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.
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.
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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What Does “Balance Your Hormones” Even Mean?
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Hormonal Health: Is It Really A Balancing Act?
Have you ever wondered what “balancing your hormones” actually means?
The popular view is that men’s hormones look like this:
Testosterone (less) ⟷ Testosterone (more)
…And that women’s hormones look more like this:
♀︎ Estrogen ↭ Progesterone ⤵︎
⇣⤷ FSH ⤦ ↴ ☾ ⤹⤷ Luteinizing Hormone ⤦
DHEA ↪︎ Gonadotrophin ⤾
↪︎ Testosterone? ⥅⛢
Clear as mud, right?
But, don’t worry, Supplements McHerbal Inc will sell you something guaranteed to balance your hormones!
How can a supplement (or dietary adjustment) “balance” all that hotly dynamic chaos, and make everything “balanced”?
The truth is, “balanced” in such a nebulous term, and this is why you will not hear endocrinologists using it. It’s used in advertising to mean “in good order”, and “not causing problems”, and “healthy”.
In reality, our hormone levels depend on everything from our diet to our age to our anatomy to our mood to the time of the day to the phase of the moon.
Not that the moon has an influence on our physiology at all—that’s a myth—but you know, 28 day cycle and all. And, yes, half the hormones affect the levels of the others, either directly or indirectly.
Trying to “balance” them would be quite a game of whack-a-mole, and not something that a “cure-all” single “hormone-balancing” supplement could do.
So why aren’t we running this piece on Friday, for our “mythbusting” section? Well, we could have, but the more useful information is yet to come and will take up more of today’s newsletter than the myth-busting!
What, then, can we do to untangle the confusion of these hormones?
Well first, let’s understand what they do, in the most simple terms possible:
- Estrogen—the most general feminizing hormone from puberty onwards, busiest in the beginning of the menstrual cycle, and starts getting things ready for ovulation.
- Progesterone—secondary feminizing hormone, fluffs the pillows for the oncoming fertilized egg to be implanted, increases sex drive, and adjusts metabolism accordingly. Busiest in the second half of the menstrual cycle.
- Testosterone—is also present, contributes to sex drive, is often higher in individuals with PCOS. If menopause is untreated, testosterone will also rise, because there will be less estrogen
- (testosterone and estrogen “antagonize” each other, which is the colorfully scientific way of saying they work against each other)
- DHEA—Dehydroepiandrosterone, supports production of testosterone (and estrogen!). Sounds self-balancing, but in practice, too much DHEA can thus cause elevated testosterone levels, and thus hirsutism.
- Gonadotrophin—or more specifically human chorionic gonadotrophin, HcG, is “the pregnancy hormone“, present only during pregnancy, and has specific duties relating to such. This is what’s detected in (most) pregnancy test kits.
- FSH—follicle stimulating hormone, is critical to ovulation, and is thus essential to female fertility. On the other hand, when the ovaries stop working, FSH levels will rise in a vain attempt to encourage the ovulation that isn’t going to happen anymore.
- Luteinizing hormone—says “go” to the new egg and sends it on its merry way to go get fertilized. This is what’s detected by ovulation prediction kits.
Sooooooo…
What, for most women, most often is meant by a “hormonal imbalance” is:
- Low levels of E and/or P
- High levels of DHEA and/or T
- Low or High levels of FSH
In the case of low levels of E and/or P, the most reliable way to increase these is, drumroll please… To take E and/or P. That’s it, that’s the magic bullet.
Bonus Tip: take your E in the morning (this is when your body will normally make more and use more) take your P in the evening (it won’t make you sleepy, but it will improve your sleep quality when you do sleep)
In the case of high levels of DHEA and/or T, then that’s a bit more complex:
- Taking E will antagonize (counteract) the unwanted T.
- Taking T-blockers (such as spironolactone or bicalutamide) will do what it says on the tin, and block T from doing the jobs it’s trying to do, but the side-effects are considered sufficient to not prescribe them to most people.
