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Could the keto diet’s benefits be linked to changes in the gut microbiota? – Gut Microbiota for Health

Posted: June 15, 2020 at 11:45 am

Although the ketogenic (or keto) diet was initially used for treating childhood refractory epilepsy in the 1920s, fasting has been used to treat epilepsy since 500 BC. Later on, variations of the ketogenic diet (such as the Atkins diet) have appeared and its use has extended into adults for purposes other than reducing seizure frequency. They include treating weight loss, metabolic syndrome, certain cancers and psychiatric disorders such as Alzheimers disease.

This high-fat diet resembles the physiological effects of fasting by restricting carbohydrate intake to between 20g and 50g non-fiber carbohydrate per day (an average person in an industrialized country consumes 200g carbohydrate per day). This means replacing grains, fruit, starchy vegetables, legumes and sweets with carb-free or very low-carb foods such as non-starchy vegetables, cheese, avocados, nuts and seeds, eggs, meat, seafood and olive or coconut oil for cooking and dressing. That fat is then turned into ketone bodies in the liver, which can be taken up and used to fuel the bodys cells.

While scientists still struggle with figuring out which mechanisms underlie the keto diets therapeutic benefits, the gut microbiota, epigenetic changes and metabolic reprogramming appear to be involved in the response to diet.

Elaine Hsiao and her colleagues found that the microbiome is required for the anti-seizure effects of the keto diet. When germ-free mice received stool from mice on a keto diet, seizures were reduced, with Akkermansia muciniphila and Parabacteroides being involved in reducing electrical activity in the brain.

This has led scientists to explore whether the keto diet might be worth considering in gastrointestinal disease.

A new study in mice and humans, led by Peter J. Turnbaugh from UC San Francisco, breaks down the effects of the keto diet on the gut microbiome involving a reduction in bifidobacteria levels and pro-inflammatory Th17 immune cells.

First, Ang and colleagues assigned 17 men who were overweight or obese (but non-diabetic) to a control diet for 4 weeks, followed by the keto diet for 4 weeks. Metagenomic sequencing revealed bifidobacteria speciesin particular Bifidobacterium adolescentisdecreased the most on the keto diet.

The authors were also interested in exploring whether these changes were specific to the keto diet or were also observed in the high-fat and high-carbohydrate diet that is known to promote metabolic disease in mice by inducing shifts in the gut microbiome. To this end, Ang and colleagues fed groups of mice with high-fat diets formulated with graded levels of carbohydrates. It turned out that Bifidobacterium levels decreased with increasing carbohydrate restriction, thus highlighting that carbohydrate restriction, rather than high-fat intake, is the main contributor to the keto diets impact on the gut microbiome.

The mucus layer was maintained in the absence of dietary carbohydrates and bile acid metabolism was not affected. This led the authors to test whether ketone bodies themselves could be directly responsible for the progressive decreasing of Bifidobacterium as carbohydrates decreased.

Feeding mice with the high-fat diet and high-carbohydrate diet or the keto diet supplemented with a synthetic ketone esterdeveloped for mimicking ketosis without modifying dietled to increased levels of beta-hydroxybutyrate ketone bodies in the intestinal lumen and less adiposity. That can be explained by the fact that, beyond the liver, intestinal epithelial cells are also a source of ketone bodies.

Interestingly, in vitro experiments in human stool samples and work in rodents showed that ketone bodies selectively inhibited bifidobacterial growth in a dose- and pH-dependent mechanism. While other members of the gut microbiota were also affected to a lesser extent, the selective inhibitory effects of ketone bodies on Bifidobacterium may involve changes at the gut ecosystems ecological level and warrants further research.

Finally, both mono-colonization of germ-free mice with B. adolescentisthe most abundant species in the baseline diet that experienced the most marked decrease after going on the keto diet and human microbiome transplantations into germ-free mice showed that the keto diet mediates the lack of intestinal pro-inflammatory Th17 induction by reducing colonization levels of B. adolescentis. The observed differences in the gut were also detected on Th17 cells in the visceral adipose tissue.

To sum up, this study shows that the keto diet induces changes in the gut microbiome characterized by marked suppression of bifidobacteria coupled with a decrease in intestinal Th17. Said reduction would be worth considering in the context of improving obesity and immune-related diseases with increased Th17 activation.

The results reported here regarding changes in beneficial bifidobacteria, together with gut-related side effects and the nutritional safety of the keto diet due to the exclusion of major food groups, warrants caution on the use of this diet for managing gut symptoms or gastrointestinal disease progression.

References:

Kossoff EH, Zupec-Kania BA, Auvin S, et al. Optimal clinical management of children receiving dietary therapies for epilepsy: updated recommendations of the international ketogenic diet study group. Epilepsia Open. 2018; 3(2):175-92. doi: 10.1002/epi4.12225.

Wheless JW. History of the ketogenic diet. Epilepsia. 2008; 49(Suppl. 8):3-5. doi: 10.1111/j.1528-1167.2008.01821.x.

Tuck CJ, Staudacher HM. The keto diet and the gut: cause for concern? Lancet Gastroenterol Hepatol. 2019; 4(12):908-9. doi: 10.1016/S2468-1253(19)30353-X.

Cabrera-Mulero A, Tinahones A, Bandera B, et al. Keto microbiota: a powerful contributor to host disease recovery. Rev Endocr Metab Disord. 2019; 20(4):415-25. doi: 10.1007/s11154-019-09518-8.

Olson CA, Vuong HE, Yano JM, et al. The gut microbiota mediates the anti-seizure effects of the ketogenic diet. Cell. 2018; 173(7):1728-41. doi: 10.1016/j.cell.2018.04.027.

Ang QY, Alexander M, Newman JC, et al. Ketogenic diets alter the gut microbiome resulting in decreased intestinal Th17 cells. Cell. 2020. doi: 10.1016/j.cell.2020.04.027.

Turnbaugh PJ, Backhed F, Fulton L, et al. Diet-induced obesity is linked to marked but reversible alterations in the mouse distal gut microbiome. Cell Host Microbe. 2008; 3:213-23. doi: 10.1016/j.chom.2008.02.015.

Newport MT, Vanltallie TB, Kashiwaya Y, et al. A new way to produce hyperketonemia: use of ketone ester in a case of Alzheimers disease. Alzheimers Dement. 2015; 11(1):99-103. doi: 10.1016/j.jalz.2014.01.006.

Reddel S, Putignani L, Del Chierico F. The impact of low-FODMAPs, gluten-free, and ketogenic diets on gut microbiota modulation in pathological conditions. Nutrients. 2019; 11(2):373. doi: 10.3390/nu11020373.

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Could the keto diet's benefits be linked to changes in the gut microbiota? - Gut Microbiota for Health

Vegan Keto Diet: List of plant-based foods you can eat on the weight loss plan – Times Now

Posted: June 15, 2020 at 11:45 am

Vegan Keto Diet: List of plant-based foods you can eat on the weight loss plan  |  Photo Credit: iStock Images

New Delhi: The Keto diet or the Ketogenic diet is one of the most popular diet plans followed by people for quick weight loss. The diet comprises of low calorie, high-fat food, that help to put the body on the process of ketosis. This helps to burn fat, instead of carbohydrates, for the energy required by the body to perform every day activities, and hence helps in weight loss.

At the same time, a vegan diet has also been linked to many health benefits ranging from weight loss to a healthier heart. So can people who want to stay vegan follow a keto diet? Well, yes, they can. However, most foods that are high in healthy fats are non-vegetarian or animal-based. Here is a list of plant-based foods that people who wish to follow a vegan keto diet can include on their plate to get the best of both worlds.

Disclaimer: Tips and suggestions mentioned in the article are for general information purpose only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

For full coverage on Coronavirus pandemic, click here.Join the Times Group initiative #MaskIndia.Share a picture with your home-made mask on your social handles using #MaskIndia. The best picture will be featured in TOI and on maskindia.com

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Vegan Keto Diet: List of plant-based foods you can eat on the weight loss plan - Times Now

Roach: Diet and exercise are first prescription to try for prediabetes – LubbockOnline.com

Posted: June 15, 2020 at 11:45 am

DEAR DR. ROACH: My husband is a 50-year-old prediabetic who has recently experienced burning feet. He refuses to think it's his high-carb diet (bread three times a day, chips, ice cream) and instead thinks he just needs some vitamins for foot pain. Could you please explain why and how what he eats affects everything he's experiencing? -- Anon.

ANSWER: Diabetic neuropathy is a condition found in people who have had diabetes for years. It causes different symptoms in different people, but pain (often burning in character) and numbness are most common. The underlying cause is uncertain, but seems to be a combination of factors leading to nerve damage.

