 29:21Speaker 03

  Ice baths. This is such an important and interesting, I think, question, is the amount, what happens when you expose your body to a little bit of stress?

• 29:32Gary O'Reilly?

  Hmm.

• 29:33Speaker 03

  So we all know, right? We are exposed to a lot of stress in our lives and everything. But there's a kind of a form of sort of natural medicine that dates back over 100 years. A lot in Europe, people used to do this, where they would expose the body to different stresses by going into a fold. You know. Water or something and then too hot and then cold and change that and expose your body to that stress and that was thought at the time to uh help you know build your your resistance you know to think and there is not a lot of research on this but what we're starting to understand is that stressing your body a little bit can actually be a

• 30:18Speaker 03

  good thing not to the extreme that you would get like for example you go in an in a ice cold uh you know bath for for you know an hour or something and you get hypothermia that's that's not good but again thi- this whole idea of

• 30:33Neil deGrasse Tyson?

  You don't wanna die.

• 30:34Speaker 03

  More is not better. You don't wanna die, no. But just a little bit of stress can actually stimulate the body to be more more resilient uh to other kinds of stresses.

• 30:47Neil deGrasse Tyson?

  Is that any different from going to a horror movie and you're getting shocked and scared every five minutes? Is that? Or or having children?

• 30:55Speaker 03

  Having children? Well, that's called psycho- that's psychological stress, right?

• 30:59Gary O'Reilly?

  So what we're saying here is we push the boundary of our envelope that bit further every time, just that little bit. So what was stressful, dramatically stressful, I can't take anymore. We're now quite comfortable because it's been inside our envelope and this must be physical as well as psychological?

• 31:17Speaker 03

  Psychological, yeah, yeah. I mean, so we are now starting to really do research on the physiology of what we call resilience. What is resilience? It's the ability to resist, recover, adapt, or grow from a challenge. What kind of challenge? All kinds of challenges. So one challenge might be jumping into a cold bath. Another challenge might be doing some new exercise that you've never done before. There is all kinds of different challenges that we encounter in life that uh if you know the whole adage of what doesn't kill you makes you stronger, you know, it's maybe it'll go quite that far, but. A little bit of stress is actually good for us. The problem is, is when stress becomes overwhelming

• 31:59Speaker 03

  and is there all the time, and that's where it's, it's, it's, it can be damaging.

• 32:04Chuck Nice?

  Now, how does that stress relate to recovery? Because you see in sports arenas, you have athletes that stress their body. So they're not using this stressful circumstance to create any type of psychological stress. They're using it to speed recovery itself. I had the chance to actually be in a cryo chamber.

• 32:32Neil deGrasse Tyson?

  Chuck, you haven't been the same ever since. I haven't told you that.

• 32:34Chuck Nice?

  And let me tell you, I've never felt more refreshed in my life.

• 32:38Speaker 03

  You liked it.

• 32:39Chuck Nice?

  For the rest of the day, I was like more alert and more awake. Wow. Wouldn't that benefit kind of wane over time? As I became kind of, forgive the pun, numb to the experience?

• 32:53Neil deGrasse Tyson?

  Because what I don't want to have happen is if I do it, and it's kind of interesting, but now I kind of want more of it. Then all of a sudden, I become a thrill seeker. When before all of that, I was just fine on the couch watching television.

• 33:06Speaker 03

  Well, everybody has to kind of judge their own, you know, what they want. Some people really like doing things that are a little bit more out of their comfort zone, just put it this way. You just have to determine what your comfort zone is. You know, somebody who...

• 33:21Neil deGrasse Tyson?

  But to Gary's point, athletically, you're pushing yourself to limits that your body's never seen before. The recovery of that puts your body in a new place so that what was extreme for you a month ago is now standard physical output so that you can then push it even further, ultimately perhaps setting a world record.

• 33:40Speaker 03

  But if somebody who stays sitting on their chair all day, for them, getting out of their comfort zone might involve maybe just walking around the block. Like for them, that's a stressful thing. It may be good for them, you know?

• 33:51Chuck Nice?

  Or 15 second cold shower.

• 33:53Speaker 03

  Or 15 second cold shower. You know, everybody has to know, and it's also individual, right? So, so everybody has to kind of do and figure that out for themselves.

• 34:02Gary O'Reilly?