- Taking spearmint or saw palmetto will lower testosterone’s effects
- Scientists aren’t sure how or why spearmint works for this
- Saw palmetto blocks testosterone’s conversion into a more potent form, DHT, and so “detoothes” it a bit. It works similarly to drugs such as finasteride, often prescribed for androgenic alopecia, called “male pattern baldness”, but it affects plenty of women too.
In the case of low levels of FSH, eating leafy greens will help.
In the case of high levels of FSH, see a doctor. HRT (Hormone Replacement Therapy) may help. If you’re not of menopausal age, it could be a sign something else is amiss, so it could be worth getting that checked out too.
What can I eat to boost my estrogen levels naturally?
A common question. The simple answer is:
- Flaxseeds and soy contain plant estrogens that the body can’t actually use as such (too incompatible). They’ve lots of high-quality nutrients though, and the polyphenols and isoflavones can help with some of the same jobs when it comes to sexual health.
- Fruit, especially peaches, apricots, blueberries, and strawberries, contain a lot of lignans and also won’t increase your E levels as such, but will support the same functions and reduce your breast cancer risk.
- Nuts, especially almonds (yay!), cashews, and pistachios, contain plant estrogens that again can’t be used as bioidentical estrogen (like you’d get from your ovaries or the pharmacy) but do support heart health.
- Leafy greens and cruciferous vegetables support a lot of bodily functions including good hormonal health generally, in ways that are beyond the scope of this article, but in short: do eat your greens!
Note: because none of these plant-estrogens or otherwise estrogenic nutrients can actually do the job of estradiol (the main form of estrogen in your body), this is why they’re still perfectly healthy for men to eat too, and—contrary to popular “soy boy” social myths—won’t have any feminizing effects whatsoever.
On the contrary, most of the same foods support good testosterone-related health in men.
The bottom line:
- Our hormones are very special, and cannot be replaced with any amount of herbs or foods.
- We can support our body’s natural hormonal functions with good diet, though.
- Our hormones naturally fluctuate, and are broadly self-correcting.
- If something gets seriously out of whack, you need an endocrinologist, not a homeopath or even a dietician.
In case you missed it…
We gave a more general overview of supporting hormonal health (including some hormones that aren’t sex hormones but are really important too), back in February.
Check it out here: Healthy Hormones And How To Hack Them
Want to read more?
Anthea Levi, RD, takes much the same view:
❝For some ‘hormone-balancing’ products, the greatest risk might simply be lost dollars. Others could come at a higher cost.❞
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Relieve GERD and Acid Reflux with Stretches and Exercises
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Looking for relief from GERD or acid reflux? Today we’re featuring an amazing video by Dr. Jo, packed with stretches and exercises designed to ease those symptoms.
Here’s a quick rundown, in case you don’t have time to watch the whole video.
If you’re not familiar with GERD, you can find our simple explanation of GERD here. Or, if you’re on the other end of the spectrum and want to do a deeper dive on the topic, we reviewed a great book on the topic).
1. Mobilize Your SEM Muscle
The sternocleidomastoid (SEM) muscle, if tight, can aggravate acid reflux. Dr. Jo shows how to gently mobilize this muscle by turning your head while holding the SEM in place. It’s simple but effective.
2. Portrait Pose Stretch
Stretch out that SEM with the Portrait Pose. Place your hand on your collarbone, turn your head away, side bend, and look up. Hold for 30 seconds. You’ll feel the tension melting away.
3. Seated Cat-Cow Motion
Open up your stomach area with this easy exercise. Sit down, roll your body forward, arch your back (Cow), then curl your spine and tuck your chin (Cat). Alternate for 30 seconds and feel the difference.
4. Quadruped Cat-Cow with Breathing
Similar to the seated cat-cow, the quadruped cat-cow focuses on flexing the lower spine whilst on all fours. Bonus tip: focus on deep belly breathing during the exercise. This helps improve digestion and ease reflux symptoms.
5. Exaggerated Pelvic Tilt
Lie on your back and tilt your pelvis back and forth. This loosens up the abdominal area and helps everything flow better.
