Better Than Ozempic?
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You probably know about Semaglutide for Weight Loss ← this was our article from back in the day when its popularity was just starting to rise
However, GLP-1 receptor agonists (GLP-1 RAs) like semaglutide (known by such brand names as Ozempic and Wegovy) most certainly have their downsides too, and when it comes to health risks/benefits, there most definitely are trade-offs, such as:
So, it’s probably not too surprising that Most People Who Start GLP-1 RAs Quit Them Within A Year (Here’s Why).
However, GLP-1 receptor agonism is only one mechanism of action.
Let’s add a mechanism of action
As well as boosting the action of GLP-1 (glucagon-like peptide 1) receptors, semaglutide’s competitor tirzepatide it also acts simultaneously on GIP (glucose-dependent insulinotropic peptide) receptors, thus adding a second mechanism of action.
For this reason, it is more effective than its predecessors, including Ozempic:
❝The first GLP-1 mimicking drug was exenatide (Bayetta). It’s still available for treating type 2 diabetes, but there are currently no generics. Exenatide does provide some weight loss, but this is quite modest, typically around 3-5% of body weight.
For liraglutide, those using the drug to treat obesity will use the stronger one (Saxenda), which typically gives about 10% weight loss.
Semaglutide, with the stronger formulation called Wegovy, typically results in 15% weight loss.
The newest GLP-1 mimicking drug on the market, tirzepatide (Mounjaro for type 2 diabetes and Zepbound for weight loss), results in weight loss of around 25% of body weight.❞
Read in full: Ozempic’s cousin drug liraglutide is about to get cheaper. But how does it stack up?
You can also read more about tirzepatide in our main feature about it, here: Mounjaro/Zepbound’s Stable Weight Loss Curve
Now for a third mechanism of action
You might have wondered, if GLP-1 is “glucagon-like peptide”, if there’s anything we can do involving glucagon itself.
And the answer is yes, there is! Adding a glucagon receptor agonist to the mix has been done. The drug is called retraglutide. So far, we’re only seeing trials funded by the company that makes the drug in question though, such as:
Looking at this and similar studies (also funded by the same company that makes the drug), it seems to only perform (at best) on a par with terzepatide, both for weight loss and in terms of adverse effects.
And most recently, a fourth mechanism of action
Researchers (Dr. Krishna Kumar et al.) have investigated adding a fourth component, an agonist of “peptide YY” (PYY), which reduces appetite and increases fat burn, and/but is quite unrelated to the first three hormones (yes, these are all hormones, by the way).
Bear in mind, these additions have been done not by adding an extra ingredient, but rather by in each case creating a chemical chimera, a single molecule that does the job of each hormone it’s agonizing—think of it like a “master key” that is designed to fit several different (but similar) locks.
Now, the problem of adding a PYY agonist into the mix is that on a molecular level, it’s very different from the first three.
The researchers’ solution? A sort of double-ended molecule that has the previous three actions at one end, and the PYY action at the other end.
Hence the paper title: Molecular Design of Unimolecular Tetra-Receptor Agonists (“tetra-” just means “four” in Greek)
One of the expected outcomes (not yet tested, because the drug is new, so we need people to have time to first be on it and see how much weight is lost in a year, and then discontinue it to see if the weight returns, which realistically means a two-year study minimum) is that there will be little or no weight rebound after discontinuation:
❝One of the limitations of the current drugs is that individual variation, possibly including how people express target receptors or respond to their corresponding hormones, can lead to lesser than desired weight loss outcomes in many patients.
By hitting four different hormone receptors at the same time, we hope to improve the chances of averaging out such variation toward the goal of achieving greater and more consistent overall effectiveness.
“A second issue is that patients tend to regain weight after discontinuing currently available GLP-1 related drugs. Recent studies indicate that weight rebound after drug discontinuation is delayed with the newer, more effective GLP-1 mimetics.
Extending from this observation, one may speculate that multi-chimeras along the lines of the one we discovered could get us closer to the bariatric surgery standard of lasting weight loss.❞
Read in full: Beyond Ozempic: New weight loss drug rivals surgery
Don’t want to wait for that, and/or prefer a more natural approach?
It is possible to get many of the effects of GLP-1 RAs without taking GLP-1RAs, by enjoying foods that increase incretin, a hormone group (the most well-known of which is GLP-1) that slows down stomach emptying, which means a gentler blood sugar curve and feeling fuller for longer. It also acts on the hypothalamus, controlling appetite via the brain too (signalling fullness and reducing hunger).
