A drug that can extend your life by 25%? Don’t hold your breath
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Every few weeks or months, the media reports on a new study that tantalisingly dangles the possibility of a new drug to give us longer, healthier lives.
The latest study centres around a drug involved in targeting interleukin-11, a protein involved in inflammation. Blocking this protein appeared to help mice stave off disease and extend their life by more than 20%.
If only defying the ravages of time could be achieved through such a simple and effort-free way – by taking a pill. But as is so often the case, the real-world significance of these findings falls a fair way short of the hype.
The role of inflammation in disease and ageing
Chronic inflammation in the body plays a role in causing disease and accelerating ageing. In fact, a relatively new label has been coined to represent this: “inflammaging”.
While acute inflammation is an important response to infection or injury, if inflammation persists in the body, it can be very damaging.
A number of lifestyle, environmental and societal drivers contribute to chronic inflammation in the modern world. These are largely the factors we already know are associated with disease and ageing, including poor diet, lack of exercise, obesity, stress, lack of sleep, lack of social connection and pollution.
While addressing these issues directly is one of the keys to addressing chronic inflammation, disease and ageing, there are a number of research groups also exploring how to treat chronic inflammation with pharmaceuticals. Their goal is to target and modify the molecular and chemical pathways involved in the inflammatory process itself.
What the latest research shows
This new interleukin-11 research was conducted in mice and involved a number of separate components.
In one component of this research, interleukin-11 was genetically knocked out in mice. This means the gene for this chemical mediator was removed from these mice, resulting in the mice no longer being able to produce this mediator at all.
In this part of the study, the mice’s lives were extended by over 20%, on average.
Another component of this research involved treating older mice with a drug that blocks interleukin-11.
Injecting this drug into 75-week old mice (equivalent to 55-year-old humans) was found to extend the life of mice by 22-25%.
These treated mice were less likely to get cancer and had lower cholesterol levels, lower body weight and improved muscle strength and metabolism.
From these combined results, the authors concluded, quite reasonably, that blocking interleukin-11 may potentially be a key to mitigating age-related health effects and improving lifespan in both mice and humans.
Why you shouldn’t be getting excited just yet
There are several reasons to be cautious of these findings.
First and most importantly, this was a study in mice. It may be stating the obvious, but mice are very different to humans. As such, this finding in a mouse model is a long way down the evidence hierarchy in terms of its weight.
Research shows only about 5% of promising findings in animals carry over to humans. Put another way, approximately 95% of promising findings in animals may not be translated to specific therapies for humans.
Second, this is only one study. Ideally, we would be looking to have these findings confirmed by other researchers before even considering moving on to the next stage in the knowledge discovery process and examining whether these findings may be true for humans.
We generally require a larger body of evidence before we get too excited about any new research findings and even consider the possibility of human trials.
Third, even if everything remains positive and follow-up studies support the findings of this current study, it can take decades for a new finding like this to be translated to successful therapies in humans.
Until then, we can focus on doing the things we already know make a huge difference to health and longevity: eating well, exercising, maintaining a healthy weight, reducing stress and nurturing social relationships.
Hassan Vally, Associate Professor, Epidemiology, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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The Comfort Book – by Matt Haig
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This book “is what it says on the tin”. Matt Haig, bestselling author of “Reasons to Stay Alive” (amongst other works) is here with “a hug in a book”.
The format of the book is an “open it at any page and you’ll find something of value” book. Its small chapters are sometimes a few pages long, but often just a page. Sometimes just a line. Always deep.
All of us, who live long enough, will ponder our mortality sometimes. The feelings we may have might vary on a range from “afraid of dying” to “despairing of living”… but Haig’s single biggest message is that life is full of wonder; each moment precious.
- That hope is an incredible (and renewable!) resource.
- That we are more than a bad week, or month, or year, or decade.
- That when things are taken from us, the things that remain have more value.
Bottom line: you might cry (this reviewer did!), but it’ll make your life the richer for it, and remind you—if ever you need it—the value of your amazing life.
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Dark Calories – by Dr. Catherine Shanahan
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You may be wondering: do we really need a 416-page book to say “don’t use vegetable oils”?
The author, who was a biochemist before becoming a family physician, takes a lot of care to explain in ways the non-chemists amongst us can understand (with molecular diagrams very well-labelled), exactly why certain seed/vegetable oils (both of those names being imprecise and unhelpful as umbrella terms) cause metabolic problems for us, when in contrast olive oil, avocado oil, and even peanut oil, do not.
Understanding is, for many, the root foundation of compliance. We are more likely to abide by rules we understand the logic behind, than seemingly arbitrary “thou shalt not…” proclamations.