6. Trunk Rotation
Lie down, bend your knees, and rotate them to one side. Hold for 30 seconds, then switch sides. It’s a great way to relax and stretch your abdominal muscles.
We know this is a quick overview (sorry if it seems rushed!), but if you have a few more minutes on your hand you can watch the whole video below.
Feel better soon! And if you have any favorite tips or videos to share, email us at 10almonds.
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Is stress turning my hair grey?
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When we start to go grey depends a lot on genetics.
Your first grey hairs usually appear anywhere between your twenties and fifties. For men, grey hairs normally start at the temples and sideburns. Women tend to start greying on the hairline, especially at the front.
The most rapid greying usually happens between ages 50 and 60. But does anything we do speed up the process? And is there anything we can do to slow it down?
You’ve probably heard that plucking, dyeing and stress can make your hair go grey – and that redheads don’t. Here’s what the science says.
What gives hair its colour?
Each strand of hair is produced by a hair follicle, a tunnel-like opening in your skin. Follicles contain two different kinds of stem cells:
- keratinocytes, which produce keratin, the protein that makes and regenerates hair strands
- melanocytes, which produce melanin, the pigment that colours your hair and skin.
There are two main types of melanin that determine hair colour. Eumelanin is a black-brown pigment and pheomelanin is a red-yellow pigment.
The amount of the different pigments determines hair colour. Black and brown hair has mostly eumelanin, red hair has the most pheomelanin, and blonde hair has just a small amount of both.
So what makes our hair turn grey?
As we age, it’s normal for cells to become less active. In the hair follicle, this means stem cells produce less melanin – turning our hair grey – and less keratin, causing hair thinning and loss.
As less melanin is produced, there is less pigment to give the hair its colour. Grey hair has very little melanin, while white hair has none left.
Unpigmented hair looks grey, white or silver because light reflects off the keratin, which is pale yellow.
Grey hair is thicker, coarser and stiffer than hair with pigment. This is because the shape of the hair follicle becomes irregular as the stem cells change with age.
Interestingly, grey hair also grows faster than pigmented hair, but it uses more energy in the process.
Can stress turn our hair grey?
Yes, stress can cause your hair to turn grey. This happens when oxidative stress damages hair follicles and stem cells and stops them producing melanin.
Oxidative stress is an imbalance of too many damaging free radical chemicals and not enough protective antioxidant chemicals in the body. It can be caused by psychological or emotional stress as well as autoimmune diseases.
Environmental factors such as exposure to UV and pollution, as well as smoking and some drugs, can also play a role.
Melanocytes are more susceptible to damage than keratinocytes because of the complex steps in melanin production. This explains why ageing and stress usually cause hair greying before hair loss.
Scientists have been able to link less pigmented sections of a hair strand to stressful events in a person’s life. In younger people, whose stems cells still produced melanin, colour returned to the hair after the stressful event passed.
4 popular ideas about grey hair – and what science says
1. Does plucking a grey hair make more grow back in its place?
No. When you pluck a hair, you might notice a small bulb at the end that was attached to your scalp. This is the root. It grows from the hair follicle.
Plucking a hair pulls the root out of the follicle. But the follicle itself is the opening in your skin and can’t be plucked out. Each hair follicle can only grow a single hair.
It’s possible frequent plucking could make your hair grey earlier, if the cells that produce melanin are damaged or exhausted from too much regrowth.
2. Can my hair can turn grey overnight?
Legend says Marie Antoinette’s hair went completely white the night before the French queen faced the guillotine – but this is a myth.
Melanin in hair strands is chemically stable, meaning it can’t transform instantly.
Acute psychological stress does rapidly deplete melanocyte stem cells in mice. But the effect doesn’t show up immediately. Instead, grey hair becomes visible as the strand grows – at a rate of about 1 cm per month.
Not all hair is in the growing phase at any one time, meaning it can’t all go grey at the same time.
3. Will dyeing make my hair go grey faster?
This depends on the dye.
Temporary and semi-permanent dyes should not cause early greying because they just coat the hair strand without changing its structure. But permanent products cause a chemical reaction with the hair, using an oxidising agent such as hydrogen peroxide.