  So what this reminds me of is the mantra we used to have, "Train harder than you perform." So you're always, yeah, so therefore, yeah, there'll be guys who are sprinting, who are quicker in training than sometimes they'll perform in a competition. So it's a, it's a very interesting scenario, but you said something, Doctor, there. Sitting down and they get up and they walk around the room. That for them is one of their small triumphs in a day. This popped up a while ago and I, I've got the right person, I think, to answer this question. Is sitting the new smoking?

• 34:34Speaker 03

  Well, I've certainly heard that and I think it's, you know, I mean, you can't compare it, apples and oranges, but I would say sitting all day, we know, is very, very bad for us.

• 34:48Neil deGrasse Tyson?

  All right, I'll be right back, guys.

• 34:51Speaker 03

  And let's all get up. Well, when I give a talk, very often what hap- that's what happens, the audience stands up. But we, the interesting thing, right? A lot of people think, oh, I sit all day, it's fine, I'll just go to the gym on Saturday and I'll work out and that'll, it doesn't cancel the effect of sitting all day. It's, it's independent of the amount of exercise you get. It's a very serious thing.

• 35:10Neil deGrasse Tyson?

  No, wait, wait, wait, wait, I'm not gonna let you go get away with that. What happens to you from sitting? What is the bad thing?

• 35:17Speaker 03

  Yeah.

• 35:17Neil deGrasse Tyson?

  What, I mean, was it Winston Churchill said, why stand if you can sit? Of cour- of course, he said that 'cause Roosevelt. He was fat and drunk. No, no. He was fat and drunk.

• 35:28Speaker 03

  Well, I wouldn't say.

• 35:30Gary O'Reilly?

  How dare you diss Winnie like that?

• 35:34Neil deGrasse Tyson?

  So, but I, I think that was out of respect for Roosevelt, of course, because Roosevelt would be as the, as a polio victim. But can you be a little more detailed about the consequences to long-term sitting, which everyone does who works in an office?

• 35:50Speaker 03

  Right. So first of all, it's really the effect of not moving. When you don't move, when your body is in the same position for hours and hours on end, what happens is your connective tissue overall.

• 36:04Speaker 03

  Over the time of your life, but even day by day remodels to the shape of what you are. If there's a part of you that never moves, that always stays in the same position, connective tissue is gonna say, "Oh, okay, let's just remodel around that." Pretty soon, when you try to do that movement, you can't. Because the connective tissue has stiffened and has remodeled around that shape. And so if somebody, for example, never moves, you know, their arm back here, well, pretty soon, they can't move it up, because the connective tissue has remodeled here. So, sitting kind of remodels our bodies in the shape of our chairs, essentially.

• 36:42Neil deGrasse Tyson?

  Okay, so it's not the sitting, it's the not moving?

• 36:44Speaker 03

  It's the not moving.

• 36:46Neil deGrasse Tyson?

  Okay, but we spend a third of our lives laying down flat in a bed. Why doesn't the connective tissue mess us up there?

• 36:52Speaker 03

  Well, I mean, you know, laying down is important to sleep, right? We need that, but notice what you do in the morning when you get up.

• 37:01Neil deGrasse Tyson?

  You stretch.

• 37:01Speaker 03

  A lot of people spontaneously just stretch. You know, you have to sort of, you know, undo this effect of having not moved. Just think of a cat and a dog getting up from a nap. First thing they'll do is they'll stretch out. Every animal in the kingdom does this. It's incredible. I've seen pictures of lions and kangaroos and, you know, all kinds of animals stretching. It's a universal response.

• 37:28Chuck Nice?

  Do they also sit on the edge of the bed and cry about the coming day that they have to face?

• 37:36Speaker 03

  I've never seen a kangaroo do that, but...

• 37:40Gary O'Reilly?

  So, Doctor, do we have advice for airline pilots?

• 37:44Speaker 03

  Well, get up once in a while, you know. They're not letting out the cockpit.

• 37:50Speaker 03

  What they can do...

• 37:51Neil deGrasse Tyson?

  When the flight attendant barricades the area, they let them out.

• 37:54Speaker 03

  I know, but they do that. They have to, they get up, they should. I mean, you know, it's not good. If you don't sit, if you're on an airplane, for example, I don't know about flying the plane, but if you're a passenger in the plane, there is a recommendation. You should move your feet up and down, you should stretch, you should get up once in a while, you should move, because blood... Pools into your legs, you can have blood clots. I mean, there's all kinds of reasons to move around.

• 38:18Neil deGrasse Tyson?

  Plus, they have these underdesk treadmills and pedals that I've seen.

• 38:23Speaker 03

  Yeah.

