Perimenopause, Insulin Resistance, and Persistent Muscle & Joint Pain: A Functional Medicine Framework: Nutritionist Leyla Muedin discusses perimenopausal musculoskeletal symptoms—new or persistent joint pain, muscle aches, and tendon problems—and highlights a Clinician’s Journal article by physical therapist Tara Moore proposing insulin resistance screening in perimenopausal musculoskeletal care. She explains that declining estradiol during the menopausal transition can worsen insulin signaling, increase visceral fat, and reduce insulin sensitivity, affecting skeletal muscle recovery and potentially contributing to tendinopathies and poor or short-lived responses to localized treatments like PT. The framework emphasizes assessing systemic metabolic contributors (e.g., sedentary behavior, high-carbohydrate nutrition patterns, PCOS, central weight gain, stress, sleep disruption) and addressing mediators such as inflammation and impaired glucose utilization. She suggests integrating metabolic risk assessment, sleep and stress strategies, resistance training, and interdisciplinary referrals, arguing that nutrition and supplementation—especially a low-carb approach—may improve recovery and pain outcomes.

Nutritionist Leyla Muedin discusses research showing simple strength tests—grip strength and a five-rep sit-to-stand chair test—predict longevity in older women. In a University at Buffalo study of over 5,000 women ages 63–99 followed for eight years, stronger grip and faster chair-stand times were linked to lower mortality; every additional 7 kg of grip strength corresponded to a 12% reduction in death risk, and faster chair-stands were also associated with improved survival, even after adjusting for activity, cardiovascular fitness, and inflammation. She emphasizes prioritizing muscle-strengthening alongside aerobic exercise and suggests accessible resistance options (weights, bodyweight moves, or household items) with professional guidance as needed. She then cites UK Biobank data linking long-term statin use to declines in grip strength and appendicular lean mass, urging discussion with physicians and added vigilance, especially for those also using GLP-1 drugs that may reduce protein intake and muscle mass.

Registered dietitian nutritionist Leyla Muedin discusses the growing interest in biological age versus chronological age and explains that biological aging is modifiable through consistent lifestyle choices. She outlines common measurement tools and biomarkers, including epigenetic clocks (DNA methylation), telomere length, VO2 max, inflammatory markers, grip strength, and muscle mass, noting that genetics account for only about 25–40% of biological aging variation. Key interventions include regular aerobic and resistance exercise, protein-adequate nutrition to preserve muscle and prevent sarcopenia (with whey protein and leucine-rich foods noted), improved sleep, stress management, reducing processed foods and visceral fat, and lowering chronic inflammation (CRP, IL-6). She also reviews hormetic stressors such as sauna use and mentions red/near-infrared light and sun exposure without sunglasses. Leyla shares client examples showing biological age can worsen or improve, and encourages repeat testing after lifestyle changes.

Eccentric Exercise: Better Results with Less Effort. Leyla Muedin, a registered dietitian nutritionist, discusses eccentric exercise and research suggesting it may deliver better results than strenuous workouts that cause muscle damage and delayed onset muscle soreness (DOMS). She explains contraction types—isometric, concentric, and eccentric—highlighting that eccentric contractions involve muscle lengthening during the lowering phase (e.g., lowering a dumbbell, walking downstairs) and can provide greater mechanical loading with lower perceived effort, less fatigue, and broad accessibility across ages and health conditions, though requiring more focus and control. She cites studies including stair-descending in elderly obese women improving cardiovascular function, insulin sensitivity, cholesterol, and strength, and a five-minute home routine (chair squats, wall pushups, chair reclines, heel drops) improving strength, flexibility, mental health, and encouraging continued exercise. She notes athletic benefits and the need for further research.

Nutritionist Leyla Muedin discusses a listener question about whether agave nectar can contribute to obesity like high-fructose corn syrup, arguing that regular use of sweeteners—including agave, honey, monk fruit, stevia, aspartame, sucralose, allulose, and sugar alcohols—can maintain sweet cravings, spike insulin, and contribute to weight-loss plateaus, with added concerns such as microbiome effects, GI upset, and aspartame’s neurotoxicity. She notes insulin’s role in fat storage and blood pressure via sodium retention, and suggests that needing a sweetener in coffee or tea may indicate dependence on sweetness. She then covers a newly developed, validated Food Noise Questionnaire (FNQ) published in Obesity to measure intrusive food-related rumination, highlighting its five Likert-scale items, study sample characteristics, and the need for further research, including effects of GLP-1 drugs.