Prediabetes, often along with the other components of metabolic syndrome -- including high blood pressure, excess abdominal fat and high cholesterol or triglycerides -- may also bring on a neuropathy with very similar symptoms. Other causes, especially vitamin B12 deficiency, are appropriate to evaluate before determining the condition is most likely due to diabetes or prediabetes.

There are no specific treatments for the neuropathy, although there are medications to ease symptoms. Treatment of the underlying metabolic syndrome is therefore of the utmost importance, and the two most important treatments are diet and exercise. Avoiding simple carbohydrates, such as found in bread and chips, or the sugars in ice cream, is paramount. Regular exercise has an independent effect that adds to the effectiveness of the dietary changes.

Your husband is at risk, and the fact that the symptoms are recent means he should look at this as a wake-up call. Changing his lifestyle dramatically now can lead not only to improvement in symptoms (or at least they won't get worse), but it will also reduce his risk of heart attack and stroke.

There are many places to get help: His doctor, a registered dietitian nutritionist and a diabetes nurse educator all are excellent potential sources of information, but he has to make the decision to start the lifestyle change. Vitamins do not help diabetic neuropathy. If he can start making the changes, I hope he will find, as most people have, that his quality of life and sense of well-being are so much better that he will not want to stop his healthier lifestyle. Medications may be helpful, but the primary treatment is diet and exercise.

DEAR DR. ROACH: My wife smoked for many years and finally quit with the help of nicotine gum that is 4 milligrams each. Since quitting almost 20 years ago, she continues to use about 12 pieces of nicotine gum per day. Does ingesting this much nicotine in this manner put her at risk for developing some type of cancer from the nicotine? -- T.D.

ANSWER: No, nicotine is not carcinogenic, that is to say cancer-causing. In large doses, it is dangerous, but the doses she is taking are not -- at least, for a person used to them. Early signs of nicotine toxicity are excess salivation, nausea and vomiting.

There are many toxic substances in tobacco, some of which are cancer-causing. The tobacco does not need to be burned; chewing tobacco and snuff increase the risk of oral cancer. About half of all people who smoke will die because of smoking-related illness. Even one cigarette a day has significant long-term health risks.

Although it's not ideal that she continues to use nicotine gum (and it's not cheap), there is no doubt that the gum is much, much safer for her than continuing to smoke.

Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2020 North America Syndicate Inc.

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Roach: Diet and exercise are first prescription to try for prediabetes - LubbockOnline.com

How Red Meat Became the Red Pill for the Alt-Right – The Nation

Posted: June 15, 2020 at 11:45 am

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Nearly a billion pounds of beef move through the JBS processing plant in Grand Island, Neb., every year. Except this year: Over the last two months, the company has had to slow production as meatpacking plants around the country have been roiled by coronavirus outbreaks.1Ad Policy

In late March, Nebraska state health officials, fearing such outbreaks, urged Governor Pete Ricketts to temporarily close the plant.2

After Ricketts rebuffed them, stories of missing hand sanitizer and soap, no personal protective gear, and insufficient safety precautions began to leak out of the plant, which as of April had 260 confirmed Covid-19 cases that can be tied back to it. Its difficult to know how many more among its 3,000 workers have been infected since then, because Ricketts has refused to disclose official plant numbers. Across the country, rural areas that contain meatpacking plants with outbreaks of Covid-19 have rates five times those of other rural areas.3

In a daily briefing on April 23, Ricketts dismissed those who thought the largely immigrant meatpacking workers in his state deserved relief by warning, Think about how mad people were when they couldnt get paper products.4

President Donald Trump issued an executive order five days later recognizing meat as a scarce and critical material essential to the national defense, adding that he would ensure a continued supply of protein for Americans under the Defense Production Act of 1950. Rickettsundeterred by the outbreaks in his state and emboldened by the White Houseissued a press release declaring May as Beef Month in Nebraska.5Related Article

Politically, this shows that meat is indispensable, said University of Notre Dame professor Joshua Specht, whose 2019 book Red Meat Republic recounts the history of American beef production. Shortages of meat will personalize the pandemic for everyone, and that is a major political problem when youre trying to say the country is open for business.6

The Covid-19 pandemic has laid bare the fragility of American supply chains, and nothing demonstrates that more acutely than the price spikes, depleted meat aisles, and imposed rationing on a food that weve come to expect in limitless quantities. The brutality of effectively sacrificing human beings to keep those aisles well stocked might be the breaking point in what was already the liveliest debate inside food: the future of beef in the American diet.7Current Issue

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Industrial beef is the most polluting, the most carbon-emitting, and the most resource-intensive form of protein. A 2018 study published in the journal Nature recommended that the average US citizen cut beef consumption by 75 percent if we want to keep the global temperature rise to less than 2degrees Celsius above preindustrial levels. In the context of Covid-19, University of Minnesota biologist Rob Wallace has made the connection between global industrial livestock farming and the proliferation of superviruses.8

If youre reading this, youve probably already heard that you should be cutting down on beef. But Trumps and Rickettss decisions show that with beef so embedded in American culture, its not going anywhere without a fight.9

JBS: This Nebraska meatpacking plant processes nearly a billion pounds of beef a yearand is a Covid-19 hot spot for its workers.

Rickettss warning of riots if big government comes for our beef echoes the claim by former Trump adviser Sebastian Gorka that the Green New Deal is a harbinger of authoritarian communism. They want to take away your hamburgers, he bellowed in a speech at the 2019 Conservative Political Action Conference. This is what Stalin dreamt about but never achieved. Gorka made it explicit: To threaten the primacy of meat in the American diet is to threaten a pillar of what it means to be a free American.10

Sebastian Gorka: The former Trump adviser warned, They want to take away your hamburgers. (CC 3.0)

Gorkas ravings about government-mandated burger confiscation sound like some nefarious plot by the same postmodern cultural Marxists decried by the Canadian psychologist Jordan Peterson. In 2018 he revealed on the wildly popular Joe Rogan Experience podcast that he was following an extreme form of the now trendy high-fat, high-protein paleolithic and ketogenic diets: just beef and water. Thanks to the carnivore diet, as he called it, Peterson said hed lost 50 pounds, cured his 30-year gum disease, and seen his lifelong depression cease. Meat, manIm telling you, meat, reads an endorsement of the diet beneath an Instagram photo of him solemnly cutting through a steak.11

Jordan Peterson: Claims he lost 50 pounds, and cured depression and gum disease thanks to a carnivore diet. (CC-BY-SA-2.0)

Peterson first emerged in the public consciousness after protesting a Canadian policy about observing gendered pronouns, which he claimed as evidence of creeping authoritarian rule. He subsequently rode that wave of free-speech martyrdom to a best-selling book, 12 Rules for Life, full of banal self-help infused with social Darwinism. Peterson addresses feelings of real alienation in his audience, but instead of locating the structural sources of their misery, he harks back to an imaginary past when men could be men, before Western civilization became preoccupied with social justice and feminism. In recent years hes become a kind of soothsayer for the mostly young white male demographic that is the subject of worried fascination in the current age of homegrown extremism.12

Its been 30 years since Carol J. Adamss landmark The Sexual Politics of Meat connected the subjugation of animals with the subjugation of women. Studies have shown that men are less likely to embrace eco-friendly practices because we perceive them as feminine; a recent survey of men in the United States found that they were less likely to wear a protective face mask during the pandemic because they viewed them as a sign of weakness.13

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Petersons promotion of the carnivore diet was met with scornful incredulity and ridiculed as a self-defeating attempt to own the libs. But defenders of the diet pushed back, reminding us that humans are meant to eat meat and that it provides essential nourishment in the wasteland of the standard American dietdefined by high-fructose corn syrup, refined grains, and industrial seed oils.14

We shouldnt project our politics onto people who are half-dead, trying to get their lives back. Thats what his daughter, Mikhaila Peterson, 28, told me when I asked her about the politics of promoting an all-beef diet in the 21st century. She put her dad on the diet after it helped her with a crippling autoimmune disease and has since rebranded it as her very own Lion Diet.15

You have to reach a certain level of desperation to try it, she admitted. But because of how the media has been portraying Dad, the diet has been unfairly associated with the alt-right. Assigning people a conscious political identity based on their diet would be unwise; Adolf Hitler, famously, was a vegetarian.16

Adrienne Rose Bitar: Diet books replicate the 19th century religious form of the Jeremiad. (Cornell University History Dept )

But it would be equally unwise to ignore the embrace of red meat by the far right. Diet books were among the best-selling literature of the 20th century. More than simply offering guidance on which foods to eat and which to avoid, they remain a way to construct grand narratives about who we are. Self-help gets trashed as being an opiate of the masses, said Adrienne Rose Bitar, the author of Diet and the Disease of Civilization. But very few dieters see themselves on an individual quest for bodily perfection. Rather they recognize societal problems like obesity or diabetes and think that theyre going to do their own small part, however impossibly, to create a better world.17