• 38:24Neil deGrasse Tyson?

  We own one, but I've never used it. It's it's like a little bicycle just sticking under your under your desk.

• 38:29Speaker 03

  Yeah, it's a little hard when you have to write notes, though. I've tried it and it's it's difficult, but it's it's it's cool.

• 38:35Chuck Nice?

  See, now what it should do is power your television.

• 38:38Neil deGrasse Tyson?

  I know. No, that should that should happen in the clubs where you where you're watching something. You should only get to see your streaming service if you were pumping energy into the system.

• 38:47Speaker 03

  Yeah.

• 38:47Neil deGrasse Tyson?

  Yeah, we keep going on the list. What else you have next?

• 38:49Gary O'Reilly?

  Okay, we've gone from sedentary bad now to yoga. What are the findings on yoga? Because there's that is nice sitting down, stretching, doing yoga. Then there's this hot yoga, and then there's people who go into this ultra yoga, and I'm thinking, whoa, that competitive stretching. Where where what what are our findings here with this?

• 39:10Speaker 03

  Generally, the way the the way that I think is most useful to say way to think about yoga is it's moving while paying attention. But paying attention to what you're doing, paying attention to the sensations of your body.

• 39:23Neil deGrasse Tyson?

  Dancers do that.

• 39:24Speaker 03

  And paying attention means not moving in injuring yourself. Because I think there there's a tendency, again, this more is better kind of mentality, which we do not want, is to say, oh, if I can stretch this much, oh, I'll stretch even more and they'll be even better for you. But then you can injure yourself doing that. So it's really paying attention to being what is your what is your range of motion, just going a little bit past that and stretching, but not going so far that you injure yourself. So that's really the idea.

• 39:58Gary O'Reilly?

  For years, doctor, we were told more stretching is better for us because otherwise we'll end up like human pieces of cardboard. When you weren't aware of stretching, then you go through stretching as an athlete, then you you're kind of like, I'm done with that. And you leave that stretching behind. And as you said, your body, the connective tissue goes into its this form, and it's difficult to rearrange that. So what's going on? Really, what is going on?

• 40:23Neil deGrasse Tyson?

  I'm a big stretcher, by the way. I'm I'm a stretching man. I used to be able to split, can't do it today, but I, I, I spent an hour stretching for any hour I spend otherwise working out, either running or with weight.

• 40:36Gary O'Reilly?

  Because of the spinal surgery I had, I worked really hard on as much flexibility as I could. So I would end up during my playing career, stretching three hours a day.

• 40:46Chuck Nice?

  Wow.

• 40:47Gary O'Reilly?

  Stupid.

• 40:47Speaker 03

  That's a lot.

• 40:48Gary O'Reilly?

  I know.

• 40:49Neil deGrasse Tyson?

  You had spinal surgery?

• 40:50Chuck Nice?

  But wait, Gary, you were a professional athlete, bro. Like, didn't you have to stretch?

• 40:55Gary O'Reilly?

  Yeah, there is, but then, but see, because of the complications of my lower back, I made sure that I kept it in as good a shape as I possibly could, so as it wasn't going to be a detrimental aspect to, to my playing career.

• 41:07Neil deGrasse Tyson?

  Heli, what happens if you overstretch?

• 41:09Speaker 03

  This is the important thing. It's the amount of stretching, what we call the amplitude of the stretch. Not just how much, how long you do it for, but how much, what we call the strain. The strain is the amount of stretching compared to the initial length. So if your initial length is like this, this, you know, the tissue, you want to stretch it by a certain amount that's, in my, in my lab, we, we say 10 to 20%.

• 41:36Chuck Nice?

  That slight strain, for the person, what are we feeling at 10 to 20%? Are we feeling discomfort, slight strain, pain? What are you feeling?

• 41:45Neil deGrasse Tyson?

  No pain, no gain.

• 41:47Speaker 03

  No, no, no.

• 41:48Chuck Nice?

  That's not old school, that's bad school.

• 41:50Speaker 03

  When I say 20, 20, 10 or 20%, it also depends on the person. For some person, it might be 5% because they are so stiff. So you want to start very, very small. And also the amount, the way that you do the strain. It should involve what we call a sheer plank. So muscles are meant to move kind of one next to the other like this. Not so much pulling on a muscle directly, but allowing the muscles to glide past one another like that. And so thinking and paying attention to the direction that you stretch in and do it gently, just right past the amount that you feel that you've reached the end and just go a little bit further and that's it. But you can, and that is the right way to stretch it.

