10 Mistakes To Sabotage Your Ozempic Progress
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Ozempic has a good reputation for getting reliable results, but there are ways to mess it up:
It’s not just inject-and-go
We’ll not keep the 10 ways a secret; they are:
- Increasing the dose too quickly: avoid cranking doses up too high too quickly, to prevent severe nausea, appetite suppression, and muscle loss. It’s worth being aware that high doses without proper management can lead to metabolic health disasters.
- Pushing through side effects: severe nausea or vomiting means you probably have an unhelpfully high dose; consult your prescribing doctor—it’s easy to feel “more is better; I don’t want to have less!”, but there really is a sweet spot, and if you’re not in it, then adjustments are needed in order to find it.
- Eating nutritionally scant food: reducing the quantity of unhealthy food isn’t enough—please prioritize nutrient-rich foods instead. Remember, “it’s not the calories in your food; it’s the food in your calories”.
- Consuming fried food and refined carbs: their general metabolic woes aside, fried foods and ultra-refined carbs can exacerbate nausea and other side effects, so it really is best to skip them. The good news is that Ozempic will help overcome those cravings more easily.
- Neglecting muscle protection: especially women, especially middle-aged or older, are at higher risk of osteoporosis and should maintain muscle mass (strong muscles and strong bones go together, by necessity). So, eat protein and do resistance training!
- Assuming it’s a monotherapy: GLP-1 drugs work best as part of a holistic protocol, including proper nutrition, strength training, and hormone therapy if appropriate.
- Not addressing metabolic health first: GLP-1 drugs are less effective in people with poor baseline metabolic health, so there’s a bit of a catch-22 here, but it’s important to be aware of. Fortunately, Ozempic and adopting a healthy lifestyle will each make the other work better.
- Neglecting comprehensive treatment plans: in other words, going through the motions of a holistic protocol and then expecting Ozempic to do all the work.
- Upping doses to overcome plateaus: plateaus often signal other issues (e.g. lack of protein, no strength training), so do address these before increasing dosage.
- Lack of collaboration with doctors: the human body is complex, and what’s going on metabolically is complex too, so there’s a lot a layperson can easily miss. For that matter, there’s a lot that doctors can easily miss too, but more heads are better than one.
For more on all of these, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
5 Ways To Naturally Boost The Ozempic Effect
Take care!
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Low-Dose Aspirin & Anemia
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We recently wrote about…
How To Survive A Heart Attack When You’re Alone
…and one of the items was “if you have aspirin readily available, then after calling an ambulance is the time to take it—but don’t exert yourself trying to find some”.
But what of aspirin as a preventative?
Many people take low-dose aspirin daily as a way to reduce the risk of atherothrombosis specifically (and thus, indirectly, they hope to reduce the risk of heart attacks).
The science of how helpful this is both clear and complicated—that is to say, the stats are not ambiguous*, but there are complicating factors of which many people are unaware.
*it will reduce the overall risk of cardiovascular events, but will not affect CVD mortality; in other words, it may improve your recovery from minor cardiac events, but is not likely to save you from major ones.
And also, it has unwanted side effects that can constitute a more relevant threat for many people. We’ll share more on that at the end of today’s article, but first…
A newly identified threat from daily aspirin use
A large (n=313,508) study of older adults (median age 73) were sorted into those who used low-dose aspirin as a preventative, and those who did not.
The primary outcome was incidence of anemia sufficient to require treatment, and the secondary outcome was major bleeding. And, at least 1 in 5 of those who experienced anemia also experienced bleeding.
The bleeding issue was not “newly identified” and will not surprise many people; after all, the very reason that aspirin is taken as a CVD preventative is for its anti-clotting property of allowing blood to flow more freely.
The anemia, however, has been getting increasing scientific scrutiny lately, after long going unnoticed in the wild. Given that anemia also gives the symptom “dizziness”, this is also a significant threat for increasing the incidence of falls in the older population, too, which can of course lead to serious complications and ultimately death.
Here’s the paper itself:
Want to know more?
As promised, here’s what we wrote previously about some of aspirin’s other risks:
Aspirin, CVD Risk, & Potential Counter-Risks
Take care!
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Blood and Water
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Q&A with the 10almonds Team
Q: I really loved the information about macular degeneration! I was wondering if you have any other advice about looking after eye health?
A: We may well do a full feature on it sometime! Meanwhile, some top tips include:
- Eat your greens (as you know from this last Tuesday’s edition of 10almonds)!