Rogan and alt-right icons like Mike Cernovich and Alex Jones are already established in the dude self-care space, selling skin serums and supplements that might otherwise be considered ladylike. In recent years soy boy has eclipsed cuck as a term to deride the tofu-loving, beta-male archetype. The same return to a past, forgotten glory of men that is central to the appeal of people like Peterson and the nostalgic project of making America great again can also be found among advocates of low-carb regimes like the paleo, keto, and carnivore diets, which stress a return to the natural and traditional foodways of a healthier past.18

Conservative radio host Dennis Pragers faux university PragerU released a video last year titled How the Government Made You Fat, in which the low-carb cardiologist Bret Scher critiques the US Department of Agricultures food pyramid. The antiBig Government message is clear: You are responsible for your own health. Dont rely on the government to take care of you. For the One America News Network correspondent and former Pizzagate enthusiast Jack Posobiec and the far-right commentator Stefan Molyneux, praising meat-heavy, low-carb nutrition is a way to draw a contrast with the crypto-vegetarian piles of birdseed at the public schools their children attend, and Molyneux speculated it could be a communist plot. For others, eating meat is a way to police the boundaries of masculinity. In 2017 the far-right Canadian commentator Faith Goldy asked whether our fridges were the reason men were all of a sudden signing up for womens studies classes. Alex Joness former sidekick Paul Joseph Watson wondered if soy was making Western men more likely to adopt left-wing beliefs. Anthony Johnson regularly hosts paleo nutritionists as part of his premier manosphere gathering, the 21 Convention.19

Even the onetime steak salesman Trump did some nutritional virtue-signaling when it was revealed that he regularly enjoyed two Big Macs at dinner. His former campaign manager Corey Lewandowski quickly clarified to CNN that Trump never ate the bread, which is the important part. The National Cattlemens Beef Associationwhich lobbied for meatpacking plants to remain open during the pandemicdispatched its former senior director of sustainable beef production research, Sara Place, to assure the conservative media host Glenn Beck that methane emissions from cow farts were fake news and that cattle are part of the climate change solution.20

Faith Goldy: The fault is not in ourselves, but in our fridges. (CC 3.0)

Contemporary right-wing politics survives on a diet of grievance, persecution, and misdirection. In the right-wing mind, feminists and social justice warriors have been joined by the CEOs of Impossible Foods and Beyond Meat, creator of the Beyond Burger (the demand for alternative meat has skyrocketed but has not surpassed the demand for beef during the pandemic), Bill Gates, animal rights activists, Greta Thunberg, and the United Nations Intergovernmental Panel on Climate Change to carry water for the vegan agenda. Modern society has created the least masculine men in history, reads one tweet by the Internets mysterious self-described meat philosopher Carnivore Aurelius. Another proclaims, The Carnivore Diet is the red pill that wakes you up to reality. In these circles, the war on meat is a war on men. Red meat is the red pill.21

Even before the current once-in-a-century public health crisis, it was an anxious time to try to eat healthy. Chronic afflictions like obesity, cancer, heart disease, and diabetescommonly referred to as diseases of civilizationpersist at rates bordering epidemic levels. As populations around the world modernize and adopt something closer to the standard American diet, health outcomes worsen. Our understanding of nutrition hasnt helped.22

The Australian historian Gyorgy Scrinis coined the term nutritionism for a paradigm that allows food corporations to rebrand and remarket ultraprocessed food as health food. In 2007 he identified a nutritional loss of legitimacy that had opened the door to the construction of new nutritional worldviews.23

The paleo diet (the defining diet of the era, according to Bitar) is one example. Drawing on evolutionary biology and the caveman mystique, paleo mimics what was supposedly available to preagricultural humans, with a meat-heavy, grain-free, minimally processed diet. Its what we ate before everyones health went to shit, to quote John Durant, the author of The Paleo Manifesto. The framing is instructive. All diet plans are an attempt to mediate the transition from an agricultural, pastoral lifestyle to an urban, industrialized oneand the distance thats put between us and our food. Existential anxiety over what that change has done to our food and thus ourselves is what unites all diet literature.24

Diet books replicate the 19th century religious form of the jeremiad, Bitar said. They say we are fat, we are ugly, we are sinnersbut together we can lose the weight and regain our understanding of what nature and God can bring. In an essay for the food studies journal Gastronomica, historian Michael Kideckel noted that this understanding of food invariably launders a reactionary view of history.25

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In this philosophy of the past, Americans must rediscover a primitive instinct from a time when women did more work within the home, immigrants and indigenous people were even more marginalized, and fewer people saw culture and tradition as the product of specific human decisions, Kideckel wrote. For Durant, our collective health went to shit when women left the kitchen, outsourcing the cooking to corporations. Their traditional role was always an important one and shouldnt be trivialized, he said in a 2017 interview.26

Dieting has been considered a feminine pursuit for so long that when Weight Watchers first marketed to men in 2007, said Tulsa University professor Emily Contois, the tagline was Real men dont diet. But the first diet plans emerged during the mid- to late 19th century, when the ideal man came to be embodied in muscular selves, nations, empires and races, wrote the essayist Pankaj Mishra, who drew parallels between the 19th centurys ideas of manliness and those that contaminate politics and culture across the world in the 21st century.27

Lord Salisbury: Inventor of the eponymous steak. Civilization is harmful to your health. (History Dept. Cornell University)

The earliest diet to go by that name was a meat-heavy, proto-low-carb plan credited to a wealthy Londoner named William Banting, who in 1863 published the pamphlet Letter on Corpulence. It was such a best seller that Bant became a synonym for diet. Dr. James Salisbury, the inventor of the steaks, was another diet pioneer. He experimented with periods of eating only a single food like bread, oatmeal, baked beans, or asparagus before landing onwhat else?beef. It was the food that is most easily digested and that we can subsist on exclusively the longest, wrote Elma Stuart, a follower of Salisburys, in her book What Must I Do to Get Well?28

Diet theorist Mose Velsor: better known as Walt Whitman, inveighed against confections, sweets, salads, things fried in grease.

Salisbury saw his book The Relation of Alimentation and Disease as a way to address the character and capabilities of Western men. Civilization, he wrote, was damaging their physical and moral health, making them more likely to sin and shirk responsibility. He may have been influenced by Mose Velsor, a columnist for the New York Atlas, who in the 1850s worried that city life was producing a generation of soy boys. When Velsors columns were rediscovered and republished in 2016 as Guide to Manly Health and Training, they bore the authors real name: Walt Whitman. Healthy manly virility, he wrote, was being depleted. To foster a more pure-blooded race, Whitman recommended an end to confections, sweets, salads, things fried in grease. Instead he advocated eating fresh meat with as few outside condiments as possible.29

The connection between eating meat and the superiority of Western men was drawn out further in an 1869 essay The Diet of Brain Workers by the neurologist George Miller Beard. What have the natives of South America, the savages of Africa, the stupid Greenlander, the peasantry of Europe, all combined, done for civilization, in comparison with any single beef-eating class of Europe? he wondered. Beard is better known for his theory that the Euro-American brain was so powerful that it could overwork itself into a condition called neurastheniastress or exhaustion. In his 1881 book American Nervousness, he wrote that the affliction that came to be known as Americanitis was caused by the technological advancements of modern civilization. One such advancement was the mental activity of women.30

To cure Americanitis, Beard prescribed that men harden themselves by working on cattle ranches, of course. Theodore Roosevelt would epitomize this transformation in American masculinity. He gained a reputation in the New York Assembly as an effeminate jane-dandy but returned from his time on the frontier with the stoic, aggressive cowboy bravado that would define and plague American masculinity for at least 100 more years.31

As president, Roosevelt popularized the term race suicide to describe the fear that excessively fertile immigrants would outbreed their racial betters. Calling it an unpardonable crime, in a 1914 article, Twisted Eugenics, he castigated women who chose to attend college or use contraception instead of focusing on repopulating the white race. Its not unlike the present-day fears of white genocide or the great replacement that youll find in the tweets of Iowa Representative Steve King or in the white nationalist literature uncovered on Trump senior policy adviser Stephen Millers e-mail server.32

Toughening up on the frontier also meant interaction with Indigenous tribes. Even Salisburys beef remedy was inspired by his observations of Native Americans. There is no reason why we of civilized communities should not live to an even greater age than man does in the wild state, he wrote. But its unlikely that Salisbury ever witnessed the healthy wild state of beef eaters, because cattle are not indigenous to North America.33

Beefs journey to the top of the American diet began with the near extinction of bison and the genocide and forced removal of Indigenous tribes who subsisted on hunting that animal. Cattle ranching becomes central to the dispossession of Native lands and the takeover of western ecosystems, Notre Dames Specht pointed out. Cattle are a tool of, and a justification for, taking that land.34

