Ozempic’s cousin drug liraglutide is about to get cheaper. But how does it stack up?
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Fourteen years ago, the older drug cousin of semaglutide (Ozempic and Wegovy) came onto the market. The drug, liraglutide, is sold under the brand names Victoza and Saxenda.
Patents for Victoza and Saxenda have now expried. So other drug companies are working to develop “generic” versions. These are likely be a fraction of current cost, which is around A$400 a month.
So how does liraglutide compare with semaglutide?
How do these drugs work?
Liraglutide was not originally developed as a weight-loss treatment. Like semaglutide (Ozempic), it originally treated type 2 diabetes.
The class of drugs liraglutide and semaglutide belong to are known as GLP-1 mimetics, meaning they mimic the natural hormone GLP-1. This hormone is released from your small intestines in response to food and acts in several ways to improve the way your body handles glucose (sugar).
How do they stop hunger?
Liraglutide acts in several regions of the unconscious part of your brain, specifically the hypothalamus, which controls metabolism, and parts of the brain stem responsible for communicating your body’s nutrient status to the hypothalamus.
Its actions here appear to reduce hunger in two different ways. First, it helps you to feel full earlier, making smaller meals more satisfying. Second, it alters your “motivational salience” towards food, meaning it reduces the amount of food you seek out.
Liraglutide’s original formulation, designed to treat type 2 diabetes, was marketed as Victoza. Its ability to cause weight loss was evident soon after it entered the market.
Shortly after, a stronger formulation, called Saxenda, was released, which was intended for weight loss in people with obesity.
How much weight can you lose with liraglutide?
People respond differently and will lose different amounts of weight. But here, we’ll note the average weight loss users can expect. Some will lose more (sometimes much more), others will lose less, and a small proportion won’t respond.
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.
What happens when you stop taking them?
Despite the effectiveness of these medications in helping with weight loss, they do not appear to change people’s weight set-point.
So in many cases, when people stop taking them, they experience a rebound toward their original weight.
What is the dose and how often do you need to take it?
Liraglutide (Victoza) for type 2 diabetes is exactly the same drug as Saxenda for weight loss, but Saxenda is a higher dose.
Although the target for each formulation is the same (the GLP-1 receptor), for glucose control in type 2 diabetes, liraglutide has to (mainly) reach the pancreas.
But to achieve weight loss, it has to reach parts of the brain. This means crossing the blood-brain barrier – and not all of it makes it, meaning more has to be taken.
All the current formulations of GLP-1 mimicking drug are injectables. This won’t change when liraglutide generics hit the market.
However, they differ in how frequently they need to be injected. Liraglutide is a once-daily injection, whereas semaglutide and tirzepatide are once-weekly. (That makes semaglutide and tirzepatide much more attractive, but we won’t see semaglutide as a generic until 2033.)
What are the side effects?
Because all these medicines have the same target in the body, they mostly have the same side effects.
The most common are a range of gastrointestinal upsets including nausea, vomiting, bloating, constipation and diarrhoea. These occur, in part, because these medications slow the movement of food out of the stomach, but are generally managed by increasing the dose slowly.
Recent clinical data suggests the slowing in emptying of the stomach can be problematic for some people, and may increase the risk of of food entering the lungs during operations, so it is important to let your doctor know if you are taking any of these drugs.
Because these are injectables, they can also lead to injection-site reactions.
During clinical trials, there were some reports of thyroid disease and pancreatitis (inflammation of the pancreas). However, it is not clear that these can be attributed to GLP-1 mimicking drugs.
In animals, GLP-1 mimicking drugs drugs have been found to negatively alter the growth of the embryo. There is currently no controlled clinical trial data on their use during pregnancy, but based on animal data, these medicines should not be used during pregnancy.
Who can use them?
The GLP-1 mimicking drugs for weight loss (Wegovy, Saxenda, Zepbound/Mounjaro) are approved for use by people with obesity and are meant to only be used in conjunction with diet and exercise.
These drugs must be prescribed by a doctor and for obesity are not covered by the Pharmaceutical Benefits Scheme, which is one of the reasons why they are expensive. But in time, generic versions of liraglutide are likely to be more affordable.
Sebastian Furness, ARC Future Fellow, School of Biomedical Sciences, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Goji Berries: Which Benefits Do They Really Have?
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Are Goji Berries Really A Superfood?
Goji berries are popularly considered a superfood, and sold for everything from anti-aging effects, to exciting benefits* that would get this email directed to your spam folder if we described them.
*We searched so you don’t have to: there doesn’t seem to be much research to back [that claim that we can’t mention], but we did find one paper on its “invigorating” benefits for elderly male rats. We prefer to stick to human studies where we can!
So how does the science stack up for the more mainstream claims?
Antioxidant effects
First and most obvious for this fruit that’s full of helpful polysaccharides, carotenoids, phenolic acids, and flavonoids, yes, they really do have strong antioxidant properties:
Immune benefits
Things that are antioxidant are generally also anti-inflammatory, and often have knock-on benefits for the immune system. That appears to be the case here.
For example, in this small-but-statistically-significant study (n=60) in healthy adults (aged 55–72 years)
❝The GoChi group showed a statistically significant increase in the number of lymphocytes and levels of interleukin-2 and immunoglobulin G compared to pre-intervention and the placebo group, whereas the number of CD4, CD8, and natural killer cells or levels of interleukin-4 and immunoglobulin A were not significantly altered. The placebo group showed no significant changes in any immune measures.