Accumulation of hydrogen peroxide and other hair dye chemicals in the hair follicle can damage melanocytes and keratinocytes, which can cause greying and hair loss.
4. Is it true redheads don’t go grey?
People with red hair also lose melanin as they age, but differently to those with black or brown hair.
This is because the red-yellow and black-brown pigments are chemically different.
Producing the brown-black pigment eumelanin is more complex and takes more energy, making it more susceptible to damage.
Producing the red-yellow pigment (pheomelanin) causes less oxidative stress, and is more simple. This means it is easier for stem cells to continue to produce pheomelanin, even as they reduce their activity with ageing.
With ageing, red hair tends to fade into strawberry blonde and silvery-white. Grey colour is due to less eumelanin activity, so is more common in those with black and brown hair.
Your genetics determine when you’ll start going grey. But you may be able to avoid premature greying by staying healthy, reducing stress and avoiding smoking, too much alcohol and UV exposure.
Eating a healthy diet may also help because vitamin B12, copper, iron, calcium and zinc all influence melanin production and hair pigmentation.
Theresa Larkin, Associate Professor of Medical Sciences, University of Wollongong
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Black Pepper’s Impressive Anti-Cancer Arsenal
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Black Pepper’s Impressive Anti-Cancer Arsenal (And More)
Piperine, a compound found in Piper nigrum (black pepper, to its friends), has many health benefits. It’s included as a minor ingredient in some other supplements, because it boosts bioavailability. In its form as a kitchen spice, it’s definitely a superfood.
What does it do?
First, three things that generally go together:
These things often go together for the simple reason that oxidative stress, inflammation, and cancer often go together. In each case, it’s a matter of cellular wear-and-tear, and what can mitigate that.
For what it’s worth, there’s generally a fourth pillar: anti-aging. This is again for the same reason. That said, black pepper hasn’t (so far as we could find) been studied specifically for its anti-aging properties, so we can’t cite that here as an evidence-based claim.
Nevertheless, it’s a reasonable inference that something that fights oxidation, inflammation, and cancer, will often also slow aging.
Special note on the anti-cancer properties
We noticed two very interesting things while researching piperine’s anti-cancer properties. It’s not just that it reduces cancer risk and slows tumor growth in extant cancers (as we might expect from the above-discussed properties). Let’s spotlight some studies:
It is selectively cytotoxic (that’s a good thing)
Piperine was found to be selectively cytotoxic to cancerous cells, while not being cytotoxic to non-cancerous cells. To this end, it’s a very promising cancer-sniper:
Piperine as a Potential Anti-cancer Agent: A Review on Preclinical Studies
It can reverse multi-drug resistance in cancer cells
P-glycoprotein, found in our body, is a drug-transporter that is known for “washing out” chemotherapeutic drugs from cancer cells. To date, no drug has been approved to inhibit P-glycoprotein, but piperine has been found to do the job:
Targeting P-glycoprotein: Investigation of piperine analogs for overcoming drug resistance in cancer
What’s this about piperine analogs, though? Basically the researchers found a way to “tweak” piperine to make it even more effective. They called this tweaked version “Pip1”, because calling it by its chemical name,
((2E,4E)-5-(benzo[d][1,3]dioxol-5-yl)-1-(6,7-dimethoxy-3,4-dihydroisoquinolin-2(1 H)-yl)penta-2,4-dien-1-one)
…got a bit unwieldy.
The upshot is: Pip1 is better, but piperine itself is also good.
Other benefits
Piperine does have other benefits too, but the above is what we were most excited to talk about today. Its other benefits include:
- Neuroprotective effects (against Alzheimer’s, Parkinson’s, and more)
- Blood-sugar balancing / antidiabetic effect
- Good for gut microbiome diversity
- Heart health benefits, including cholesterol-balancing
- Boosts bioavailability of other nutrients/drugs
Enjoy!
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Lycopene’s Benefits For The Gut, Heart, Brain, & More
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What Doesn’t Lycopene Do?