At the same time that American manhood was redefined as the strong, silent type roaming the western frontier, beef became hypercommodified, readily available and relatively inexpensive for the first time in history. The idea that beef is something you eat all the time is the product of industrial agriculture, its a product of cities, and its a product of the expansion of commodity markets, Specht continued.35

To have a seemingly limitless supply of beef was such a global novelty that it became a badge of Americanness. Immigrants would write home and say, Life in America is hard, but at least I get red meat all the time, Specht said. We can but wonder how the largely immigrant workforce at the JBS plant in Grand Island felt about receiving 10pounds of free ground beef as a coronavirus bonus.36

W here do you go these days to mingle with some of the thought leaders advocating for beef to remain a central part of the American diet? Out west. Last August, over 150 people came together for three days at the University of San Diego student center for the eighth annual Ancestral Health Symposium, a big-tent conference that encompasses paleo, keto, and carnivore people along with anyone else who wants to examine current health challenges through the context of our ancestral heritage, according to the Ancestral Health Societys website. Its a heterogeneous community with plenty of internal debate, but its members share an intense skepticism of the medical, nutritional, and scientific establishment and a celebration of real, natural, traditional food.37

This is the Wild West, man. This is the fringe that the mainstream poaches from, a sturdily built, sandy-haired chiropractor from Los Angeles told me as we looked out at a room of lean, mostly white attendees outfitted for functionalitywicking athletic shirts, yoga pants, five-toed shoes, Xero sandals, blue-light-blocking shades, and slick metal water bottles. He wasnt wrong. The ancestral health community has been on the front lines of reclaiming healthy fat from unfair criticism; despite critiques of the community as overly patriarchal, some feminists have praised ancestral diets as a respite from a culture that equates beauty with thinness, to quote Bitar. If you know about collagen peptides, circadian rhythms, gut microbes, or the dangers of inflammation, these people may have had something to do with it.38

Yet there remains the fact that humans must change our relationship to meat, especially beef, if we are to avoid ecological catastrophe, let alone improve the lives of meatpacking workers or help the animals themselves. But if meat is of essential value to human health, we seem to be in an existential bind, trapped between our perceived nutritional needs and the capacity of our ecosystem and labor force to meet them. In Can Seven Billion Humans Go Paleo? the writer Erica Etelson wondered, If theres not enough animal protein to go around without cooking the planet, who should be first in line? Thats the mostly unasked question at the heart of the meat debate: one of power and ethics, not fat and protein. Thats also the dilemma that many people grapple with (this soycialist writer included) as they eat the occasional burger, steak, or oxtail.39

Ive been called right wing for saying meat is healthy, said Diana Rodgers, a farmer and dietitian. Its very political, but it shouldnt be. Youre either a less-meat environmentalist or you eat a lot of meat and dont care about the environment. Rodgers was in the midst of debunking the EAT-Lancet Commissions planetary health diet, which aims to accommodate the growing global population and planetary limits. The guidelines allow for only one serving of red meat per weeka death sentence to the people in this small auditorium. Rodgers disclosed that the General Mills meat snack company Epic Provisions had paid her way to the conference to help promote her upcoming book and documentary Sacred Cow (the nutritional, environmental and ethical case for better beat, according to her website), which was cowritten by Robb Wolf, the author of the best-selling The Paleo Solution.40

Allan Savory: Former soldier, ecologist, rancher, and originator of the controversial holistic management approach to soil conservation. (CC-by-sa-4.0)

Rodgers argues that beef is the ideal food for the health of the planet because of the potential for holistic range managementan approach to cattle rearing popularized by Zimbabwean rancher Allan Savory and his namesake institute. To oversimplify, cattle are strategically moved around a plot of land in a way that mimics the millions of bison that grazed for thousands of years in North America. This grazing technique restores grasslands and revitalizes soil in a way that allows for substantialmaybe even earth-savinglevels of carbon sequestration. While holistic range management (and the prospect of carbon-neutral burgers) makes intuitive sense and has serious momentum, its also highly polarizing.41

There are credible scientists on either side of the Savory debate, including David Briske and Richard Teague, two professors in the same department at Texas A&M University. Savorys past as an officer in the Rhodesian Army hasnt done him any favors among his critics, who portray him as a delusional iconoclast with no respect for scientific rigor. But to his proponents, which include a growing list of farmers around the world, Savory is a misunderstood sage. The complexity and dynamism of his methods cannot be fully appreciated in summary form.42

If there is a middle ground between the dystopian reality of the beef industry and the unsettling vision of a world without animal agriculture posited by Impossible Foods CEO Pat Brown, holistic range management could be just that. It doesnt seem right that the Norwegian billionaire couple behind EAT-Lancet, Gunhild and Petter Stordalen, are allowed to prescribe diets for the rest of the world while they fly around in a private jet with their own carbon footprint unregulated. I was open to the possibility that the Shake Shack burger I ate the night before was not a personal moral failing but actually a righteous rebellion against the 1 percent. That would make life easier. Then an audience member asked Rodgers if there would be enough land to support a large population on the beef-heavy diet she recommends. She assured him there would be.43

And it could sustain the same population or more as an agrarian-based economy?44

Rodgers was visibly flustered. What I can tell you is that theres too many of us, she replied. Do we want lots of people fed like crap, or do we want healthy people? Our current system is completely failing and producing sick people and killing our environment. So regenerative agriculture is actually the only solution we have moving forward. And, you know, theres too many people.45

Perhaps Rodgers should have chosen an other title for her lecture than Feeding the World a Healthy and Sustainable Dietand other opponents than EAT-Lancet and Impossible Foods. At least their visions attempt to account for the worlds population as it exists. Only 3percent of the beef produced in the United States is designated as grass-fed; even less is raised by Savorys method. Any hypothetical solution in which factory farms transform into holistically managed ranges will ultimately have to confront the multinational agribusiness industry that has been consolidating power for decades. Eating beef is political, whether we want it to be or not. But what was most troubling about Rodgerss answer was her too many people declaration: In those thought experiments, its always the less powerful who count as extra. Its not necessarily right wing to say that meat is healthy, but to quickly revert to claims of overpopulation calls up the darkest strains of both the conservation movement and ancestral health diet literature.46

In 1975 a doctor named Walter Voegtlin self-published his foundational text, The Stone Age Diet, which told a story similar to Rodgerss about the lack of sufficient animal protein to feed a surplus population. Voegtlins solution included limit[ing] reproduction to superior types of individuals and practicing euthanasia of imperfect newborns. Rodgers and others who advise people to eat more meat surely dont endorse that approach, but its worth highlighting how similar their framing is: For some to thrive, others must disappear.47

The Blonde Buttermaker: This former vegetarian liberal has become an animal-fat-obsessed white nationalist.

I kept Rodgers and Voegtlin in mind toward the end of an interview with Tristan Haggard, the proprietor of the popular keto-carnivore YouTube channel Primal Edge Health, which is also the name of his diet brand. A gregarious former vegan, he had spent much of our two-hour Skype call building his case that the plant-based-food movement evolved out of the eugenics movement and is behind a conspiracy to depopulate the world by feminizing men through industrialized vegan kibble. His mantra, Eat meat, make families, is a response to what he sees as the growing cultural degeneracy of modern city life. Instead of being concerned with how you can feed your family or protect your community, men are taught about how cool they might look in a dress, Haggard said. Thats why he fled California to raise his family on a farm in the Andes Mountains in Ecuador. Now he lives like a 21st century primal maneating grass-fed steak, drinking raw milk, and creating content for his subscribers and clients about the dangers of modern soycial engineering.48

I told Haggard I had just heard Rodgers recite the same Malthusian talking points he attributes to vegans. Im glad you brought that up. Its important to read with nuance, he said. While he recognized that overpopulation arguments are usually directed at his neighbors in the Global South, hes appeared on the white nationalist publishing company Arktoss channel to talk up the carnivore diet as part of the fight against globalist hegemony, and hes also rushed to the defense of the Nazis kicked out of the farmers market in Bloomington, Ind. It seems that for Haggard, regardless of your political leanings, if youre on the side of more meat, youre part of the resistance.49

Haggard touts small-scale, local agriculture as a weapon against the globalists, yet he calls climate change a word game and factory farming a straw man argument. His fun-house mirror of inconsistent, repellent, and altogether weird beliefs is not uncommon among prominent followers of Weston Price, the godfather of the ancestral health movement. In 1939, Price published a flawed but compelling ethnography, Nutrition and Physical Degeneration, describing traditional preindustrial diets from the Alps to the Andes. He found several constants, the most important of which are the vitality of animal fat and the degeneration of peoples health after exposure to the Western industrial diet. Today his followers have translated his work into contemporary diet guidelines. Rather than eschew any specific food group, they focus on minimally processed food and old-world farming and food-preservation techniques.50

