Beneficial Bacteria for Humans: Probiotics, Prebiotics and Postbiotics

Probiotics are among the hottest supplements of 2019 and with good reason. The positive role of
these “good” bacteria are being revealed in everything from digestive health to brain support on an almost-daily basis.

Learn more about probiotics, prebiotics and postbiotics below, or listen to the podcast on in which Life Extension’s own Michael A. Smith, MD, discusses the latest information concerning probiotics with nutrition expert Crystal Gossard, DCN, CNS, LDN.

While most of us are familiar with antibiotics, not everyone knows exactly what probiotics are. While antibiotics reduce or stop the growth of bacteria, probiotics are bacteria. The difference between these bacteria and those we seek to combat with antibiotics is that probiotic microorganisms are beneficial to the body, and therefore desirable, while those we want to treat with antibiotics are, of course, potentially harmful.

What are probiotics good for?

Probiotics colonize the intestinal tract and support gastrointestinal health, including digestion. We are learning more all the time about how they can benefit not only the GI tract, but the entire body. In fact, there are an estimated 10 times more microbial cells in the human body than human cells.1 Many of these microorganisms are the beneficial bacteria known as probiotics.

Common Probiotics and Probiotic Strains

Probiotic bacteria are classified by genus, species and strain. Two common genera are Lactobacillus and Bifidobacterium. Other genera include Escherichia, Enterococcus, Bacillus, Propionibacterium, Streptococcus, Pediococcus, Leuconostoc and Saccharomyces. Common Lactobacillus species are acidophilus, bulgaricus, casei, fermentum, plantarum and rhamnosus, and better-known Bifidobacterium include animalis, bifidum, breve, infantis, lactis and longum. Following these species names may be a number or letter designating the strain, as in Lactobacillus acidophilus NCFM.

Best Foods for Gut Health: Foods High in Probiotics

Yogurt is the most well-known food that contains one or more probiotic cultures. Other foods that contain probiotics include fermented products such as kimchi, miso, sauerkraut, kombucha, kefir, buttermilk, some cheeses and sourdough. Probiotics are also available in supplement form.

Probiotics Supplements: Multiple Strains

Probiotics in supplemental form are capsules, liquids or lozenges that contain concentrated amounts of probiotic bacteria. Popular probiotic species are Lactobacillus acidophilus, Lactobacillus rhamnosus, Lactobacillus bulgaricus, Bifidobacterium infantis and Bifidobacterium bifidum, among others. Many supplements contain several strains to support a specific area of concern or general well-being.

Why take probiotics?

Probiotics help maintain healthy intestinal flora by limiting the overgrowth of potentially harmful bacteria. The balance of bacteria that live in our intestines is important for digestive and immune health.2 Probiotic bacteria may also help control the overgrowth of fungi such as Candida albicans, not only in the intestines, but in the mouth and other areas.3

Probiotics have been used around the world for many years in various forms. The legendary longevity benefits attributed to probiotic foods such as kefir might have a basis in their recently revealed health properties. While not everyone likes yogurt or sauerkraut, and kimchi may be hard to find, consuming a probiotic capsule is an easy way to encourage healthy microflora.

How do probiotics affect the brain?

The beneficial effect on mental states that may be associated with probiotics is facilitated by signaling between the digestive tract and the brain.4 The gut and brain communicate through the vagus nerve, endocrine signaling mediators and the immune system.

It has been observed that Alzheimer’s disease and Parkinson’s disease patients have a high incidence of gastrointestinal disorders.5,6 Unfavorable alterations in gut microflora may result in greater permeability of the gut barrier, potentially leading to immune activation and systemic inflammation. This can impair the function of the blood-brain barrier, thereby causing neuroinflammation and neurodegeneration.7 Therefore, management of intestinal flora may help support brain health.