So that’s an important strength of the book, demystifying various fats and how our body responds to them on a biochemical level, not just “is associated with such-and-such, based on observational population studies”. This kind of explanation clears up why, for example, seed oils correlate with obesity more than calories, sugar, wheat, or beef—having as it does to do with affecting our body’s ability to generate and use energy.
She also offers practical tips/reminders throughout, such as how “organic” does not necessarily mean “healthy” (indeed, many poisonous plants can be grown “organically”), and nor does “organic” mean “unrefined”, it speaks only for the conditions in which the raw product was first made, before other things were done to it later.
We learn a lot, too, about the processes of oxidation, the biochemistry behind that (more diagrams!), and of course the inflammatory response to same (an important factor in most if not all chronic disease).
The style is mostly very easy-to-read pop-science, though if you’re not a chemist, you’ll probably need to slow down for the biochemistry explanations (this reviewer certainly did).
Bottom line: this is more than just a litany against vegetable oils; it’s a ground-upwards education in metabolic biochemistry for the layperson, and what that means for us in terms of chronic disease risks.
Click here to check out Dark Calories, and learn what’s going on with these oils!
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The Metabolism Reset Diet – by Alan Christianson
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The liver is an incredible organ that does a very important job, but what’s not generally talked about is how we can help it… Beyond the obvious “try to not poison it too much with alcohol, tobacco, etc”. But what can we do that’s actually positive for it?
That’s what Alan Christianson offers in this book.
Now, usually when someone speaks of a “four week cleanse” as this book advertises on its front cover, it’s a lot of bunk. The liver cleanses itself, and the liver and kidneys between them (along with some other organs and processes) detoxify your body for you. No amount of celery juice will do that. However, this book does better than that:
What it’s about, is not really about trying to do a “detox” at all, so much as supporting your liver function by:
- Giving your liver what it needs to regenerate (mostly: protein)
- Not over-taxing your liver while it does so
The liver is a self-regenerating organ (the mythological story of Prometheus aside, here in real life it can regenerate up to 80% of itself, given the opportunity), so whatever the current state of your liver, it’s probably not too late to fix it.
Maybe you’ve been drinking a little too much, or maybe you’ve been taking some meds that have hobbled it a bit (some medications strain the liver rather), or maybe your diet hasn’t been great. Christianson invites you to draw a line under that, and move forwards:
The book gives an overview of the science involved, and explains about the liver’s role in metabolism (hence the promised weight loss benefits) and our dietary habits’ impact on liver function. This is about what we eat, and also about when we eat it, and how and when our body metabolizes that.
Christianson also provides meal ideas and recipes. If we’re honest (and we always are), the science/principles part of the book are worth a lot more than the meal-plan part of the book, though.
In short: a great book for understanding how the liver works and how we can help it do its job effectively.
Click here to check out “The Metabolism Reset Diet” on Amazon today!
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Exercise and Fat Loss (5 Things You Need To Know)
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It’s easy to think “I’ll eat whatever; I can always burn it off later”, and if it’s an odd occasion, then that’s fine; indeed, a fit and healthy body can usually weather small infrequent dietary indiscretions easily. But…
You can’t outrun a bad diet
Exercise can create a calorie deficit, but over time, the body balances this out by adjusting one’s metabolism, leading to a plateau in fat loss—and as you might know, you can’t out-exercise a bad diet. On the contrary, dietary adjustments are crucial for fat loss and body recomposition.
About that calorie deficit in the first place, by the way: extreme calorie deficits through exercise alone can lead to muscle loss, reduced energy, and thus sabotage long-term fat loss because having muscle mass increases one’s base metabolic rate (while having fat does not).
Another thing to bear in mind about exercise is that longer workouts without adequate rests in between can cause burnout, injury, or weight gain due to the body doing its best to conserve energy.
So, a good diet is a necessary condition for both muscle maintenance and fat loss.
Five Key Diet Tips:
- Include foods you love: don’t feel obliged cut out favorite foods that are a little unhealthy; incorporate them in moderation for sustainability.
- Keep adjustments small: avoid making drastic dietary changes all at once; make gradual tweaks to prevent feeling deprived.
- Prioritize protein: focus on including a protein source in every meal to increase satiety and aid in muscle building.
- Avoid low-calorie diets: drastically cutting calories can lead to muscle loss, metabolic adaptation, and overeating.
- Embrace diet evolution: changes may not feel sustainable at first, but adjustments over time help achieve long-term balance. You can always “adjust course” as you go.
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
Are You A Calorie-Burning Machine?
Take care!
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No, taking drugs like Ozempic isn’t ‘cheating’ at weight loss or the ‘easy way out’
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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.
Obesity medication that is effective has been a long time coming. Enter semaglutide (sold as Ozempic and Wegovy), which is helping people improve weight-related health, including lowering the risk of a having a heart attack or stroke, while also silencing “food noise”.