In the vendor room at the Ancestral Health Symposium, I spoke with a disarmingly friendly volunteer from the Weston A. Price Foundation about the pleasures of bone marrow and roasting vegetables in duck fat and another who was in the midst of shooting a documentary about grass-fed beef. The foundation is best known for Nourishing Traditions, the best-selling cookbook by its founder, Sally Fallon Morell, which popularized Prices work. While the pandemic has shown the importance of local, organic farms, which Prices followers have supported for years, theyre still easily dismissed as cranks because of their opposition to the scientific and medical establishment, as demonstrated by their commitment to unpasteurized dairy.51

Unfortunately, thats not the most controversial claim the foundations leaders have made. In 2018, Morrell wrote on her blog that the Earth stopped warming in the late 1990s and now is in a cooling trend, so we dont have to feel guilty for driving an SUV or eating bacon. The foundation doesnt have an official position on climate change, and when some of her followers protested in the comment section, she replied that the discourse around global warming reminded her of the relentless propaganda against animal fats. Like Haggard, she seems willing to embrace anyone sympathetic to her cause.52

In 2015, Morrell appeared on Red Ice Radio, a Swedish media platform that the Southern Poverty Law Center called one of the most effective white nationalist outlets on the Internet. Before it was banned from YouTube, Red Ice unveiled a cooking and lifestyle show hosted by a neo-Nazi domestic goddess named the Blonde Buttermaker. In an interview on the white nationalist channel NoWhiteGuilt, she spoke of how influential Prices work had been on her journey from former liberal vegetarian to animal-fat-obsessed white nationalist. In the wrong hands, emphasizing ancestral wisdom can be reinterpreted as a permission to embrace ethnonationalism.53

But Prices research does have value if read critically. In Diet and the Disease of Civilization, Bitar analyzes his work using the anthropologist Renato Rosaldos concept of imperialist nostalgia, in which agents of colonialism long for the very forms of life they intentionally altered or destroyed.54

Nowhere was such nostalgia more evident than during the symposium presentation by Paul Saladino, a young, charismatic, and totally shredded carnivore MD. Saladino described the uphill battle in consciousness to convince the world that plant fiber is unnecessary for human consumption. Repeating the ancestral health movements dictum that Indigenous cultures prized fat as a symbol of health and fertility, Saladino encouraged the audience members to swap their kale salads for rib eye and organ meats. He closed by invoking an Andean tribal saying, Wiracocha, which he translated as I wish you a sea of fat.55

Wiracocha was also used to describe Spanish conquistadors, whose white skin was foamy like fat. Its a coincidence that reveals the historical revisionism pervasive in this community. Throughout the weekend there were photographs of healthy, happy, well-fed preindustrial Indigenous groups. But there was no acknowledgment that the rise of cattle ranching depended on eliminating the means of subsistence for Indigenous tribesor that the destruction of foodways has been a deliberate strategy of colonial powers. The slideshows simply showed beautiful people victimized by the forces of nature, whose wisdom was now bestowed on us. A young woman asked Saladino what he would say to someone curious about the carnivore diet. Welcome to the tribe, he replied.56

A sympathetic look at this confused yearning for tribal belonging would take into account what Bitar discovered as the main recurring theme in paleo diet books. Surprisingly, it has little to do with food or nutrition. Our ancestors enjoyed a balanced life of working, playing, relaxing, and worshipping. They felt closeness to one another and everyone had purpose, Bitar said, quoting from Living Paleo for Dummies. Its a human need as basic as food: meaning and connection, especially in a country defined by loneliness and living through a second gilded age of economic inequality.57

This was made even clearer during the last presentation I attended, by a naturopath named Nasha Winters. She informed us that in the past three years, American life expectancy rates declined. The diseases of civilization now have companyopiate addiction, alcoholism, and suicide, the diseases of despair.58

Nowhere is the degeneration of the quality of life in the United States more acute than in the communities surrounding the meatpacking plants that dot rural areas. Americans do need better diets, but we also need to realize that while consumer politics might be transformative for individuals, as public policy, it amounts to window dressing. As University of CaliforniaSanta Cruz professor Julie Guthman noted in her book Weighing In: Obesity, Food Justice, and the Limits of Capitalism, the artificially low price of food has long functioned as a replacement for a living wage and a social safety net, and it comes with serious environmental and public health consequences.59

Over the past 100 years, from Upton Sinclair to Michael Pollan, many Americans have been curious about how the sausage is made. But what most of them really want to know is whether they can keep eating it. The public became concerned with the conditions inside meatpacking plants not out of a concern for workers health but out of worry for what meat shortages might do to their own. Sinclairs famous regret was that he aimed for the publics heart with The Jungle but hit them in the stomach instead. He hoped that exposing the horrifying conditions in meatpacking plants could spark a socialist uprising, but all he got was the Meat Safety Act of 1906.60

The logic that consumer prices are the highest good in terms of social policy, thatcomes from beef, said Joshua Specht. Any movement to reduce meat consumption must address the role that cheap beef has played in providing meaning and nourishment to the masses, or else that ground will be ceded to the Sebastian Gorkas and Donald Trumps of the world.61

The coronavirus pandemic and the looming global ecological crisis are collective problems that individual solutions wont be able to solve. But as Bitar writes, the best way to approach the question of diet is not to call out ignorance but rather to understand myths. When we examine these myths, we can see them truly as the stories we tell ourselves about ourselves, and, perhaps, a story for which we can write a better plot. As difficult as it is to forecast what America will look like after the pandemic, it could be enough of a ground-shifting historical event to spawn new storiesabout why we eat, what we eat, and what we must change to survive.62

Food is so much about who we are and who weve been. To just change that overnight is not really that easy, actually, said Specht. But food isnt just a building block for who we are, its a building block for the kind of society we want to live in. If we can ground our food system in a more rigorous understanding of history, perhaps then we can remake it as a reflection of the society we want to live in. That would be the real red pill, waking us to a new reality.63

Originally posted here:
How Red Meat Became the Red Pill for the Alt-Right - The Nation

Switching to Ozempic(R) from another GLP-1 RA significantly reduced blood sugar and weight in people – PharmiWeb.com

Posted: June 15, 2020 at 11:44 am

This material is intended for global medical media only, excl US.

For journalistic assessment and preparation before publication.

- A separate real-world study showed that people with type 2 diabetes on two oral antidiabetic drugs who intensified with a glucagon-like peptide-1 receptor agonist (GLP-1 RA) were significantly more likely to reach their blood sugar goals and lose weight compared to adding a further oral antidiabetic drug(s) or insulin.1

BAGSVRD, Denmark, June 15, 2020 /PRNewswire/-- Novo Nordisk today announced results from two real-world studies: EXPERT, which confirms the efficacy Ozempic (onceweekly semaglutide) demonstrated in the SUSTAIN clinical trial programme, and PATHWAY, which supports recommendations in clinical guidelines by showing that initiation of a GLP-1 receptor agonist (GLP-1 RA) helps people with type 2 diabetes reach their blood sugar goals (measured by HbA1c) while also losing weight. These studies, which analysed data from US databases, were presented during the American Diabetes Association 80th Scientific Sessions.1,2

The EXPERT study showed that a switch to Ozempic from another GLP-1 RA in people with type 2 diabetes was associated with statistically significant reductions in blood sugar and weight, independent of the previous GLP-1 RA used. After 6 months, the study showed HbA1c reductions of 2.2% for people with HbA1c levels above 9% at baseline and HbA1c reductions of 1.1% for those with HbA1c levels above 7% at baseline. These reductions were sustained after 12 months. Average weight loss of 2.2 kg was observed at 6 months, but was more pronounced with 3.5 kg at 12 months, for all participants.2

A second real-world study, PATHWAY, pointed to the increased effectiveness of the GLP-1 RA class compared with other oral antidiabetic drugs or insulin in people with type 2 diabetes on two oral antidiabetic drugs requiring treatment intensification. Ozempic was not one of the GLP-1 RA treatments given at intensification because the study data were collated before Ozempic was fully established on the US market.

The PATHWAY study showed thatintensifying treatment with a GLP-1 RA resulted in a statistically significant increased likelihood of achieving HbA1c below 7% and weight reduction from baseline compared with adding a further oral antidiabetic(s). These blood glucose and weight reductions were more pronounced compared with insulin intensification, where those taking a GLP-1 RA were almost twice as likely to achieve HbA1c below 7% and approximately three times more likely to lose weight.1

"GLP-1 receptor agonists have been shown to safely lower blood glucose levels and help lower weight, therefore they are recommended by all diabetes treatment guidelines as either second- or third-line treatment options in most people with type 2 diabetes," said study investigator Dr. Ildiko Lingvay, who consults for Novo Nordisk and is a Professor of Internal Medicine, and Population and Data Sciences at UT Southwestern Medical Center. "These data provide information from the real-world use of GLP-1 receptor agonists and further support the recommendations in the clinical guidelines by showing that initiation of a GLP-1 receptor agonist helps more people with type 2 diabetes reach their blood sugar goals while also helping them lose weight."