An article published in 2019 – “Man and the microbiome: a new theory of everything?” – observes that the gut microbiome has been implicated in a variety of psychological disorders. “Preclinical studies have provided us with key insights into the mechanisms by which the microbiome influences bidirectional gut-brain communication,” the authors write. “The complex and widespread influence of the microbiome on many physiological and psychological processes has generated a keen interest in its therapeutic potential for depression, anxiety, autism, and other psychiatric disorders. It has been shown that the microbiome composition of people suffering with such conditions differs significantly from that of healthy controls, and although the area is in its infancy, interventional studies that alter a person's microbiome through the use of probiotics, prebiotics, or dietary change can alleviate psychopathological symptoms.”8

The Difference Between Prebiotics and Probiotics

Prebiotics act as food for probiotic bacteria. Inulin from chicory and fructo-oligosaccharides (FOS) from inulin are common prebiotic supplements that nourish probiotics. Other prebiotics include beans, legumes, starchy fruits, cereals, onions and other vegetables, as well as other foods such as milk and fungi.9 Polyphenols such as resveratrol and anthocyanins also have prebiotic properties.9

What are postbiotics?

Postbiotics have been defined as “those molecules released by bacteria and other microorganisms that, when administered in adequate amounts, confer health benefits to the host.”10 It is the opinion of the author of this definition that greater benefit may be derived from the ferment of fermented foods than the bacteria present in the foods: “The many nutrients the bacteria make, what I call the postbiotics, while fermenting the foods, are what are beneficial to the GI and the immune system.”10

Postbiotics are nonliving compounds that have a long shelf life. Among the hundreds of postbiotics are peptides and the short-chain fatty acids acetate, butyrate and propionate.

What are Phages and How Do They Work?

“Phages” is a short way of saying “bacteriophages,” which describes submicroscopic packages of DNA or RNA enclosed in a protein envelope that target bacteria. Certain bacteriophages selectively target specific undesirable bacteria while leaving beneficial bacteria undisturbed.

Bacteriophages were discovered over 100 years ago and are generating renewed interest in the face of antibiotic resistance.11

Bacteriophage Probiotic: What is phage therapy?

Phage therapy involves the use of bacteriophages in the treatment of bacterial infections. Phages can also be used preventively. Combining phages with probiotics may reduce the growth of undesirable bacteria, allowing the beneficial probiotic bacteria to thrive.

About Live Foreverish: Join Dr. Mike as he sits down with some of today’s leading medical, health and wellness experts to discuss a variety of health-related topics. From whole-body health to anti-aging and disease prevention, you’ll get the latest information and advice to help you live your life to the fullest. If you like what you hear, please take a moment to give Live Foreverish a 5-star rating on iTunes!

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  10. Maguire M et al. Rev Neurosci. 2019 Jan 28;30(2):179-201.
  11. Kortright KE et al. Cell Host Microbe. 2019 Feb 13;25(2):219-232.

Herpes Virus Research Update: Natural and Conventional Treatments

Is there a cure for herpes simplex?

At this time, there is no cure for herpes. Although some people successfully suppress viral outbreaks, the virus is present in the nervous system of its host for life.

In 1982, TIME magazine ran a cover story that described herpes as “The New Scarlet Letter”—a source of shame and ostracization. However, the unwarranted hysteria surrounding what has been labeled “the herpes epidemic” was soon eclipsed by the ferocious emergence of another sexually transmitted disease: the AIDS virus, which was deadly and untreatable at the time. Nevertheless, herpes, while rarely fatal, remains an incurable disease.1

What are the types of herpes viruses?

When people hear the word “herpes,” it is herpes simplex—the virus that causes cold sores on the lips and genital lesions—that commonly comes to mind. However, Herpesviridae represents a large family of viruses that, in addition to herpes simplex 1 and 2, includes herpes zoster, the cause of chicken pox and shingles; Epstein-Barr virus, which causes mononucleosis and is implicated in other diseases as well; cytomegalovirus, which is estimated to infect up to 80% of all U.S. adults by the age of 40; roseola, which commonly affects infants; human herpesvirus 7, another childhood disease; and Kaposi’s sarcoma.2

Other members of the herpes family infect animals, such as the feline herpes virus that causes upper respiratory infections in cats. While herpes simplex type 1 is responsible for the majority of oral herpes infections that cause cold sores and type 2 is more often associated with the blisters that characterize genital herpes, both forms of the virus can be found in either area.