For what foods to focus on, see:
5 Ways To Naturally Boost The “Ozempic Effect” ← this is from Dr. Jason Fung, who is perhaps most well-known for his work in functional medicine for reversing diabetes, and he’s once again giving us sound advice about metabolic hormone-hacking with dietary tweaks!
You can also check out: Ozempic vs Five Natural Supplements
Enjoy!
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Kiwi vs Strawberries – Which is Healthier?
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Our Verdict
When comparing kiwi to strawberries, we picked the kiwi.
Why?
Both are very worthy candidates, but…
In terms of macros, kiwi has more fiber, carbs, and protein, making it the more nutrient-dense option in this category.
In the category of vitamins, kiwi has more of vitamins A, B1, B2, B5, B6, B7, B9, C, E, K, and choline, while strawberries have (very slightly) more vitamin B3. A very clear win for kiwi in this round.
Looking at minerals, kiwi has more calcium, copper, magnesium, phosphorus, and potassium, while strawberries have more iron, manganese, and selenium. Another win for strawberries.
When it comes to phytochemicals, both are good, but kiwi has some anticancer properties that strawberries don’t, so we say that’s another win for kiwi here.
Adding up the sections makes for an overwhelming overall win for kiwi, but by all means enjoy either or both; diversity is good!
Want to learn more?
You might like:
Top 8 Fruits That Prevent & Kill Cancer ← kiwi is #1 on the list, for promoting cancer cell death while sparing healthy cells!
Enjoy!
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Artichoke vs Eggplant – Which is Healthier?
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Our Verdict
When comparing artichoke to eggplant, we picked the artichoke.
Why?
It was quite one-sided today!
In terms of macros, artichoke has nearly 2x the fiber and carbs, and more than 3x the protein, making it the most nutrient-dense option by far in this round.
In the category of vitamins, artichoke has more of vitamins B1, B2, B3, B5, B6, B7, B9, C, and K, while eggplant boasts only (slightly) more vitamin E, yielding a 9:1 victory for artichoke.
Looking at minerals next, artichoke has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while eggplant boasts only (slightly) more selenium, giving an 8:1 victory for artichoke in this round.
In other considerations, artichoke is much higher in polyphenols, so that’s another point in its favor.
Adding up the sections is barely needed today; it’s a clear total win for artichoke. Still, do enjoy either or both (perhaps together; ratatouille is a great option to use them both and more), as diversity is good!
Want to learn more?
You might like:
- Oven-Roasted Ratatouille ← this is a super-easy but very tasty recipe; it includes eggplant by default but not artichoke, just add that in, treating it the same as the eggplant and zucchini
- Why You’re Probably Not Getting Enough Fiber (And How To Fix It)
Enjoy!
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Eggplant vs Mushroom – Which is Healthier?
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Our Verdict
When comparing eggplant to mushrooms, we picked the mushrooms.
Why?
Well, there wasn’t mushroom for disagreement!
But first, you may be wondering: which mushrooms? Button mushrooms? White mushrooms? Chestnut mushrooms? Portobello mushrooms? And the answer is yes.
Those (and more; it represents most mushrooms that are commonly sold fresh in western supermarkets) are all the same species at different ages; namely, Agaricus bisporus—not to be mistaken for fly agaric, which despite the name, is not even a member of the Agaricus genus, and is in fact Amanita muscari. This is an important distinction, because fly agaric is poisonous, though fatality is rare, and it’s commonly enjoyed recreationally (after some preparation, which reduces its toxicity) for its psychoactive effects. It’s the famous red one with white spots. Anyway, today we will be talking instead about Agaricus bisporus, which is most popular western varieties of “edible mushroom”.
Of course, technically all mushrooms are edible, just, some of them are edible only once 😉
(the above line is a joke, please do not eat the kind that will kill you)
With all that in mind, let’s get down to it:
In terms of macros, eggplant has nearly 2x the carbs and 3x the fiber, while mushrooms contain more than 3x the protein. We’ll call this a tie for macros.