"More than half of people with type 2 diabetes do not reach their blood sugar target, yet we know that consistently poor blood sugar control can lead to serious complications," said Mads Krogsgaard Thomsen, executive vice president and chief science officer of Novo Nordisk. "Real-world data is therefore essential to help physicians select optimal treatment for their patients to meet their blood sugar goals, and it is reassuring to see from the EXPERT study that the efficacy Ozempic demonstrated in the SUSTAIN Phase 3 clinical trial programme is reflected in routine clinical practice."

Whilst real-world evidence generates valuable insights about the effectiveness of a medicine in a real-life setting, there are also limitations. Real-world studies may be subject to bias and confounding factors, aspects that are controlled for in randomised controlled trials (RCTs). For example, electronic data may be inconsistently collected, with missing data elements that can result in reduced statistical validity. Similarly, adverse events are rarely captured in databases that act as data sources for real-world studies. Therefore real-world evidence should be considered alongside the results of RCTs and the findings evaluated with appropriate caution. As seen in clinical trials, the most common side effects of Ozempic include nausea, vomiting, diarrhoea, stomach (abdominal) pain, and constipation.

For additional media materials, including video footage of the EXPERT and PATHWAY study investigators providing further context on the data, please visit: http://www.epresspack.net/novonordiskADA2020/RWEGLP1Class

About EXPERT

The GLP-1-Experienced Patients Switching to Once-Weekly Semaglutide in a Real-World Setting (EXPERT) study used prescription data from Explorys (IBM Watson Health) US medical records database (data cut-off 12/5/19). Adults with type 2 diabetes with 1 prescription for semaglutide (index/switch date), a prescription for any other GLP-1 RA (baseline) in the previous year, and separate HbA1c/weight measurements at 6 and/or 12 months post-index and in the 90-day pre-index period were identified from the database. Participants with valid HbA1c (n=365) and weight (n=480) data were included in the study and had similar baseline characteristics.2

About PATHWAY

The PATHWAY study compared treatment intensification options for glycaemic control in people with type 2 diabetes on two oral antidiabetic drugs (OADs). The PATHWAY study used linked electronic medical records and claims data from IBM MarketScan Explorys Claims-EMR (index period: 3/1/1310/31/18). The study comprised two groups: the HbA1c cohort (n= 4,792) and the weight and composite endpoint analysis cohort (n = 3,927). Participants with 1 claim for 2 different OADs in the 180 days pre-index, 1 claim for another OAD/GLP-1 RA/insulin (index date), 1 HbA1c and/or weightmeasurement 180 days post-index, and 1 HbA1c and/or weight measurement close to index date (baseline) were included in the study. Cohorts for GLP-1 RAs vs OADs and vs insulin were propensity score matched pairwise by baseline variables and exact matched by HbA1c category, resulting in well balanced cohorts across all baseline characteristics.1

About SUSTAIN clinical trial programme

The SUSTAIN clinical development programme for Ozempiccurrently comprises 10 Phase 3 global clinical trials, including a cardiovascular outcomes trial, which included people with type 2 diabetes and high cardiovascular risk. The programme involves more than 10,000 adults with type 2 diabetes in total.3-12

About Ozempic

Ozempic(once-weekly semaglutide) is an analogue of the naturally occurring hormone glucagon-like peptide-1 (GLP-1). It is administered in a once-weekly injection of 0.5 mg or 1 mg and indicated as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes as well as to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease.13 Ozempicwas first approved by the US FDA in 2017 and is now launched in 25 countries.

About Novo Nordisk

Novo Nordisk is a leading global healthcare company, founded in 1923 and headquartered in Denmark. Our purpose is to drive change to defeat diabetes and other serious chronic diseases such as obesity and rare blood and endocrine disorders. We do so by pioneering scientific breakthroughs, expanding access to our medicines and working to prevent and ultimately cure disease. Novo Nordisk employs about 43,100 people in 80 countries and markets its products in around 170 countries. For more information, visit novonordisk.com,Facebook, Twitter, LinkedIn, YouTube.

References

Further information

SOURCE Novo Nordisk

See original here:
Switching to Ozempic(R) from another GLP-1 RA significantly reduced blood sugar and weight in people - PharmiWeb.com

Switching to Ozempic from another GLP-1 RA significantly reduced blood sugar and weight in people with type 2 diabetes in routine clinical practice -…

Posted: June 15, 2020 at 11:44 am

This material is intended for global medical media only, excl US.

For journalistic assessment and preparation before publication.

- A separate real-world study showed that people with type 2 diabetes on two oral antidiabetic drugs who intensified with a glucagon-like peptide-1 receptor agonist (GLP-1 RA) were significantly more likely to reach their blood sugar goals and lose weight compared to adding a further oral antidiabetic drug(s) or insulin.1

BAGSVRD, Denmark, June 13, 2020 /PRNewswire/-- Novo Nordisk today announced results from two real-world studies: EXPERT, which confirms the efficacy Ozempic (onceweekly semaglutide) demonstrated in the SUSTAIN clinical trial programme, and PATHWAY, which supports recommendations in clinical guidelines by showing that initiation of a GLP-1 receptor agonist (GLP-1 RA) helps people with type 2 diabetes reach their blood sugar goals (measured by HbA1c) while also losing weight. These studies, which analysed data from US databases, were presented during the American Diabetes Association 80th Scientific Sessions.1,2

The EXPERT study showed that a switch to Ozempic from another GLP-1 RA in people with type 2 diabetes was associated with statistically significant reductions in blood sugar and weight, independent of the previous GLP-1 RA used. After 6 months, the study showed HbA1c reductions of 2.2% for people with HbA1c levels above 9% at baseline and HbA1c reductions of 1.1% for those with HbA1c levels above 7% at baseline. These reductions were sustained after 12 months. Average weight loss of 2.2 kg was observed at 6 months, but was more pronounced with 3.5 kg at 12 months, for all participants.2

A second real-world study, PATHWAY, pointed to the increased effectiveness of the GLP-1 RA class compared with other oral antidiabetic drugs or insulin in people with type 2 diabetes on two oral antidiabetic drugs requiring treatment intensification. Ozempic was not one of the GLP-1 RA treatments given at intensification because the study data were collated before Ozempic was fully established on the US market.

The PATHWAY study showed thatintensifying treatment with a GLP-1 RA resulted in a statistically significant increased likelihood of achieving HbA1c below 7% and weight reduction from baseline compared with adding a further oral antidiabetic(s). These blood glucose and weight reductions were more pronounced compared with insulin intensification, where those taking a GLP-1 RA were almost twice as likely to achieve HbA1c below 7% and approximately three times more likely to lose weight.1

"GLP-1 receptor agonists have been shown to safely lower blood glucose levels and help lower weight, therefore they are recommended by all diabetes treatment guidelines as either second- or third-line treatment options in most people with type 2 diabetes," said study investigator Dr. Ildiko Lingvay, who consults for Novo Nordisk and is a Professor of Internal Medicine, and Population and Data Sciences at UT Southwestern Medical Center. "These data provide information from the real-world use of GLP-1 receptor agonists and further support the recommendations in the clinical guidelines by showing that initiation of a GLP-1 receptor agonist helps more people with type 2 diabetes reach their blood sugar goals while also helping them lose weight."

"More than half of people with type 2 diabetes do not reach their blood sugar target, yet we know that consistently poor blood sugar control can lead to serious complications," said Mads Krogsgaard Thomsen, executive vice president and chief science officer of Novo Nordisk. "Real-world data is therefore essential to help physicians select optimal treatment for their patients to meet their blood sugar goals, and it is reassuring to see from the EXPERT study that the efficacy Ozempic demonstrated in the SUSTAIN Phase 3 clinical trial programme is reflected in routine clinical practice."

Whilst real-world evidence generates valuable insights about the effectiveness of a medicine in a real-life setting, there are also limitations. Real-world studies may be subject to bias and confounding factors, aspects that are controlled for in randomised controlled trials (RCTs). For example, electronic data may be inconsistently collected, with missing data elements that can result in reduced statistical validity. Similarly, adverse events are rarely captured in databases that act as data sources for real-world studies. Therefore real-world evidence should be considered alongside the results of RCTs and the findings evaluated with appropriate caution. As seen in clinical trials, the most common side effects of Ozempic include nausea, vomiting, diarrhoea, stomach (abdominal) pain, and constipation.