Herpes treatment and cold sores

Topical acyclovir, the first pharmaceutical treatment designed to improve herpes symptoms and healing time, entered the market the same year as the publication of the TIME article.3

Acyclovir was subsequently approved as an oral drug to be consumed up to five times daily, beginning at the first sign of a herpes lesion. The approval of acyclovir was followed by the release of famciclovir and valacyclovir. In addition to treating active lesions, these drugs can be used daily for long-term suppression by individuals who experience frequent outbreaks.

Although these antiviral drugs lower a user’s viral load, they do not guarantee protection against transmission of the virus.

Is there a natural cure for herpes?

Natural, over-the-counter options

While not curative, there are natural treatments that may help improve defenses against active lesions or improve symptoms. The amino acid L-lysine has been used to combat herpes since long before the advent of the currently used antiviral drugs. Lysine competes with another amino acid, arginine, which is needed for the herpes virus to replicate. Trials that evaluated the effects of L-lysine among people with recurrent outbreaks have resulted in fewer active infections, decreased symptoms and faster healing time in comparison with a placebo.4,5

Vitamin C’s well-known antiviral effect has been tested against herpes in several studies.6 In a small trial, vitamin C and bioflavonoids were helpful when begun during the prodrome stage prior to the appearance of a blister, which is characterized by itching, tingling and burning.7

Other natural therapies that may be beneficial for herpes include fucoidan (a compound derived from brown seaweed), curcumin, lactoferrin and reishi mushroom.8-11

There is medical evidence indicating that the herpes simplex virus more readily reproduces during times of stress.12 Anyone plagued by frequent outbreaks can attest to this phenomenon. Insufficient sleep, overworking, negative emotions and sun exposure are common triggers.

How is herpes prevented?

Herpes simplex is generally spread via skin-to-skin contact in oral or genital areas. While it is recommended to avoid unprotected contact with people who have visible blisters, it should be noted that viral shedding has been documented even in the absence of lesions.13

Herpes virus and the brain

While a cold sore may appear relatively innocuous, recent research has found the presence of the herpes virus in the brains of patients with Alzheimer’s disease.14 Although the finding does not establish a causative effect for the virus, a new Phase II study involving adults with mild Alzheimer’s disease who test positive for herpes simplex virus 1 or 2 will evaluate the effects of the antiviral valacyclovir as a possible therapy for slowing the disease.15

How far away is a cure for herpes?

While there’s no cure in sight, effective medications are available that may be all that’s needed to keep the virus dormant for some individuals. Natural interventions may be supportive as well. Although herpes may not warrant the stigma that has plagued this disease, the link with Alzheimer’s disease suggests that there is a lot we still don’t know about the potential risks of herpes.


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Does My Diet Affect My Unborn Child’s Obesity Risk?

Stewart Lonky, MD

Does my diet affect my unborn child’s obesity risk?

Yes. In fact, evidence suggests that both parents’ diets may play a crucial role in their unborn child’s susceptibility to developing obesity later in life.1

So, having overweight parents may significantly increase one’s obesity risk, but how does this happen, exactly?

As you may know, DNA is often thought of as the "blueprint of life" because it contains all the information that determines our physical appearance and health, although some scientists have complained that the "blueprint for life" metaphor is inadequate for something as "intricate, complex, multilayered and dynamic" as DNA.2 We inherit about 23,000 genes from both our mother and father.

Currently, there’s no reliable way to alter our genes, although scientists tried gene editing inside the body of Brian Madeux, a 44-year-old California man with Hunter syndrome, an incurable metabolic disease. Madeux didn’t benefit in any measurable way from the gene editing treatment he received.3

If we can’t change our genes, what can we do?