• 42:35Speaker 03

  If you go past that, to the point where it hurts, you're probably injuring.

• 42:39Gary O'Reilly?

  But what if I stretch too much? What then becomes an issue? I mean, apart from tearing.

• 42:44Speaker 03

  You can call inflammation.

• 42:45Gary O'Reilly?

  Yeah.

• 42:46Speaker 03

  You can cause injuries. You can actually, uh, uh, cause, especially people who are already very mobile. People who have loose tissues, they can actually dislocate their joints. They can do a lot of mu- damage to their joints by doing too much.

• 43:00Gary O'Reilly?

  So let's go back to inflammation. Because after I finished playing, I had to have surgery on my hamstring. Because I had a lump, the size of a small orange. It apparently turned out benign, luckily, thank you. Um, but is that possible? Is that something I've created by pulling a hamstring and tearing it just by performing? Or was that be something that could have, could have? Because I'm not expecting to diagnose it now. Have been something that built up from all of that stretching?

• 43:29Speaker 03

  It's hard to say. I mean, I think, I think that, um, you, you, you're mentioning inflammation. And inflammation is something that is, uh, very interesting. It's a part of healing that is important. You cannot heal an injury without inflammation. On the other hand, after a while, when inflammation is no longer needed, it needs to turn itself off. And we have built in mechanisms inside us to turn off inflammation. The problem is, a lot of times, what we do is we take anti-inflammatory drugs to reduce inflammation. And there's some evidence that that can retard healing and impair the healing process. So I don't know what was the problem, you know, when you had the issue with your muscle.

• 44:14Speaker 03

  But generally, what we, what we now know is that small amounts of stretching can actually reduce inflammation naturally.

• 44:23Speaker 03

  And but exaggerated amounts of stretching can increase it. So it's finding that right balance, a little bit like the Goldilocks, not too much, not too little. Applies to a lot of the things that we talked about today.

• 44:36Gary O'Reilly?

  But we have a mantra of kill stuff, don't we? And what is it, the one-a-side or whatever it is, just kill stuff. We see it in industrialized farming. We know people just take anti-inflammatories and now it's turning itself around. It's a kind of outface.

• 44:53Speaker 03

  It's less wanting to suppress and anti-this, anti-that. It's more support the health. What are the natural healing mechanisms that we have inside us and how best to support them? And a lot of this is lifestyle, having a good diet, managing stress, getting enough in the right kind of physical activity. These are the things that we have that are built into us to help us be healthy.

• 45:19Neil deGrasse Tyson?

  We are absolutely screwed then.

• 45:22Speaker 03

  Well, I mean, yes and no. In a sense that we have it, we have those mechanisms, but we need help sometimes to be able to support all of that lifestyle. And this is, I think, unfortunately, what our healthcare system is lacking right now. Is the structure in place to help people to improve their health.

• 45:44Neil deGrasse Tyson?

  Could you reflect on the prevailing assumption that anything artificial is bad and anything natural is good for you? The prevalence of packaging that says all natural, all natural. And I think of all, every time I see that, I think of everything that's natural that is poisonous. I mean, strychnine, arsenic, that's all natural, right? So where is the messaging coming from? And what role do you have in your niche within the NIH to try to influence that? Because getting back to the earliest point Gary made, there's a teenage YouTube influencer that's peddling some new cure that they found works for them.

• 46:27Neil deGrasse Tyson?

  And these are influencers paid as such. So where should the inquisitive?

• 46:37Neil deGrasse Tyson?

  Consumer place their confidence.

• 46:40Speaker 03

  Well, first of all, I would say follow the science. At NCCI, one of our mantras is natural does not necessarily mean safe. There's, you know, the if something is natural, there's all kinds of things that are natural that are that that are harmful, right? And so we have to protect ourselves against harms, whether they're natural or not. And so again, at NCCI, one of the things that we pride ourselves on is that our one of our important parts of our mission is to inform the public on the science that's available.

• 47:19Neil deGrasse Tyson?

  So there's the messaging. Good. Which which wasn't previously there before your branch of the NIH was carved.

• 47:24Speaker 03

  Exactly. That was the founding mission of NCCI is to inform the public about what we know and what we don't know.

• 47:32Neil deGrasse Tyson?

  I think Congress forced that to be funded because their constituents wanted to know more about alternative met what then called alternative medicine. It was such a rising commercial force in our culture and in our economy that Congress felt we've got to get some kind of authentic messaging here and thus got carved your your piece of that pie, correct?