- Exercise! Generally. We’re not talking about eye exercises here, we’re talking about exercises that will support:
- Healthy heart rate
- Healthy blood pressure
- Healthy blood oxygenation
- Healthy blood sugar levels
- Healthy blood flow in general (so keep hydrated too! There’s a reason phlebotomists ask you to be well-hydrated before they take blood)
Eye health is a good indicator for a lot of other things, and that’s because whether or not the eyes are the window to your soul, they’re definitely the window to what your blood’s like, and that affects (and is affected by) so many other things.
- On that note, don’t smoke!
- Protect your eyes physically, too. This means:
- UV-blocking sunglasses when appropriate
- Protective eye-wear when appropriate
You think safety glasses are for laboratories and construction sites, then you go and do comparable tasks in your home? Your eyes are just as damageable in your kitchen or garden as they would be in a lab or workshop.
Some bits and bobs that can help:
- Safety sunglasses! Because a thing can do two jobs (useful in the garden now the days are brightening up!)
- Pulse oximeter! Check your own heart rate, pulse strength, and blood oxygenation at home!
- Blood pressure monitor! Because it’s so important for a lot of things and you really should have one.
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Intermittent Fasting In Women
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It’s Q&A Day at 10almonds!
Have a question or a request? We love to hear from you!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝Does intermittent fasting differ for women, and if so, how?❞
For the sake of layout, we’ve put a shortened version of this question here, but the actual wording was as below, and merits sharing in full for context
Went down a rabbit hole on your site and now can’t remember how I got to the “Fasting Without Crashing” article on intermittent fasting so responding to this email lol, but was curious what you find/know about fasting for women specifically? It’s tough for me to sift through and find legitimate studies done on the results of fasting in women, knowing that our bodies are significantly different from men. This came up when discussing with my sister about how I’ve been enjoying fasting 1-2 days/week. She said she wanted more reliable sources of info that that’s good, since she’s read more about how temporary starvation can lead to long-term weight gain due to our bodies feeling the need to store fat. I’ve also read about that, but also that fasting enables more focused autophagy in our bodies, which helps with long-term staving off of diseases/ailments. Curious to know what you all think!
~ 10almonds subscriber
So, first of all, great question! Thanks for asking it
Next up, isn’t it strange? Books come in the format:
- [title]
- [title, for women]
You would not think women are a little over half of the world’s population!
Anyway, there has been some research done on the difference of intermittent fasting in women, but not much.
For example, here’s a study that looked at 1–2 days/week IF, in other words, exactly what you’ve been doing. And, they did have an equal number of men and women in the study… And then didn’t write down whether this made a difference or not! They recorded a lot of data, but neglected to note down who got what per sex:
Here’s a more helpful study, that looked at just women, and concluded:
❝In conclusion, intermittent fasting could be a nutritional strategy to decrease fat mass and increase jumping performance.
However, longer duration programs would be necessary to determine whether other parameters of muscle performance could be positively affected by IF. ❞
~ Dr. Martínez-Rodríguez et al.
Those were “active women”; another study looked at just women who were overweight or obese (we realize that “active women” and “obese or overweight women” is a Venn diagram with some overlap, but still, the different focus is interesting), and concluded:
❝IER is as effective as CER with regard to weight loss, insulin sensitivity and other health biomarkers, and may be offered as an alternative equivalent to CER for weight loss and reducing disease risk.❞
As for your sister’s specific concern about yo-yoing, we couldn’t find studies for this yet, but anecdotally and based on books on Intermittent Fasting, this is not usually an issue people find with IF. This is assumed to be for exactly the reason you mention, the increased cellular apoptosis and autophagy—increasing cellular turnover is very much the opposite of storing fat!
You might, by the way, like Dr. Mindy Pelz’s “Fast Like A Girl”, which we reviewed previously
Take care!
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What Are The “Bright Lines” Of Bright Line Eating?
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This is Dr. Susan Thompson. She’s a cognitive neuroscientist who has turned her hand to helping people to lose weight and maintain it at a lower level, using psychology to combat overeating. She is the founder of “Bright Line Eating”.
We’ll say up front: it’s not without some controversy, and we’ll address that as we go, but we do believe the ideas are worth examining, and then we can apply them or not as befits our personal lives.
What does she want us to know?
Bright Line Eating’s general goal
Dr. Thompson’s mission statement is to help people be “happy, thin, and free”.