Although we can't yet directly alter our genes, some factors influence their expression. Our environment and experiences leave chemical “signatures” on our genes. Collectively, these signatures are called the epigenome.

The word “epigenetics” means “above” or “on top of” genetics and, simply stated, refers to external DNA modifications that turn gene expression on or off. Both positive experiences, such as exercise and a healthy diet, and negative influences, like environmental toxins exposure, can change the chemistry that encodes genes in our cells. This process, known as epigenetic modification, can be reversible but is heritable.

In one study, researchers demonstrated that differences in gene expression (epigenetics) play a crucial role in determining one's predisposition to obesity. In genetically identical mice and human twins, epigenetic markers altered the activity of weight-control genes to produce distinct subpopulations of lean and obese individuals.4

These modifications do not change the genetic code but do alter the physical structure of DNA. Moreover, these modifications change the “behavior” or “expression” of that gene. One way our bodies turn genes on or off is with modifications called methyl groups, which attach to DNA and change how it interacts with other molecules. DNA methylation—the addition of a methyl group to part of the DNA molecule, which often prevents specific genes from being expressed—is the most common epigenetic change. Epigenetic changes in a fetus may be introduced from food that the mother consumes, but environmental toxins, such as pesticides, compounds in cigarette smoke, or even the non-stick cookware she uses to prepare meals may influence development as well.

Since epigenetic markers control genetic expression, effectively turning the gene “on” or “off”, early life experiences that change the epigenome—when the specialized cells of internal organs such as the brain, heart or kidneys are first developing—can have a powerful impact on a child’s lifetime physical and mental health.

How do parents epigenetically influence their child’s development?

A growing body of research suggests that parents epigenetically influence embryonic development. How a child responds to stress, her overall health and how she will eventually parent her own children could be influenced by epigenetic changes her parents, and even grandparents, made to her DNA. Writing in the peer-reviewed journal Science, UC Santa Cruz researchers were able to show how “epigenetic memory can be passed across generations and from cell to cell during [embryonic and fetal] development.”5,6

Not surprisingly, these changes may also influence how easy or hard it may be for a child to avoid obesity. Poor nutrition before and at the beginning of pregnancy, and possibly while a baby is nursing7, can be stored as a type of epigenetic memory on a child’s genome, setting the table for metabolic diseases, including obesity or even diabetes.8 The period following conception—the stage in development when the rate of DNA synthesis is extremely high—leaves an embryo vulnerable to epigenetic modifications.

Nutrition’s “epigenetic memory” was also observed by University of Cambridge researchers, who were able to demonstrate the epigenetic transfer of nutrition memory in mouse models.9 While further research is needed, it’s becoming clearer that our life choices and experiences may epigenetically influence the health of future generations.

In another study, researchers at the London School of Hygiene and Tropical Medicine looked at specialized regions of the genome called metastable epialleles, or MEs. These regions are critical because they're the sites where epigenetic (methylation) markers are "laid down" during the first few days following conception. In the study, the researchers analyzed the DNA methylation patterns of Chinese human embryos conceived via in vitro fertilization throughout the stages of early development.

Specifically, they looked at the establishment and elimination of epigenetic markers and compared the findings with fully-differentiated, 6-to-10-week-old liver cells. They found atypical and variable ME methylation patterns when compared to other regions on the genome, especially in the embryonic liver cells. These findings suggest that methylation patterns may be sensitive to external environmental factors, leading to speculation that these regions could have evolved to sense the mother's nutritional environment, record the information on DNA and help the baby adapt to its circumstances.10

In a separate experiment, the same team discovered that methylation patterns of MEs could be affected by the mother’s (and possibly the father’s) pre-conceptional nutrition habits, confirming the volatility of the methylation in these genomic regions.11

What this boils down to is that embryos may be keenly aware of their mother’s nutritional environment and adjust accordingly to survive.