As demand for semaglutide increases, so are claims that taking it is “cheating” at weight loss or the “easy way out”.
We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.
Nor should we shame people taking semaglutide. It’s a drug used to treat diabetes and obesity which needs to be taken long term and comes with risks and side effects, as well as benefits. When prescribed for obesity, it’s given alongside advice about diet and exercise.
How does it work?
Semaglutide is a glucagon-like peptide-1 receptor agonist (GLP-1RA). This means it makes your body’s own glucagon-like peptide-1 hormone, called GLP-1 for short, work better.
GLP-1 gets secreted by cells in your gut when it detects increased nutrient levels after eating. This stimulates insulin production, which lowers blood sugars.
GLP-1 also slows gastric emptying, which makes you feel full, and reduces hunger and feelings of reward after eating.
GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.
Some studies have found less GLP-1 gets released after meals in adults with obesity or type 2 diabetes mellitus compared to adults with normal glucose tolerance. So having less GLP-1 circulating in your blood means you don’t feel as full after eating and get hungry again sooner compared to people who produce more.
GLP-1 has a very short half-life of about two minutes. So GLP-1RA medications were designed to have a very long half-life of about seven days. That’s why semaglutide is given as a weekly injection.
What can users expect? What does the research say?
Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).
A large group of randomised controlled trials, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.
Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections led to 6–12% greater weight loss compared to placebo or alternative interventions. The average weight change depended on how long medication treatment lasted and length of follow-up.
Higher doses of semaglutide are prescribed for obesity than for type 2 diabetes. fcm82/Shutterstock Weight reduction due to semaglutide also leads to a reduction in systolic and diastolic blood pressure of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in triglyceride levels (a type of blood fat) and improved physical function.
Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a 20% lower risk of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.
Who is eligible for semaglutide?
Australia’s regulator, the Therapeutic Goods Administration (TGA), has approved semaglutide, sold as Ozempic, for treating type 2 diabetes.
However, due to shortages, the TGA had advised doctors not to start new Ozempic prescriptions for “off-label use” such as obesity treatment and the Pharmaceutical Benefits Scheme doesn’t currently subsidise off-label use.
The TGA has approved Wegovy to treat obesity but it’s not currently available in Australia.
When it’s available, doctors will be able to prescribe semaglutide to treat obesity in conjunction with lifestyle interventions (including diet, physical activity and psychological support) in adults with obesity (a BMI of 30 or above) or those with a BMI of 27 or above who also have weight-related medical complications.
What else do you need to do during Ozempic treatment?
Checking details of the STEP trial intervention components, it’s clear participants invested a lot of time and effort. In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.
Support sessions were designed to help people stick with consuming 2,000 kilojoules (500 calories) less daily compared to their energy needs, and performing 150 minutes of moderate-to-vigorous physical activity, like brisk walking, dancing and gardening each week.
STEP trials varied in other components, with follow-up time periods varying from 68 to 104 weeks. The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.
Trial participants also exercised for 150 minutes a week. Elena Nichizhenova/Shutterstock A review of obesity medication trials found people reported they needed less cognitive behaviour training to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and avoiding things that trigger eating.
But what are the side effects?
Semaglutide’s side-effects include nausea, diarrhoea, vomiting, constipation, indigestion and abdominal pain.
In one study these led to discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.
More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.
To reduce risk or severity of side-effects, medication doses are increased very slowly over months. Once the full dose and response are achieved, research indicates you need to take it long term.
Given this long-term commitment, and associated high out-of-pocket cost of medication, when it comes to taking semaglutide to treat obesity, there is no way it can be considered “cheating”.
Read the other articles in The Conversation’s Ozempic series here.
Clare Collins, Laureate Professor in Nutrition and Dietetics, University of Newcastle
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Hope Not Nope – by Dr. Dillon Caswell
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The author a Doctor of Physical Therapy, writes from both professional expertise and personal experience, when it comes to the treatment of long term injury / disability / chronic illness.
His position here is that while suffering is unavoidable, we don’t have to suffer as much or as long as many might tell us. We can do things to crawl and claw our way to a better position, and we do not have to settle for any outcome we don’t want. That doesn’t mean there’s always a miracle cure—we don’t get to decide that—but we do get to decide whether we keep trying.
Dr. Caswell’s advice is based mostly in psychology—a lot of it in sports psychology, which is no surprise given his long history as an athlete as well as his medical career.
The style is very easy-reading, and a combination of explanation, illustrative (often funny) anecdotes, and a backbone of actual research to keep everything within the realms of science rather than mere wishful thinking—he strikes a good balance.
Bottom line: if your current health outlook is more of an uphill marathon, then this book can give you the tools to carry yourself through the healthcare system that’s been made for numbers, not people.
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