You will note that this presupposes thinness as desirable, and presumes it to be healthy, which frankly, it’s not for everyone. Indeed, for people over a certain age, having a BMI that’s slightly into the “overweight” category is a protective factor against mortality (which is partly a flaw of the BMI system, but is an interesting observation nonetheless):
When BMI Doesn’t Quite Measure Up
Nevertheless, Dr. Thompson makes the case for the three items (happy, thin, free) coming together, which means that any miserable or unhealthy thinness is not what the approach is valuing, since it is important for “thin” to be bookended by “happy” and “free”.
What are these “bright lines”?
Bright Line Eating comes with 4 rules:
- No flour (no, not even wholegrain flour; enjoy whole grains themselves yes, but flour, no)
- No sugar (and as a tag-along to this, no alcohol) (sugars naturally found in whole foods, e.g. the sugar in an apple if eating an apple, is ok, but other kinds are not, e.g. foods with apple juice concentrate as a sweetener; no “natural raw cane sugar” etc is not allowed either; despite the name, it certainly doesn’t grow on the plant like that)
- No snacking, just three meals per day(not even eating the ingredients while cooking—which also means no taste-testing while cooking)
- Weigh all your food (have fun in restaurants—but more seriously, the idea here is to plan each day’s 3 meals to deliver a healthy macronutrient balance and a capped calorie total).
You may be thinking: “that sounds dismal, and not at all bright and cheerful, and certainly not happy and free”
The name comes from the idea that these rules are lines that one does not cross. They are “bright” lines because they should be observed with a bright and cheery demeanour, for they are the rules that, Dr. Thompson says, will make you “happy, thin, and free”.
You will note that this is completely in opposition to the expert opinion we hosted last week:
What Flexible Dieting Really Means
Dr. Thompson’s position on “freedom” is that Bright Line Eating is “very structured and takes a liberating stand against moderation”
Which may sound a bit of an oxymoron—is she really saying that we are going to be made free from freedom?
But there is some logic to it, and it’s about the freedom from having to make many food-related decisions at times when we’re likely to make bad ones:
Where does the psychology come in?
Dr. Thompson’s position is that willpower is a finite, expendable resource, and therefore we should use it judiciously.
So, much like Steve Jobs famously wore the same clothes every day because he had enough decisions to make later in the day that he didn’t want unnecessary extra decisions to make… Bright Line Eating proposes that we make certain clear decisions up front about our eating, so then we don’t have to make so many decisions (and potentially the wrong decisions) later when hungry.
You may be wondering: ”doesn’t sticking to what we decided still require willpower?”
And… Potentially. But the key here is shutting down self-negotiation.
Without clear lines drawn in advance, one must decide, “shall I have this cake or not?”, perhaps reflecting on the pros and cons, the context of the situation, the kind of day we’re having, how hungry we are, what else there is available to eat, what else we have eaten already, etc etc.
In short, there are lots of opportunities to rationalize the decision to eat the cake.
With clear lines drawn in advance, one must decide, “shall I have this cake or not?” and the answer is “no”.
So while sticking to that pre-decided “no” still may require some willpower, it no longer comes with a slew of tempting opportunities to rationalize a “yes”.
Which means a much greater success rate, both in adherence and outcomes. Here’s an 8-week interventional study and 2-year follow-up:
Bright Line Eating | Research Publications
Counterpoint: pick your own “bright lines”
Dr. Thompson is very keen on her 4 rules that have worked for her and many people, but she recognizes that they may not be a perfect fit for everyone.
So, it is possible to pick and choose our own “bright lines”; it is after all a dietary approach, not a religion. Here’s her response to someone who adopted the first 3 rules, but not the 4th:
Bright Lines as Guidelines for Weight Loss
The most important thing for Bright Line Eating, therefore, is perhaps the action of making clear decisions in advance and sticking to them, rather than seat-of-the-pantsing our diet, and with it, our health.
Want to know more from Dr. Thompson?
You might like her book, which we reviewed a while ago:
Bright Line Eating – by Dr. Susan Peirce Thompson
Enjoy!
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Fix Your Upper Back With These Three Steps
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When it comes to back pain, the lower back gets a lot of attention, but what about when it’s nearer the neck and shoulders?
Reaching for better health
In this short video, Liv describes and shows three exercises:
Exercise 1: Thoracic Pullover (Dumbbell Pullover)
Purpose: Improves overhead reach and shoulder mobility.
Equipment: light weight, yoga block, or foam roller.
Steps:- Lie on the floor with the foam roller/block beneath the upper back.
- Hold the weight in both hands, arms extended upward.
- Inhale deeply and reach the weight toward the ceiling.