These findings also underscore the importance of a healthy maternal environment in the early stages of embryonic development and reinforce the fact that epigenetic modifications stemming from diet and the environment can be passed down to future generations, potentially jeopardizing a child's health.

So, is there an ideal diet to reduce a child’s obesity risk?

Though I’ve never been a fan of one-size-fits-all diets, there’s good evidence that the Mediterranean Diet, which emphasizes plant-based foods, including vegetables, legumes, fruits, cereals and nuts has some health advantages. Importantly, the diet draws amply on healthy, monounsaturated fat from virgin olive oil. Red meat is eaten in low amounts—

if at all—while wine and fish are consumed moderately. The diet has long been associated with a reduced risk of cardiovascular disease12,13, cancer14, Alzheimer’s disease15, obesity and metabolic syndrome12,13, and might confer some epigenetic benefits on expectant parents. Some research suggests that the Mediterranean Diet might epigenetically protect the fetus from developing diseases later in life by adjusting histone modifications (histones are a family of proteins that associate with DNA in the nucleus and help condense it).16

What is the takeaway message?

For anyone newly pregnant or considering pregnancy, it’s critical that both parents maintain a healthy diet and avoid, as much as possible, exposure to toxic chemicals. Indeed, the fact that certain epigenetic markers are sensitive to and affected by nutrient input at conception focuses attention on how vital it is for both parents to eat a healthy and well-balanced diet before conception and during pregnancy.

The takeaway here is to better understand the epigenetic influences on weight gain and how patterns are established early on. With further research, we can expect to come to a heightened and enlightened understanding of epigenetic nutritional memory so we may better understand how early life experiences set the stage for positive or negative health outcomes throughout our lives.

About the Author: Stewart Lonky, M.D., is a physician, toxicologist, and biomedical engineer. He is board certified in internal medicine, pulmonology and critical care medicine, and a recognized expert in the related fields of preventive medicine and environmental toxicology and its associated diseases. Dr. Lonky is known for his cutting edge research into the causes, treatment and prevention of toxic chemical exposures and heralded for his in-depth knowledge of obesity's biological, environmental, and social influences, which is the subject of his forthcoming book. Dr. Lonky resides and practices in Los Angeles, California.

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  8. Lee HS. Impact of Maternal Diet on the Epigenome during In Utero Life and the Developmental Programming of Diseases in Childhood and Adulthood. Nutrients. 2015;7(11):9492-9507.
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Can Memory Improve? Reversing Cognitive Decline

Can memory improve?

It’s been said that some things, like love, wisdom and wine, get better with age. But when it comes to memory, there’s a universal belief that decline is inevitable and a normal part of getting older.

However, recent research suggests that memory can improve with the right lifestyle, supplements and other techniques.

Is memory loss a normal part of aging?

The severe loss of memory that occurs in Alzheimer’s disease or vascular dementia is certainly not normal. Neither is the loss that occurs in mild cognitive impairment, which can be a precursor to dementia. It’s a general misperception that forgetting things more often and experiencing greater difficulty learning new things are to be expected as we grow older. These occurrences may be common, but they’re not “normal”.

What causes memory loss?

In addition to Alzheimer’s disease and vascular dementia, other diseases and conditions can cause memory loss,1 including stroke, Parkinson’s disease, HIV, syphilis, multiple sclerosis, head trauma, epilepsy, depression and chronic alcoholism. Less severe conditions, including menopausal hormone decline, mild concussions, insomnia, stress, hypoglycemia (low blood sugar), dehydration, anxiety, multitasking, prescription drug side effects, vitamin B12 deficiency, exposure to toxins, and even high altitudes can impair memory, although this impairment is often reversible when the cause has been addressed.