Lycopene is an antioxidant carotenoid famously found in tomatoes; it actually appears in even higher levels in watermelon, though. If you are going to get it from tomato, know that cooking improves the lycopene content rather than removing it (watermelon, on the other hand, can be enjoyed as-is and already has the higher lycopene content).
Antioxidant properties
Let’s reiterate the obvious first, for the sake of being methodical and adding a source. Lycopene is a potent antioxidant with multiple health benefits:
Lycopene: A Potent Antioxidant with Multiple Health Benefits
…and as such, it does all the things you might reasonably expect and antioxidant to do. For example…
Anti-inflammatory properties
In particular, it regulates macrophage activity, reducing inflammation while improving immune response:
Lycopene Regulates Macrophage Immune Response through the Autophagy Pathway Mediated by RIPK1
As can be expected of most antioxidants and anti-inflammatory agents, it also has…
Anticancer properties
Scientific papers tend to be “per cancer type”, so we’re just going to give one example, but there’s pretty much evidence for its utility against most if not all types of cancer. We’re picking prostate cancer though, as it’s one that’s been studied the most in the context of lycopene intake—in this study, for example, it was found that men who enjoyed at least two servings of lycopene-rich tomato sauce per week were 30% less likely to develop prostate cancer than those who didn’t:
Dietary lycopene intake and risk of prostate cancer defined by ERG protein expression
If you’d like to see something more general, however, then check out:
Potential Use of Tomato Peel, a Rich Source of Lycopene, for Cancer Treatment
It also fights Candida albicans
Ok, this is not (usually) so life-and-death as cancer, but reducing our C. albicans content (specifically: in our gut) has a lot of knock-on effects for other aspects of our health, so this isn’t one to overlook:
The title does not make this clear, but yes: this does mean it has an antifungal effect. We mention this because often cellular apoptosis is good for an overall organism, but in this case, it simply kills the Candida.
It’s good for the heart
A lot of studies focus just on triglyceride markers (which lycopene improves), but more tellingly, here’s a 10-year observational study in which diets rich in lycopene were associated to a 17–26% lower risk of heart disease:
Relationship of lycopene intake and consumption of tomato products to incident CVD
…and a 39% overall reduced mortality in, well, we’ll let the study title tell it:
…which means also:
It’s good for the brain
As a general rule of thumb, what’s good for the heart is good for the brain (because the brain needs healthy blood flow to stay healthy, and is especially vulnerable when it doesn’t get that), and in this case that rule of thumb is also borne out by the post hoc evidence, specifically yielding a 31% decreased incidence of stroke:
Dietary and circulating lycopene and stroke risk: a meta-analysis of prospective studies
Is it safe?
As a common food product, it is considered very safe.
If you drink nothing but tomato juice all day for a long time, your skin will take on a reddish hue, which will go away if you stop getting all your daily water intake in tomato juice.
In all likelihood, even if you went to extremes, you would get sick from the excess of vitamin A (generally present in the same foods) sooner than you’d get sick from the excess of lycopene.
Want to try some?
We don’t sell it, and also we recommend simply enjoying tomatoes, watermelons, etc, but if you do want a supplement, here’s an example product on Amazon
Enjoy!
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White Bread vs White Pasta – Which Is Healthier?
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Our Verdict
When comparing a white bread to a white pasta, we picked the pasta.
Why?
Neither are great for the health! But like for like, the glycemic index of the bread is usually around 150% of the glycemic index for pasta.
All that said, we heartily recommend going for wholegrain in either case!
Bonus tip: cooking pasta “al dente”, so it is still at least a little firm to the bite, results in a lower GI compared to being boiled to death.
Bonus bonus tip: letting pasta cool increases resistant starches. You can then reheat the pasta without losing this benefit.
Please don’t put it in the microwave though; you will make an Italian cry. Instead, simply put it in a colander and pour boiling water over it, and then serve in your usual manner (a good approach if serving it separately is: put it in the serving bowl/dish/pan, drizzle a little extra virgin olive oil and a little cracked black pepper, stir to mix those in, and serve)
Enjoy!
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