- Exhale and arc your spine over the block, moving the weight backward.
- Keep core tension to maintain a neutral lower back position.
- Perform 10 repetitions.
Exercise 2: Rotational Mobility Stretch
Purpose: enhances torso rotation, core strength, and hip mobility.
Equipment: none (or a mat)
Steps:- Lie on your side with knees stacked at 90° and arms extended in front.
- Hold a weight in the top hand.
- Inhale and lift the top arm toward the ceiling, extending the shoulder blade.
- Exhale and twist your torso, allowing the arm to move toward the floor.
- Modify by extending the bottom leg for a deeper twist if needed.
- Perform 6 reps per side, switching legs and repeating on the other side.
Exercise 3: Doorway/Pole Side Stretch
Purpose: targets multiple areas for a deep, satisfying stretch.
Equipment: door frame, pole, or wall.
Steps:- Stand at arm’s length from the wall or frame.
- Cross the outer leg (furthest from the wall) behind the inner leg.
- Place the closest hand on the wall and reach the other arm overhead.
- Grip the wall or frame with the top hand, pressing away with the bottom hand.
- Lean into a banana-shaped curve and rotate your chest upward for a deeper stretch.
- Hold for 20–30 seconds per side and repeat 2–3 times.
For more on all of these, plus visual demonstrations, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
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Track Your Blood Sugars For Better Personalized Health
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There Will Be Blood
Are you counting steps? Counting calories? Monitoring your sleep? Heart rate zones? These all have their merits:
- Steps: One More Resource Against Osteoporosis!
- Calories: Is Cutting Calories The Key To Healthy Long Life?
- Sleep: A Head-To-Head Of Google and Apple’s Top Apps For Getting Your Head Down
- Heart Rate Zones: Heart Rate Zones, Oxalates, & More
About calories: this writer (it’s me, hi) opines that intermittent fasting has the same benefits as caloric restriction, without the hassle of counting, and is therefore superior. I also personally find fasting psychologically more pleasant. However, our goal here is to be informative, not prescriptive, and some people may have reasons to prefer CR to IF!
Examples that come to mind include ease of adherence in the case of diabetes management, especially Type 1, or if one’s schedule (and/or one’s “medications that need to be taken with food” schedule) does not suit IF.
And now for the blood…
A rising trend in health enthusiasts presently is the use of Continuous Glucose Monitors (CGMs), which do exactly what is sounds like they do: they continually monitor glucose. Specifically, the amount of it in your blood.
Of course, these have been in use in diabetes management for years; the technology is not new, but the application of the technology is.
A good example of what benefits a non-diabetic person can gain from the use of a CGM is Jessie Inchauspé, the food scientist of “Glucose Revolution” and “The Glucose Goddess Method” fame.
By wearing a CGM, she was able to notice what things did and didn’t spike her blood sugars, and found that a lot of the things were not stuff that people knew/advised about!
For example, much of diabetes management (including avoiding diabetes in the first place) is based around paying attention to carbs and little else, but she found that it made a huge difference what she ate (or didn’t) with the carbs. By taking many notes over the course of her daily life, she was eventually able to isolate these patterns, showed her working-out in The Glucose Revolution (there’s a lot of science in that book), and distilled that information into bite-size (heh) advice such as:
10 Ways To Balance Blood Sugars
That’s great, but since people like Inchauspé have done the work, I don’t have to, right?
You indeed don’t have to! But you can still benefit from it. For example, fastidious as her work was, it’s a sample size of one. If you’re not a slim white 32-year-old French woman, there may be some factors that are different for you.
All this to say: glucose responses, much like nutrition in general, are not a one-size-fits-all affair.
With a CGM, you can start building up your own picture of what your responses to various foods are like, rather than merely what they “should” be like.
This, by the way, is also one of the main aims of personalized health company ZOE, which crowdsourced a lot of scientific data about personalized metabolic responses to standardized meals:
Not knowing these things can be dangerous
We don’t like to scaremonger here, but we do like to point out potential dangers, and in this case, blindly following standardized diet advice, if your physiology is not standard, can have harmful effects, see for example:
Diabetic-level glucose spikes seen in non-diabetic people
Where can I get a CGM?
We don’t sell them, and neither does Amazon, but you can check out some options here:
The 4 Best CGM Devices For Measuring Blood Sugar in 2024
…and if your doctor is not obliging with a prescription, note that the device that came out top in the above comparisons, will be available OTC soon:
The First OTC Continuous Glucose Monitor Will Be Available Summer 2024
Take care!
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