• 47:58Speaker 03

  Yes, and also it was not just a commercial force. It was a what we called a sort of a grassroots. There was a paper published in New England Journal of Medicine in 1994 that that did a survey of, I believe it was 20,000 or 40,000 households. Forty percent of people were using some kind of of what they called alternative medicine at the time, which we now call complementary. And of those 40% of people, 75% did not inform their doctors about it. This was brought and this this revelation, it was shocked.

• 48:36Speaker 03

  You know, people to people didn't realize that this was back in 1994.

• 48:39Neil deGrasse Tyson?

  And that was before the Internet was a big force on our lives. It was just only beginning, right? So that was already embedded in the system.

• 48:45Speaker 03

  Yeah, and has increased since then. The the the number of people who are using complementary therapies is greater now than it was then.

• 48:53Chuck Nice?

  You should tell your doctor if like whatever you're taking outside of

• 48:56Speaker 03

  Absolutely.

• 48:57Chuck Nice?

  prescribed medicine, you should get get a list and give it to your doctor.

• 49:00Speaker 03

  Absolutely, that's extremely important. We don't have two different sources of healthcare. One, you know, they don't talk to one another. That's what integrative health is about. That's why it's about integrating, bringing together.

• 49:13Chuck Nice?

  Wow, OK. Whoa, that that might be the most important thing that we've talked about today.

• 49:19Speaker 03

  Good thing to end on.

• 49:19Chuck Nice?

  Because I'm sure I'm telling you right now, I am sure most people that are including me, I'm sorry to say, which I can't believe that I haven't done this, have not taken a list of whatever supplements, whatever, you know, extra pharma materials that they're putting in their body and giving that list to their doctor, which I am definitely going to do immediately.

• 49:44Neil deGrasse Tyson?

  Yeah, and Chuck, that's happened since you took that cold bath. You your brain hasn't been the same.

• 49:48Speaker 03

  You can tell your doctor about the cold bath, too.

• 49:52Neil deGrasse Tyson?

  Helene, the last I checked, the budget for that branch of the NIH was around $30 million. Has that gone up since then?

• 49:59Speaker 03

  No, our budget is is about 175 million.

• 50:03Neil deGrasse Tyson?

  Oh, OK, so that's it's gone up.

• 50:05Chuck Nice?

  More budget envy, more budget envy.

• 50:08Neil deGrasse Tyson?

  No, no, no, that's just her her bit. All of NIH is in the billions.

• 50:13Speaker 03

  Oh, billion, yes. In addition to MCCIH's own budget, we also collaborate with many other institutes across NIH to do this kind of research.

• 50:26Neil deGrasse Tyson?

  Right, but all of NIH, their budget is in the tens of billions.

• 50:29Speaker 03

  Billions.

• 50:30Neil deGrasse Tyson?

  Which are much, much larger than the 100 million that you're getting. But still, that's a lot of money to to to to put us in a new place that we never even knew needed attention from before. So I'm delighted to see this kind of attention given to it.

• 50:44Speaker 03

  The attention on these types of nonpharmacological whole person, whole person approaches to health is growing for sure.

• 50:53Neil deGrasse Tyson?

  Well, Helene, thank you very much for this interview. Oh, my gosh. And we learned that Gary had nine back surgeries.

• 51:00Gary O'Reilly?

  Yeah, at least.

• 51:02Chuck Nice?

  You're like the 50 cent of back surgery.

• 51:05Gary O'Reilly?

  Yeah, I got... Keep moving. Yeah, thank you. Yeah, I got that scar down my back where you could put all the batteries in.

• 51:11Neil deGrasse Tyson?

  No, is that what that is?

• 51:12Gary O'Reilly?

  That is what that is, yeah.

• 51:13Neil deGrasse Tyson?

  All right, Chuck, good to have you, man. Always a pleasure. All right, Gary.

• 51:18Gary O'Reilly?

  Thank you, Neil.

• 51:19Neil deGrasse Tyson?

  I learn something about you every time.

• 51:21Gary O'Reilly?

  Just keep reading the book.

• 51:23Neil deGrasse Tyson?

  All right, and Dr. Langjovan, again, thank you for joining us.

• 51:27Speaker 03

  Thank you, it was a pleasure.

• 51:28Neil deGrasse Tyson?

  I'm Neil deGrasse Tyson, your personal astrophysicist. As always, bidding you to keep looking up.