For additional media materials, including video footage of the EXPERT and PATHWAY study investigators providing further context on the data, please visit: http://www.epresspack.net/novonordiskADA2020/RWEGLP1Class

About EXPERT

The GLP-1-Experienced Patients Switching to Once-Weekly Semaglutide in a Real-World Setting (EXPERT) study used prescription data from Explorys (IBM Watson Health) US medical records database (data cut-off 12/5/19). Adults with type 2 diabetes with 1 prescription for semaglutide (index/switch date), a prescription for any other GLP-1 RA (baseline) in the previous year, and separate HbA1c/weight measurements at 6 and/or 12 months post-index and in the 90-day pre-index period were identified from the database. Participants with valid HbA1c (n=365) and weight (n=480) data were included in the study and had similar baseline characteristics.2

About PATHWAY

The PATHWAY study compared treatment intensification options for glycaemic control in people with type 2 diabetes on two oral antidiabetic drugs (OADs). The PATHWAY study used linked electronic medical records and claims data from IBM MarketScan Explorys Claims-EMR (index period: 3/1/1310/31/18). The study comprised two groups: the HbA1c cohort (n= 4,792) and the weight and composite endpoint analysis cohort (n = 3,927). Participants with 1 claim for 2 different OADs in the 180 days pre-index, 1 claim for another OAD/GLP-1 RA/insulin (index date), 1 HbA1c and/or weightmeasurement 180 days post-index, and 1 HbA1c and/or weight measurement close to index date (baseline) were included in the study. Cohorts for GLP-1 RAs vs OADs and vs insulin were propensity score matched pairwise by baseline variables and exact matched by HbA1c category, resulting in well balanced cohorts across all baseline characteristics.1

About SUSTAIN clinical trial programme

The SUSTAIN clinical development programme for Ozempiccurrently comprises 10 Phase 3 global clinical trials, including a cardiovascular outcomes trial, which included people with type 2 diabetes and high cardiovascular risk. The programme involves more than 10,000 adults with type 2 diabetes in total.3-12

About Ozempic

Ozempic(once-weekly semaglutide) is an analogue of the naturally occurring hormone glucagon-like peptide-1 (GLP-1). It is administered in a once-weekly injection of 0.5 mg or 1 mg and indicated as an adjunct to diet and exercise to improve glycaemic control in adults with type 2 diabetes as well as to reduce the risk of major adverse cardiovascular events in adults with type 2 diabetes and established cardiovascular disease.13 Ozempicwas first approved by the US FDA in 2017 and is now launched in 25 countries.

About Novo Nordisk

Novo Nordisk is a leading global healthcare company, founded in 1923 and headquartered in Denmark. Our purpose is to drive change to defeat diabetes and other serious chronic diseases such as obesity and rare blood and endocrine disorders. We do so by pioneering scientific breakthroughs, expanding access to our medicines and working to prevent and ultimately cure disease. Novo Nordisk employs about 43,100 people in 80 countries and markets its products in around 170 countries. For more information, visit novonordisk.com,Facebook, Twitter, LinkedIn, YouTube.

References

Further information

https://www.novonordisk.com

SOURCE Novo Nordisk

Here is the original post:
Switching to Ozempic from another GLP-1 RA significantly reduced blood sugar and weight in people with type 2 diabetes in routine clinical practice -...

From Weight Loss to Better Immunity: Here’s why you should add Zumba to your fitness routine – PINKVILLA

Posted: June 15, 2020 at 11:44 am

Zumba Training: Sucheta Pal, Zumba Master Trainer has shared some lesser-known and other important details about this popular workout.

We all know how fun and popular Zumba workout is. But aside from this major perk and social benefits of a group workout, one can improve quality of life as there are several health benefits of it right from weight loss to better immune system, better blood pressure among others. Those who burn excess calories have toned body and sculpted muscles but looking for an easy and effective workout then look no further. For the unversed, Zumba workout features movements inspired by varied styles of Latin American dance.

It is a full-body-workout which means it involves the movement of the entire body right from your arms to your feet. To know more about this particular workout, we asked Sucheta Pal, Master Trainer (Zumba Education Specialist ZES), Zumba, Miami to reveal how Zumba can help to build immunity considering how important it is right now more than ever. She also shared about India's largest living room fitness masterclass (featured none other than Zumba creator Beto Perez) which was held recently. Read on to know more.

1. Can you share how Zumba aids in immunity?

The first and foremost benefit of Zumba which is like a "happy workout" is that it slows down the release of stress hormones which is the number one reason for illness. The increase in blood circulation and body temperature during and after exercise tremendously helps fight infections better. The best part is that regular exercise like Zumba has an anti-inflammatory influence which is key to fighting off viruses.

2. How can Zumba help weight watchers?

Many of our participants across the world have recorded a calorie burn of over 500 and sometimes even reaching 800 calories per session which typically lasts 60 mins. We have had amazing stories of Zumba fans in India who have seen substantial weight loss within 3 months of regularly attending classes whether live or virtual.

4. What are the types of Zumba that people are not aware of?

Zumba is one of the top group fitness brands in the world. Its also now a household name in India with every gym and studio offering a class whether it's in Mumbai or in Madurai. But some of the other formats of Zumba are now slowly catching on. One major hit is the Zumba Kids program which has specially designed music and kid-friendly choreography created to get the little rockstars moving and grooving. Another format is Aqua Zumba which takes this fitness party like the class to the pool in summers. We also have the Zumba Gold program for the active old adults and Zumba Toning for those who wish to incorporate some dumbells into their Zumba workout. Only licensed Zumba instructors in these formats conduct these specialized formats and will be listed on zumba.com for anyone to find and attend.

4. What are the vital things to know/follow before you start a virtual or offline Zumba class?

It is very important that we treat a virtual class similar to how we would a live class. Have ample space to move safely at your home, have a bottle of water for hydration, wear comfortable workout clothes and the right shoes to ensure ease of movement and safety. With a virtual class, one thing to add would be to test out the online platform via which your licensed Zumba instructor will be teaching the class whether its zumba.dance or Zoom and attach a speaker and have a good internet connection to create the right experience for yourself.

5. Can you share about the record-breaking living room fitness masterclass?

We created history in India with this class. Not only through the huge number of participants but with 17 Zumba Education Specialists leading the class from their homes in every corner of the country. We are proud to spotlight the importance of fitness instructors in this country, especially during these difficult times.

ALSO READ: Zumba creator Beto Perez OPENS UP on weight loss, lesser-known benefits and myths of this workout

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From Weight Loss to Better Immunity: Here's why you should add Zumba to your fitness routine - PINKVILLA

Dr. Oz: A Message To The Vulnerable – Forbes

Posted: June 15, 2020 at 11:44 am

In this sensitive, timely and, literally, vital piece, Dr. Oz outlines the doable and practical ways that all of us, especially the most vulnerable among us, can realistically tackle the conditions that undermine good health and make people less able to fight such terrible diseases as Covid-19.

Guest post by Dr. Mehmet Oz.

Vulnerable populations have been hard hit by Covid-19.

We are taught early on in medical school that when an avalanche of complex patient data sounds like hoofbeats, we should expect horses more than zebras. As the nation has focused on a daily firehose of Covid-19 information, doctors have been searching for the subtle predictors of why some groups are spared and others suffer disproportionately. We now have evidence explaining why African Americans have over twice the complication rate with Covid-19 as white populations. Over the past weeks, this documentation has revealed the higher prevalence of such chronic health conditions as obesity, hypertension, diabetes and lung diseaseailments that are much more common in underserved communities due to complex factors, including chronic stress and jobs that make social distancing nearly impossible.It also exposes how African Americans are disproportionately suffering.

. For example, Northwell Health, the large New York hospital system, shared the fact that 88% of their hospitalized patients have two or more co-morbid conditions. CDC data and experiences from other countries reflect similar findings.

Not surprisingly, when the Presidents new guidelines for Opening up America Again'' were announced, I noticed that if the guidelines were followed 60% of our fellow citizens wouldnt be going anywhere for quite a while. Through the first two phases, shelter in place remains the rule for the vulnerable population who have co-morbid conditions. Many would advise restricting this groups activity until we have a vaccine.

Its feared that highlighting this reality would embarrass people who are already struggling. But after helping people address their chronic conditions for my entire career, Im confident that this empowering wake-up call would be heeded by many Americans who feel their lives and livelihood are no longer under their control. More important, influencing these risk factors through lifestyle changes would accrue benefits far beyond this pandemic.

So how do we make it easy for people to do the right thing? We start with knowledge.If the body is fighting internal battles to protect its health against poor lifestyle choices, our immune-system defenses are distracted from external threats like the Covid-19 virus. Chronic ailments also damage the thin lining of our arteries, which causes scarring and plaques to build up. Viral infections may increase blood clotting, cause an overreaction by the immune system (so-called cytokine storm), and plaque rupture leading to heart attacks.