In Alzheimer’s disease, memory loss is associated with the accumulation in the brain of proteins known as amyloid beta and tau. While amyloid beta is the better known of these proteins, attempts to treat Alzheimer’s disease by reducing the burden of amyloid beta in the brain have met with failure more often than success. Some researchers have turned to tau as a promising target in Alzheimer’s disease. Tau protein forms the neurofibrillary tangles commonly observed in the brains of Alzheimer’s disease patients. Yet, like amyloid beta, it is not yet known whether tau plays a causative role in Alzheimer’s disease.

Vascular dementia is caused by impaired blood flow to the brain. It can be the result of the same process (atherosclerosis) that occurs in the rest of the body of someone who has cardiovascular disease. Strokes and mini-strokes significantly increase the risk of vascular dementia.

Is cognitive decline reversible?

In a recently published interview, Dale E. Bredesen, MD, who is an expert in the mechanisms of neurodegenerative diseases and originator of The Bredesen Protocol™ for improving cognition, stated “Although the dogma has been that there is nothing that prevents, slows, or reverses the course of cognitive decline in diseases such as Alzheimer’s disease, there are clearly multiple studies now—in both anecdotal and controlled trials—that show examples in which there is indeed prevention and/or reversal of decline.”2

What helps memory?

Regular sound sleep and exercise are very important for supporting memory. Other important factors are a healthy diet (which includes eating regularly to avoid episodes of low blood sugar), stress management, taking steps to reduce underlying diseases such as cardiovascular disease and diabetes, staying hydrated and addressing hormone imbalances.

Which nutritional supplements help memory and concentration?

Quite a few supplements have been shown in experimental or clinical research to benefit memory and learning ability or slow their decline. These include choline, dimethylaminoethanol (DMAE), Ginkgo biloba, ashwagandha, Bacopa monnieri, Huperzine A, vinpocetine, phosphatidylserine, omega-3 fatty acids, lithium and others.3-13

How does exercise help memory?

Exercise promotes the formation of neurons in the brain, increases brain volume, boosts cognitive function and helps the brain maintain its ability to adapt to changes.14 It also improves circulation and the delivery of oxygen and supports vascular health.

How can future technology improve memory?

While the loss of memory is a growing concern for an aging population worldwide, research in this area is also growing. Scientists are investigating such aids as brain implants and computer-brain interfaces that expand memory and improve other functions. Online brain training programs are available now that work like exercise in the brain to help improve memory and learning, while tracking progress over time.

Nootropic compounds that may enhance memory have been the subject of research during the past several decades. These so-called “smart-drugs” have the potential to benefit everyone from college students seeking to improve exam scores to elderly men and women suffering from cognitive decline. The future may see the development of more advanced compounds and the use of smart drugs by more people.

Memory is more likely to improve with the adoption of more than just one or two of the therapies discussed in this post. A multifaceted, personalized program such as that developed by Dr Bredesen will improve the odds of maintaining our memories and perhaps even reverse some aspects of memory loss.


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Are Fitness Trackers Accurate? Choosing the Right One

Peter Marino, CPT, CHC

Are fitness trackers accurate at calorie counting?

Do fitness trackers calculate calories accurately? Right out of the box, no fitness tracker is 100
percent accurate in counting the calories burned by physical activity. That's because calorie-burning depends on so many factors such as health, speed, body weight, height, physical strength, type of workout environment and other variables.

Studies show that different fitness apps deliver variable results. Stress, hydration levels, temperature, excitement, and other factors also impact the burn rate.1

Related: Exercise Enhancement Protocol

The good news is that fitness apps motivate people to get more exercise and burn more calories. Comparing your daily rate enables you to determine accurately whether you're burning more calories by the day, week, or month. Artificial intelligence, or AI, is used by many trackers to get to know your personal health habits over time, which improves calorie-counting accuracy. 2

How can I make my device more accurate?

So just how accurate are fitness trackers? One study found that none of the seven devices tested delivered accurate measurements of energy expenditure. They varied from 27 percent to 93 percent from the scientific readings that measured the body's chemical changes caused by calorie burning. 3 However, you can fine-tune your devices to make them more accurate. Check online reviews of your fitness tracker to see whether it overestimates or underestimates the number of calories burned. You can adjust your workouts accordingly. Check to see whether moving your arms excessively affects your calorie count too much and adjust your activity for greater accuracy.

