Welcome to Straight Talk on Health. I’m your host Dr. Chet Zelasko. Straight Talk on Health is a joint production with WGVU in Grand Rapids MI. I examine the practical application of health information. Nutrition. Exercise. Diet. Supplementation. I look at the science behind them, and let you know whether it’s something to consider or not. You can check out other things that I do on my website Drchet.com and sign up for my free emails.
This is the final episode for this season. I thought I would talk about recent research and share come comments on what I’ve observed in the health arena. Let’s begin by talking about artificial intelligence or AI for short and health information. As I researched a topic on PubMed, the government database of published journal articles, books, and the genetic database, there was an announcement that the National Center for Biotechnological Information would be down for usual maintenance. That is something we’ve come to expect from just about any database-based website.
But it made me pause for a few minutes. When I use an AI to research a topic, I’m not really interested in what it says; I’m interested in the research used in the AI search. For things I search for, it always includes scientific research from the PubMed database. I discard comments from other websites that are based on interpretation of research. Given the state of the Dept of Health and Human Services and the National Institutes of Health, what if research on some topics were intentionally left out? That means that we would not be getting the full research on health conditions and treatments. Or, some research that was not peer-reviewed might be added to the database. If that were to happen, a human might be able to understand that something isn’t right but AI is only as good as the database it uses. Take home message: don’t trust AI for medical advice.
Here's a recently published study that had some interesting results. At some point, most of us experience lower back pain. Many people use walking as their mode of exercise—could walking contribute to the development of lower back pain? A recent study examined the rate of lower back pain and walking.
Researchers tracked over 11,000 participants in the Norwegian HUNT study. To qualify, the subjects could not have had any back pain prior to being included in the study. The initial testing period included wearing an accelerometer during each test period as well as a questionnaire related to lower back pain. The tests were repeated and the subjects were tracked for just over four years, and 1,659 subjects developed lower back pain.
The subjects were grouped into quartiles by number of minutes walked per day for the analysis, and there was an inverse relationship between the risk of lower back pain and both walking intensity and minutes walked. Simply stated, the more a person walked, the lower the rate of lower back pain. The more energy expended by walking faster, the risk of back pain was lower.
The lesson for people 20 and older? If you don’t have any orthopedic obstacles, the more time spent walking as well as the higher the speed of the walking, the lower your risk of developing lower back pain. Walking 30–45 minutes per day most days a week can get you fitter as well as reduce the risk of back pain. The path to better health may just be a simple walk a day, and the great thing is that it’s a multigenerational activity. Walking as a family sets an example for the kids that exercise is something everybody does, and you’ll be setting them up for a healthier life.
If you’re new to walking, remember the talk test. If you have to take deeper breaths but can still carry on a conversation, that’s just about right. If you’re sucking wind so much that you’re gasping for air, that’s too much exertion for beginners. However, if you can sing, that’s not hard enough.
The next one is about a challenge I put out to my email readers. This was the third time I’ve challenged them to eat more vegetables and fruit every day over summer holiday weekends. This time I changed the challenge from who could eat the most servings of vegetables and fruit to eating at least five servings of fresh or frozen vegetables and fruits every day—Friday through Sunday.
What’s the incentive for them? Everyone who eats five fruits and veggies per day can participate in my next monthly conference call for a member group I call the Insiders. It’s been a long time since I opened it up to non-Insiders, and getting an invitation was simple just by eating the five veggies and fruits per day for the weekend. How many people responded to the challenge? 12--and 3 were vegans. 9 people out the thousands on my email list. It was disappointing to say the least.
Paula had a suggestion. Next time, make the challenge about reducing ultra-processed food over the same holidays. Maybe it’s easier to avoid eating something than it is to add something in. We’ll see. In the meantime, how many vegetables and fruits do you eat every day? 5 should be the minimum.
Let’s turn to GLP-1 Receptor Agonists. If you listened to that episode of STOH, I suggested that they were fine to use, assuming a person wasn’t allergic to the shots, as long as a person had an exit strategy. In other words, learning what to eat, how much to eat, and how to move after the weight loss to sustain the effort and expense of losing the weight. An article was just published in JAMA Internal Medicine Online by a group of public health experts including Dr. JoAnn Manson. She’s specialized in nutrition, supplements, and women’s research since I was a grad student. They essentially said the same thing but with a wonderful chart about what to do to prepare physicians for what they should do before, during, and after they prescribe the medication to track the patient. The goal is that the physician will teach patients the exit strategy.
I’m sorry to say that physicians are not the right people to do this. They can be empathetic, wonderful, and caring physicians but they are not good teachers. If they were, we would never have the obese nation we currently have in the US today. The only way I see that this approach could be effective is to have a dietician or NP trained in dietetics to help people develop that exit strategy and be able to answer questions as they come up. Leave the doctor’s role to the tracking of metabolic function and safe weight loss. Leave the teaching to those who have been trained to do it. I know it sounds harsh but that’s the way it should be. But the paper does a wonderful job of exactly what needs to happen to achieve a successful outcome and reduce the risk of regaining weight—the single biggest complaint of people who have used GLP-1 RA.
Final thought: I was listening to a podcast while biking indoors. Of all things, it was about hot dog joints. One owner of joint in Detroit asked a guy, who was financially secure, why he was still working in the restaurant part time at 84 years old. He told the owner “It’s better to wear out than rust out. And don’t you ever forget it.”
I believe there’s a lot of wisdom in those words. I would add one more part to it. “On your own terms.” There is a difference approaching 84 years old living an immobile life and with many self-inflicted conditions. It’s entirely another when you are sharp enough and fit enough to still enjoy looking forward to another day. Genetics, environment, and prior body abuse aside, you can still work at being as independent as you can every day. Eating enough vegetables and fruit are a part of that process. So is regular exercise. Wear out, don’t rust out, on your own terms. It all comes down toone thing: What are you prepared to do today?
That’s all the time I have for this episode. If you like this podcast, please hit the share button and tell your friends and colleagues about it. Until next time, this is Dr. Chet Zelasko saying health is a choice. Choose wisely today and every day.
Reference: JAMA Network Open. 2025;8(6):e2515592. doi:10.1001/jamanetworkopen.2025.15592
Reference: Podcast. The Sporkful. “This Hot Dog Tastes Like Home” 07/04/2025
JAMA Intern Med Online. doi: 10.1001/jamainternmed.2025.1794