Registered dietitian nutritionist Leyla Muedin discusses a Nature Communications study of 108,723 French adults in the NutriNet-Santé cohort (2009–2023) examining long-term exposure to food preservatives and type 2 diabetes. Using detailed dietary records cross-referenced with product/additive databases, researchers identified 58 preservative-related additives and analyzed 17 consumed by at least 10% of participants; 1,131 diabetes cases occurred. Higher overall preservative intake was associated with a 47% increased diabetes risk (49% for non-antioxidant preservatives; 40% for antioxidant additives), with several specific additives linked to higher risk. Leyla questions whether the findings reflect preservatives themselves or the ultra-processed, refined-carbohydrate foods that contain them, emphasizing recommendations to favor fresh, minimally processed foods and limit refined carbs and processed foods.

Registered dietitian nutritionist Leyla Muedin discusses how exposure to natural daylight may improve metabolic health beyond diet and exercise, highlighting a controlled crossover study of 13 adults aged 65+ with type 2 diabetes published in Cell Metabolism. Participants spent 4.5 days in living spaces lit by either natural light through large windows or artificial light, with identical meals, sleep, activity, and screen time; after a 4-week washout they switched conditions. Natural light was associated with more hours of blood glucose in the normal range, less glucose variability, higher evening melatonin, and improved fat oxidative metabolism, suggesting effects on circadian “body clocks” and coordination between central and peripheral clocks. Muedin recommends getting morning light on the face, reducing sunglasses and high SPF use, dimming lights at night, keeping consistent sleep, and spending more time outdoors; she also notes that architecture can limit sunlight exposure.

Dietitian Nutritionist Leyla Muedin discusses a Stanford-led randomized controlled trial published in Nature Medicine in which a five-day, calorie-restricted fasting-mimicking diet improved symptoms and inflammatory markers in people with mild to moderate Crohn’s disease. In the three-month study of 97 patients, 65 followed monthly five-day cycles of 700–1100 calories/day with plant-based meals, while 32 continued usual diets; about two-thirds of the fasting-mimicking group reported symptom improvement, with fatigue and headaches but no serious side effects, and fecal calprotectin and other inflammatory molecules decreased. She notes bowel rest and the specific carbohydrate diet as additional approaches. The episode also explains how antibiotics can cause diarrhea by disrupting gut bacteria, lists higher-risk antibiotics, offers supportive steps (hydration, BRAT foods, avoiding irritants), recommends Saccharomyces boulardii taken away from antibiotics, and outlines warning signs requiring medical care, including possible C. difficile.

Nutritionist Leyla Muedin discusses joint inflammation—its symptoms (swelling, pain, redness, warmth, morning stiffness, reduced range of motion) and why it is usually a sign of an underlying condition rather than a disease itself. She reviews common causes including osteoarthritis (cartilage wear and tear), rheumatoid arthritis (autoimmune synovium attack with prolonged morning stiffness and fatigue), gout (uric acid crystals, often in the big toe), psoriatic arthritis, injuries, autoimmune diseases (e.g., lupus, ankylosing spondylitis, Sjogren’s), infections such as septic arthritis requiring urgent care, and surrounding-tissue problems like tendonitis and bursitis. Lifestyle factors that worsen inflammation include excess weight, poor diet (including unaddressed food allergies; avoiding nightshades is suggested), insulin resistance contributing to gout, lack of exercise, smoking, and stress. Management strategies include rest, bracing, ice vs. heat, OTC anti-inflammatories, gentle low-impact exercise, anti-inflammatory foods, weight loss, treating root causes, and supplements such as glucosamine, chondroitin, MSM, bromelain, turmeric, Boswellia, and quercetin.

Nutritionist Leyla Muedin discusses news from Secretary Robert F. Kennedy Jr.’s “Take Back Your Health” tour, highlighting hospital commitments to nutrition-driven care, including connecting Florida farms directly to hospital food systems. She reports that CMS issued a quality and safety special alert directing hospitals to align meals with the 2025–2030 Dietary Guidelines for Americans, emphasizing whole nutrient-dense foods and adequate protein while reducing ultra-processed foods, sugar-sweetened beverages, refined carbohydrates, and added sugars, and reinforcing Medicare participation requirements such as meeting individual nutrition needs, dietitian oversight, current therapeutic diet manuals, and integrating nutrition into quality improvement. At Nicklaus Children’s Hospital, Kennedy and CMS Administrator Dr. Mehmet Oz met with healthcare leaders; the hospital signed a pledge to partner with Florida producers to improve food quality, remove procurement barriers, and expand medically tailored meals and training. Muedin praises regenerative agriculture and local supply chains and contrasts these efforts with past high-carbohydrate hospital diets.