Choosing an AI-powered fitness device can improve calorie-count accuracy over time, so you might want to invest in a device that learns more about you each day.

You can begin by entering all your personal information accurately in your device such as height, weight, health, and type of activity. Ideally, fitness devices monitored by a physician can provide a better picture of your progress in losing weight and strengthening your health. Fitness apps encourage you to become more active. When you engage in exercise, the heart pumps more blood, oxygen, and nutrients to the muscles.

For comparative purposes, most fitness trackers work well enough to determine whether you're burning more or fewer calories when you exercise. Just be consistent and accurate while trying to increase your exercise level a little each day.

How do I choose the right fitness tracker?

Choosing a fitness tracker depends on many variables that include design, price, accuracy, and features. Smart watches can sync to your computer or phone. It's important to know your current health and fitness level. If you're tracking your activity for medical purposes, you might want to consult your physician.

Beginners often benefit from using a simple step tracker that monitors physical activity throughout the day and estimates the number of calories burned. If you're into sports, bodybuilding or just keeping physically fit, you might want to choose a tracker with advanced features such as a heartbeat monitor. Swimmers might choose a waterproof wearable to measure their water-based activities. AI technology holds the promise of eventually providing the most accurate monitoring.

Do fitness trackers calculate calories accurately? That depends on your efforts and choice of device. Choosing the right fitness trackers depends on each person's goals, budget, personal preferences, and willingness to monitor their results daily. That said, a study showed the validation and reliability of different devices for different fitness measurements and found FitBit to be the most reliable, tested, and validated out of all the devices tested. But don’t take my word for it; here’s the link to the research study. 4

About the Author: Peter Marino, CPT, CHC, owner of Posh Fitnessgraduated from Brooklyn College with a Bachelor’s Degree in Athletic Training. He has also finished his Plan IV requirements and extensive study at Hunter College. Peter is certified as a Health Coach (ACE), Nutrition Specialist (CNS), a Golf Conditioning Specialist, a Kettlebell Instructor (by Kettlebell Concepts), and a MetaFit Trainer. Peter Marino has given interactive seminars on nutrition and fitness for healthcare clinics, Morgan Stanley, IBM, Alliance Bernstein and the Hotel Union of New York, where he has also provided one-on-one counseling. He has written for many journals, magazines, and websites such as: Swarm Knowledge, NYS Dental Journal (Ergonomics), Men's Exercise, and his own blog,, where he has written about strength training, nutrition, and science related topics.

  1. Dannecker, K. L., Sazonova, N. A., Melanson, E. L., Sazonov, E. S., & Browning, R. C. (2013). A comparison of energy expenditure estimation of several physical activity monitors. Medicine and Science in Sports and Exercise, 45(11), 2105-2112.
  2. Sasaki, J. E., Hickey, A., Mavilia, M., Tedesco, J., John, D., Kozey Keadle, S., & Freedson, P. S. (2014). Validation of the Fitbit Wireless Activity Tracker® for Prediction of Energy Expenditure. Journal of Physical Activity and Health, 12(2), 149-154.
  3. Shcherbina A, Mattsson CM, Waggott D, Salisbury H, Christle JW, Hastie T, Wheeler MT, Ashley EA. Accuracy in Wrist-Worn, Sensor-Based Measurements of Heart Rate and Energy Expenditure in a Diverse Cohort. Journal of Personalized Medicine. 2017; 7(2):3.
  4. Henriksen A, Haugen Mikalsen M, Woldaregay AZ, et al. Using Fitness Trackers and Smartwatches to Measure Physical Activity in Research: Analysis of Consumer Wrist-Worn Wearables. J Med Internet Res. 2018;20(3):e110. Published 2018 Mar 22. doi:10.2196/jmir.9157

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