In the category of vitamins, eggplant is higher in vitamins A, E, and K, while mushrooms contain more of vitamins B1, B2, B3, B5, B6, B7, B9, B12, and D. Most notably for vegans, mushrooms are a good non-animal source of vitamins B12 and D3, which nutrients are not generally found in plants. Mushrooms, of course, are not technically plants. In any case, the vitamins category is an easy win for mushrooms.
When it comes to minerals, eggplant has more calcium, magnesium, and manganese, while mushrooms have more copper, iron, phosphorus, potassium, selenium, and zinc. One more strong round in mushrooms’ favor!
One final thing worth noting is that mushrooms are a rich source of the amino acid ergothioneine, which has been called a “longevity vitamin” for its healthspan-increasing effects (see our article below), so that’s one more point for mushrooms.
Adding up the sections makes for an overwhelming win for mushrooms, but by all means do enjoy either or both, as diversity is best!
Want to learn more?
You might like:
The Magic Of Mushrooms: “The Longevity Vitamin” (That’s Not A Vitamin)
Enjoy!
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Cabbage vs Chard – Which is Healthier?
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Our Verdict
When comparing cabbage to chard, we picked the chard.
Why?
Both have their merits! But one comes out on top:
In terms of macros, cabbage gets off to a good start with more fiber, for comparable protein and carbs; a modest win for cabbage in this round.
In the category of vitamins, cabbage has more vitamin B9, while chard has more of vitamins A, B2, B3, C, E, and K, including 60x the vitamin A, 12x the vitamin E, and 10x the vitamin K. Thus, a strong win for chard on vitamins.
Looking at minerals next, cabbage is not higher in any minerals, while chard has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, winning another round easily.
In other considerations, chard has more polyphenols, especially kaempferol and quercetin, so wins its third round in a row.
Adding up the sections makes for a clear overall win for chard, but by all means enjoy either or both, as diversity is good!
Want to learn more?
You might like:
Enjoy!
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Dr. Stacy Sims’ Guide to Fitness and Nutrition after 40
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It’s worth noting that Dr. Sims has directed research programs at Stanford University focusing on female athlete health and performance, and she also has 94 peer-reviewed papers on the topic to her name.
Here’s what she has to say for those of us in the “women over 40” bracket:
What most people miss
Some notes on daily rhythm: Dr. Sims recommends to eat within an hour of waking, because cortisol spikes about 30 minutes afterwards, so, we can counter it with breakfast. She also advises we bookend our workouts with food, especially 30–40g of protein afterwards. Eat regularly through the day, have an adequate dinner, and avoid eating after dinner, to work with normal hormonal fluctuations.
You may be thinking “but I have long since menopaused; I do not have hormonal fluctuations”; in such a case, then do remember that “hormonal” doesn’t just mean sex hormones, it also means cortisol, serotonin, dopamine, leptin, ghrelin, insulin, and many others!
About heavy lifting after 40: declining estrogen changes muscle signalling, so women must rely more on central-nervous-system stimulation. Heavy loads create this stimulus, improving strength, power, lean mass, and nerve firing when hormonal signalling is reduced. So, lift heavy! But, also safely, please.
Some specific notes on high-intensity interval training (HIIT) of various kinds:
- SIT (sprint interval training): very short maximal bursts of 30 seconds or less at perceived exertion 9–10, followed by long recovery. effective for metabolic control and for signalling between skeletal muscle, the liver, and visceral fat. two intervals are usually the maximum for beginners if the effort is truly maximal.
- High-intensity training in general: true high intensity (e.g. 1–4 minute efforts at 80–90% of maximum heartrate with equal recovery) generates hormones that help lower cortisol afterwards. Moderate intensity does not create the same adaptive hormonal response.
On bone density, she recommends:
- Don’t bother with weighted vests for walking: wearing a weighted vest while walking can maintain existing bone but does not stimulate new growth. Basically, it doesn’t improve bone density because it lacks multi-directional stress, which is what’s needed per Wolff’s Law.
- Do use multi-directional jumps: for example, flat-footed pogo stick jumps or jumping rope, for about 10 minutes, three times per week. The “bone jump” app (developed from a 5-year study in 35–45-year-old women with low-normal bone density) provides structured jump progressions.
Two biggest things she wants us all to take into account, if we remember nothing else:
- Address sleep before fine-tuning training. Better sleep improves cravings, gut health, training response, and stress regulation.
- Ignore diet fads and instead focus on meal timing, consistent intake, and sufficient protein. Match your nutrition to your stress levels and training.