But we can reverse these risks, starting with simple steps to move us from being Vulnerable to Vital as we engage in life.

High blood pressureabove 140/90is reported by many doctors to be both the biggest driver of aging and the most common risk factor among those hospitalized by Covid-19. Walking is an ideal first step for people to take as the country is reopening, but vulnerable populations should socially distance. For them something to remember is high-intensity interval training (HIIT), which can help reducethe stiffness of artery walls, leading to alowerrestingblood pressure. HIIT allows us to exercise at our max for short periods and at lower intensity in between.Try doing intense squats, jumping jacks or planks for one minute and then rest for another minute. Gently build up to 4 minutes of activity followed by 3 minutes off until you reach 20 minutes total. Or even better, visit IHRSA.org and enter your zip code to find a gym near you that can safely kickstart you with some home online programs.

Losing inches off your waistline will also reduce blood pressure and prevent fat cells from creating inflammation, which inhibits the bodys ability to fight infections and even lowers the effectiveness of some vaccines. Roughly half of hospitalized young patients are obese because of inflammation, which starts in belly fat. This is why the tape measure is the best tool in determining if we are inflamed. Forget Quarantine Fifteen (the catch phrase for weight gain during the Covid-19 lockdown) on the scale; instead, get out a tape measure: Mens waists should be less than 37 inches, womens less than 35 inches.

To shave off a few inches, start by cutting back on simple sugars and lean into ancient whole grains like quinoa or farro. Immune-supporting herbs and spices upgrade the diet while reducing salt, so start addingginger,garlicand turmeric into meals. Snacks like nuts and hummus help quench our cravings. Desserts are metabolic suicide and should go the way of the handshake during Covid-19.If you still want to mindlessly eat calories to feed your feelings, opt for high-volume foods with little calories to lessen the damage. My favorites are air-popped popcorn, watermelon, frozen grapesand, of course, kale.

Pre-diabetes afflicts a third of the U.S.population, though many people are unaware they fit the category. It is addressed by the weight-loss tips offered above. If you want a comprehensive jumpstart, my television show, The Dr. Oz Show, has developed and tested a very popular System 20 plan designed for 2020 that will help you lose 20 pounds (if you need to lose weight) while cutting down the risks of chronic illness by up to 20%. Intermittent fasting is critical to its success, so we ask that you delay breakfast until late morning and eat dinner in early evening so your body can recover from having to digest food all night long.The program is free. Print out the one-sheet for your fridge, so you can start cutting back on processed foods.

Finally, lung disease hinders our ability to power through pneumonia, which often accompanies Covid-19 in hospitalized patients. Vaping and smoking damage the lungs defense mechanisms, so let me share the advice that I offer my heart-surgery patients: At least for the several weeks around your procedure, help me to help you by stopping smoking/vaping. Covid-19 is as dangerous as heart surgery for some people, so please accept the same advice. Hopefully, once you break the habit, youll never go back to inhaling again.

Even a few weeks of having a healthy lifestyle should yield measurable improvements, but youll feel better almost immediately. And instead of passively watching the world spin wildly around you, youll be able to can take charge of your most precious assetyour bodyand say goodbye to your sheltering-in-place days.

Mehmet Oz, M.D., Attending Physician, New York Presbyterian/Columbia, host of The Dr. Oz Show

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Dr. Oz: A Message To The Vulnerable - Forbes

Kokum connection – The New Indian Express

Posted: June 15, 2020 at 11:44 am

By Express News Service

Garcinia cambogia is an exotic fruit grown in South India and has been used by our ancestors for ages. It has particularly been used in Indian cooking for the sour notes that it imparts. For those who may not know, garcinia cambogia is nothing but our very own kokum, better known as the Malabari tamarind.

It has many healing properties and nutrients. Additionally, in summers its one of the most easily available superfoods that aids in cooling the body.

It is also rich in hydroxycitric acid or HCA that helps in fat-burning, boosts metabolism, acts as an appetite suppressant, and aids in weight loss.

The HCA in the fruit inhibits the enzyme, citrate lyase, from converting carbohydrates into fat. This process forces the body to burn carbohydrates.

One could say that its an elixir of weight loss. Also, the Alpha Lipoic acid that is found in kokum is an effective antioxidant. The acid binds with toxic metals in the blood and removes them from the body.

Kokum extract or supplements are best taken before meals because it works upon the nutrients that we ingest. But remember, the concentration of the supplement should not exceed 2,000 mg. To see results, one would need to take kokum for about three months.

However, side effects, if taken without consulting a doctor or used for extended periods, could include nausea, discomfort in the digestive tract andheadaches.Safe for those above the age of 18, pure garcinia extract/supplement can be used in its concentrated form.

While the plant and its fruit have been eaten safely for years, breastfeeding mothers or pregnant women should avoid HCA supplements. Additionally, diabetics, who take insulin or glyburide, should talk to their doctors/nutritionists before taking an HCA supplement, as it could cause a sudden drop in blood sugar.It can also interfere with blood thinners, psychiatric medicines, pain medicines, and statins, which are drugs used to lower cholesterol. It is always best to consult a health care provider before taking any supplement.

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Kokum connection - The New Indian Express

Weight loss: Expert shares effective ways to burn belly fat fast – Express

Posted: June 15, 2020 at 11:42 am

Weight loss can often be associated with intense diets that not only restrict what you can eat but also restrict key nutrients and vitamins from entering the body. Belly fat is one of the hardest places on the body to lose fat but an expert in the field has revealed his top tips on how to lose belly fat following simple easy steps. With the UK still in lockdown, here are some easy steps you can follow from the comfort of your own home in order to lose weight.

Belly fat, also known as visceral fat is often one of the places that people find hard to lose weight because that area contains a large number of fat cells.

Fat around the stomach occurs when the body is consuming more energy than the body is using and therefore it gets stored as fat.

The high amount of fat cells around the belly area dont respond as easily as other cells do to a process known as lipolysis, the fat breakdown process.

David Weiner, Training Specialist at Freeletics told theExpress.co.ukthat the two most effective ways to get rid of this type of fat are diet and exercise.

READ MORE:Weight loss diet plan: 5:2 intermittent fasting diet helps you lose weight fast

While this may not be new information, he has revealed what you should be eating to help this area burn fat.

He said: The basic principle of losing visceral fat is to consume fewer calories than your body needs and eating a diet rich in healthy and wholesome foods, like fresh fruit, fresh vegetables, wholegrain and lean protein, and eliminate processed, high sugar and high fat foods from your diet.

If you consume high fat unhealthy foods then you will most likely be eating more calories than you are burning, resulting in you losing no weight at all.

David continued: Use low-fat cooking methods, such as broiling, boiling, or baking, instead of frying.

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When using oils, reach for the healthier options such as olive oil, instead of butter or peanut oil.

Olive oil is considered to be one of the healthiest fats in the world. It is rich in a substance called oleic acid, which has a powerful anti-inflammatory effect and health benefits go further than just weight loss.

The healthy oil has been linked to weight loss as well as lowering blood pressure and reducing the risk of heart disease. It may be high in calories but a small splash should go a long way.

The expert said: Reducing your intake of carbohydrates could also help as research indicates that excess carbohydrate consumption can cause high levels of visceral fat.

Consuming carbohydrates causes blood sugars to rise, which then will cause insulin levels to rise. This then results in glucose to go into fat cells, which will ultimately turn into fat.

Slimmers who wish to reduce their carbohydrate intake may opt for following a Keto or Atkins diet.

A reduction in carbs puts your body into a metabolic state known as ketosis. When the body does not have enough glucose for energy, it burns stored fats instead.

The ketosis state also makes your body very efficient when it comes to burning belly fat.

However dieting isnt for everyone and there are other methods you can do in order lose belly fat and one of them is undertaking exercise as part of your regular routine.

It is a well known fact that anyone wanting to lose weight must be in a calorie deficit in order to do so. This means burning off more calories than your body is consuming. Therefore exercise is a fundamental aspect of any weight loss journey.

David continued: Physical activity and exercise are also an effective way to reduce levels of visceral fat. Aerobic activity which stimulates the heart and breathing rate, causing it to increase is one of the best ways to burn belly fat.

Exercises including swimming, walking, running or cycling are the best form of exercise to help burn belly fat.

The expert said: High Intensity Interval Training (HIIT) can also increase your bodys ability to burn fat and elevate your bodys fat burning potential throughout the day. HIIT exercise refers to workouts which include short bursts of intensive activity followed by periods of lower intensity exercise which really push your body and maximise its calorie and fat burning potential.

Experts recommend around one hour of exercise per day and this must be a mixture of cardio as well as strength training.

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Weight loss: Expert shares effective ways to burn belly fat fast - Express


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