Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight. But what do we actually know about them? This month, The Conversation’s experts explore their rise, impact and potential consequences.

You’ve no doubt heard of Ozempic but have you heard of Wegovy? They’re both brand names of the drug semaglutide, which is currently in short supply worldwide.

Ozempic is a lower dose of semaglutide, and is approved and used to treat diabetes in Australia. Wegovovy is approved to treat obesity but is not yet available in Australia. Shortages of both drugs are expected to last throughout 2024.

Both drugs are expensive. But Ozempic is listed on Australia’s Pharmaceutical Benefits Schedule (PBS), so people with diabetes can get a three-week supply for A$31.60 ($7.70 for concession card holders) rather than the full price ($133.80).

Wegovy isn’t listed on the PBS to treat obesity, meaning when it becomes available, users will need to pay the full price. But should the government subsidise it?

Wegovy’s manufacturer will need to make the case for it to be added to the PBS to an independent advisory committee. The company will need to show Wegovy is a safe, clinically effective and cost-effective treatment for obesity compared to existing alternatives.

In the meantime, we asked five experts: when supplies resume, should governments subsidise drugs like Ozempic for weight loss?

Four out of five said yes

This is the last article in The Conversation’s Ozempic series. Read the other articles here.

Disclosure statements: Clare Collins is a National Health and Medical Research Council (NHMRC) Leadership Fellow and has received research grants from the National Health and Medical Research Council (NHMRC), the Australian Research Council (ARC), the Medical Research Future Fund (MRFF), the Hunter Medical Research Institute, Diabetes Australia, Heart Foundation, Bill and Melinda Gates Foundation, nib foundation, Rijk Zwaan Australia, the Western Australian Department of Health, Meat and Livestock Australia, and Greater Charitable Foundation. She has consulted to SHINE Australia, Novo Nordisk (for weight management resources and an obesity advisory group), Quality Bakers, the Sax Institute, Dietitians Australia and the ABC. She was a team member conducting systematic reviews to inform the 2013 Australian Dietary Guidelines update, the Heart Foundation evidence reviews on meat and dietary patterns and current co-chair of the Guidelines Development Advisory Committee for Clinical Practice Guidelines for Treatment of Obesity; Emma Beckett has received funding for research or consulting from Mars Foods, Nutrition Research Australia, NHMRC, ARC, AMP Foundation, Kellogg and the University of Newcastle. She works for FOODiQ Global and is a fat woman. She is/has been a member of committees/working groups related to nutrition or food, including for the Australian Academy of Science, the NHMRC and the Nutrition Society of Australia; Jonathan Karnon does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment; Nial Wheate in the past has received funding from the ACT Cancer Council, Tenovus Scotland, Medical Research Scotland, Scottish Crucible, and the Scottish Universities Life Sciences Alliance. He is a fellow of the Royal Australian Chemical Institute, a member of the Australasian Pharmaceutical Science Association and a member of the Australian Institute of Company Directors. Nial is the chief scientific officer of Vaihea Skincare LLC, a director of SetDose Pty Ltd (a medical device company) and a Standards Australia panel member for sunscreen agents. Nial regularly consults to industry on issues to do with medicine risk assessments, manufacturing, design and testing; Priya Sumithran has received grant funding from external organisations, including the NHMRC and MRFF. She is in the leadership group of the Obesity Collective and co-authored manuscripts with a medical writer provided by Novo Nordisk and Eli Lilly.

Fron Jackson-Webb, Deputy Editor and Senior Health Editor, The Conversation

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Rice is a culinary staple in Australia and around the world.

It might seem like a given that brown rice is healthier than white and official public health resources often recommend brown rice instead of white as a “healthy swap”.

But Australians definitely prefer white rice over brown. So, what’s the difference, and what do we need to know when choosing rice?

What makes rice white or brown?

Rice “grains” are technically seeds. A complete, whole rice seed is called a “paddy”, which has multiple parts:

1. the “hull” is the hard outer layer which protects the seed
2. the “bran”, which is a softer protective layer containing the seed coat
3. the “germ” or the embryo, which is the part of the seed that would develop into a new plant if was germinated
4. the “endosperm”, which makes up most of the seed and is essentially the store of nutrients that feeds the developing plant as a seed grows into a plant.

Rice needs to be processed for humans to eat it.

Along with cleaning and drying, the hard hulls are removed since we can’t digest them. This is how brown rice is made, with the other three parts of the rice remaining intact. This means brown rice is regarded as a “wholegrain”.

White rice, however, is a “refined” grain, as it is further polished to remove the bran and germ, leaving just the endosperm. This is a mechanical and not a chemical process.

What’s the difference, nutritionally?

Keeping the bran and the germ means brown rice has more magnesium, phosphorus, potassium B vitamins (niacin, folate, riboflavin and pyridoxine), iron, zinc and fibre.

The germ and the bran also contain more bioactives (compounds in foods that aren’t essential nutrients but have health benefits), like oryzanols and phenolic compounds which have antioxidant effects.

But that doesn’t mean white rice is just empty calories. It still contains vitamins, minerals and some fibre, and is low in fat and salt, and is naturally gluten-free.

White and brown rice actually have similar amounts of calories (or kilojoules) and total carbohydrates.

There are studies that show eating more white rice is linked to a higher risk of type 2 diabetes. But it is difficult to know if this is down to the rice itself, or other related factors such as socioeconomic variables or other dietary patterns.

What about the glycaemic index?

The higher fibre means brown rice has a lower glycaemic index (GI), meaning it raises blood sugar levels more slowly. But this is highly variable between different rices within the white and brown categories.

The GI system uses low (less than 55), medium (55–70) and high (above 70) categories. Brown rices fall into the low and medium categories. White rices fall in the medium and high.

There are specific low-GI types available for both white and brown types. You can also lower the GI of rice by heating and then cooling it. This process converts some of the “available carbohydrates” into “resistant starch”, which then functions like dietary fibre.

Are there any benefits to white rice?

The taste and textural qualities of white and brown rices differ. White rice tends to have a softer texture and more mild or neutral flavour. Brown rice has a chewier texture and nuttier flavour.

So, while you can technically substitute brown rice into most recipes, the experience will be different. Or other ingredients may need to be added or changed to create the desired texture.

Removing more of the outer layers may also reduce the levels of contaminants such as pesticides.

We don’t just eat rice

Comparing white and brown rice seems like an easy way to boost nutritional value. But just because one food (brown rice) is more nutrient-dense doesn’t make the other food (white rice) “bad”.

Ultimately, it’s not often that we eat just rice, so we don’t need the rice we choose to be the perfect one. Rice is typically the staple base of a more complex dish. So, it’s probably more important to think about what we eat with rice.

Adding vegetables and lean proteins to rice-based dishes can easily add the micronutrients, bioactives and fibre that white rice is comparatively lacking, and this can likely do more to contribute to diet quality than eating brown rice instead.

Emma Beckett, Adjunct Senior Lecturer, Nutrition, Dietetics & Food Innovation – School of Health Sciences, UNSW Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.