For more on all of this, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like:
Next Level – by Dr. Stacy Sims ← this is her book specifically about going from strength to strength through menopause and beyond 😎
Take care!
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Spit or swallow? What’s the best way to deal with phlegm?
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A spitting pot I consider as an essential part of the bed-room apparatus.
That’s what French physician René Laennec wrote in 1821. Laennec, who invented the stethoscope, spent his days gazing at his patients’ phlegm. In the days before x-rays and blood tests, phlegm was considered a valuable diagnostic tool.
Today, most of us don’t carry around a spitting pot. But a persistent question remains, especially during winter, when noses are dripping and chests are rattling.
When you have a cough, should you spit out phlegm or is it better to swallow it?
It might feel like an odd or even slightly stomach-churning topic, but it’s a remarkably common question patients ask doctors.
Pop Paul-Catalin/Shutterstock What is phlegm?
Phlegm, also known as sputum, is the thick, sticky mucus your lungs and windpipe make. This acts as a defensive barrier to protect them.
Its main ingredients are mucins – large, sugar-coated proteins that trap viruses, bacteria, allergens and dust. These mucins also regulate inflammation and the body’s immune response to bacteria and viruses.
We most commonly see phlegm with viral illness during winter. But phlegm is also evident in other medical conditions including asthma and allergies, bacterial infections, such as sinusitis, or with smoking or exposure to air pollution.
In fact, we’re always making phlegm, even when we are healthy. Cells in the lungs secrete mucus to keep surfaces moist and trap irritants. When we encounter something potentially harmful, such as a virus or allergen, immune cells detect the threat and release signals that tell mucus-producing cells to step up their game.
This extra mucus helps trap the invader and move it out of the lungs. Tiny hairs lining the airways (called cilia) then sweep the mucus up to the throat, where we cough it out or swallow it.
These tiny hairs, or cilia, sweep phlegm up to your throat. Sakurra/Shutterstock The case for spitting
Some people feel better if they spit out phlegm, especially if the phlegm is thick, sticky or irritates the throat.
Spitting also lets you see what’s coming up. If phlegm contains blood, for example, it is important to see a doctor to exclude a more serious underlying illness, such as tuberculosis or cancer.
If you do spit out, do so into a tissue and throw it in the bin. Wash your hands afterwards. This reduces the risk of spreading infection to others via respiratory droplets or contaminated surfaces.
However, spitting out phlegm isn’t always practical, or polite. And for most viral infections, it doesn’t help you get better any faster than swallowing. The aim is to remove phlegm from the lungs, which occurs with either method.
Spitting is also not feasible for young children, who haven’t yet developed the coordination to do so effectively. They’ll generally swallow their phlegm. https://www.youtube.com/embed/WW4skW6gucU?wmode=transparent&start=0 How mucus keeps us healthy all year round, even if we’re not sick.
The case for swallowing
It might not sound particularly appealing, but swallowing phlegm is a normal process, and harmless. In fact, we often swallow phlegm without realising it.
The lungs generate about 50 millilitres of phlegm daily. It goes unnoticed because it’s thin, blends with saliva and we continuously swallow it. We only become aware of it when it thickens, such as during a viral infection.
After you swallow phlegm, it travels to the stomach, where acid and enzymes break it down, along with any germs it carries.
Swallowing phlegm doesn’t “recycle” the germs, and it won’t result in the infection spreading elsewhere.
In fact, swallowing viruses can even help build immunity. Once inside the gut, immune cells begin to recognise pieces of the virus and start preparing the body to respond more effectively to it in the future. Some important immunisations, such as the oral polio vaccine, work through this very mechanism.
So, what’s the verdict?
Whether you spit or swallow phlegm, both are safe. Spitting can help some people feel better, especially if their cough is associated with thick phlegm that’s causing distress.
But for most healthy people, there’s no need to force a cough or spit out phlegm. Swallowing phlegm is completely safe. And in young children, it’s the only feasible option.
In the end, it won’t matter if you spit or swallow your phlegm this winter. So choose what feels right (and least icky) for you.
Niall Johnston, Conjoint Associate Lecturer, Faculty of Medicine, UNSW Sydney and Phoebe Williams, Paediatrician & Infectious Diseases Physician; Senior Lecturer & NHMRC Fellow, Faculty of Medicine, University of Sydney
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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