Whereas the GoChi group showed a significant increase in general feelings of well-being, such as fatigue and sleep, and showed a tendency for increased short-term memory and focus between pre- and post-intervention, the placebo group showed no significant positive changes in these measures.❞
“GoChi” here is a brand name for goji berries, and it’s not clear from the abstract whether the company funded the study:
Here’s another study, this time n=150, and ages 65–70 years old. This time it’s with a different brand (“Lacto-Wolfberry”, a milk-with-goji supplement drink) and it’s also unclear whether the company funded the study. However, taking the data at face value:
❝In conclusion, long-term dietary supplementation with Lacto-Wolfberry in elderly subjects enhances their capacity to respond to antigenic challenge without overaffecting their immune system, supporting a contribution to reinforcing immune defense in this population. ❞
In other words: it allowed those who took it to get measurably more benefit from the flu vaccinations that they received, without any ill effects.
Anticancer potential
This one’s less contentious (the immune benefits seemed very credible; we’d just like to see more transparent research to say for sure), so in the more clearly-evidenced case against cancer we’ll just drop a few quick studies, clipped for brevity:
- Goji berry (Lycium barbarum) inhibits the proliferation, adhesion, and migration of oral cancer cells
- A closer look at immunomodulatory properties of goji berries extract in human colon cancer cells
- Lycium barbarum polysaccharides induce apoptosis in human prostate cancer cells and inhibits prostate cancer growth
- Identification of goji berry cyclic peptides and anticervical carcinoma activity
- Antiproliferative effects of Lycium barbarum’s (goji berry) fractions on breast cancer Cell Lines
You get the idea: it helps!
Bonus benefit for the eyes
Goji berries also help against age-related macular degeneration. The research for this is in large part secondary, i.e. goji berries contain things x, y, and z, and then separate studies say that those things help against age-related macular degeneration.
We did find some goji-specific studies though! One of them was for our old friends the “Lacto-Wolfberry” people and again, wasn’t very transparent, so we’ll not take up extra time/space with that one here.
Instead, here’s a much clearer, transparent, and well-referenced study with no conflicts of interest, that found:
❝Overall, daily supplementation with Goji berry for 90d improves MPOD by increasing serum Z levels rather than serum L levels in early AMD patients. Goji berry may be an effective therapeutic intervention for preventing the progression of early AMD.❞
- MPOD = Macular Pigment Optical Density, a standard diagnostic tool for age-related macular degeneration
- AMD = Age-related Macular Degeneration
(that whole paper is very compelling reading, if you have time)
If you want a quicker read, we offer:
How To Avoid Age-Related Macular Degeneration
and also…
Where to get goji berries?
You can probably find them at your local health food store, if not the supermarket. However, if you’d like to buy them online, here’s an example product on Amazon for your convenience
Enjoy!
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How To Grow In Comfort
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How To Grow (Without Leaving Your Comfort Zone)
“You have to get out of your comfort zone!” we are told, from cradle to grave.
When we are young, we are advised (or sometimes more forcefully instructed!) that we have to try new things. In our middle age, we are expected to be the world’s greatest go-getters, afraid of nothing and always pushing limits. And when we are old, people bid us “don’t be such a dinosaur”.
It is assumed, unquestioned, that growth can only occur through hardship and discomfort.
But what if that’s a discomforting lie?
Butler (2023) posited an idea: “We never achieve success faster and with less effort than when we are in our comfort zone”
Her words are an obvious callback to the ideas of Csikszentmihalyi (1970) in the sense of “flow”, in the sense in which that word is used in psychology.
Flow is: when a person is in a state of energized focus, full involvement, and enjoyment of an activity.
As a necessary truth (i.e: a function of syllogistic logic), the conditions of “in a state of flow” and “outside of one’s comfort zone” cannot overlap.
From there, we can further deduce (again by simple logic) that if flow can be found, and/but cannot be found outside of the comfort zone, then flow can only be found within the comfort zone.
That is indeed comforting, but what about growth?
Imagine you’ve never gone camping in your life, but you want to get outside of your comfort zone, and now’s the time to do it. So, you check out some maps of the Yukon, purchase some camping gear, and off you go into the wilderness. In the event that you survive to report it, you will indeed be able to say “it was not comfortable”.
But, did growth occur? Maybe, but… it’s a folly to say “what doesn’t kill us makes us stronger” as a reason to pursue such things. Firstly, there’s a high chance it may kill us. Secondly, what doesn’t kill us often leaves us incredibly weakened and vulnerable.
When Hannibal famously took his large army of mostly African mercenaries across the Alps during winter to march on Rome from the other side, he lost most of his men on the way, before proceeding to terrorize Northern Italy convincingly with the small remainder. But! Their hard experience hadn’t made them stronger; it had just removed the weaker soldiers, making the resultant formations harder to break.
All this to say, please do not inflict hardship and discomfort and danger in the hopes it’ll make you stronger; it will probably do the opposite.
But…
If, instead of wilderness trekking in the Yukon…
- You start off with a camper van holiday, then you’ll be taking a fair amount of your comfort with you. In effect, you will be stretching and expanding your comfort zone without leaving it.
- Then maybe another year you might try camping in a tent on a well-catered camping site.
- Later, you might try “roughing it” at a much less well-catered camping site.
- And so on.
Congratulations, you have tried new things and undergone growth, taking your comfort zone with you all the way!
This is more than just “easing yourself into” something
It really is about taking your comfort with you too. If you want to take up running, don’t ask “how can I run just a little bit first” or “how can I make it easier” (well, feel free to ask those things too, but) ask yourself: how can I bring my comfort with me? Comfortable shoes, perhaps, an ergonomic water bottle, shade for your head, maybe.
❝Any fool can rough it, but a good soldier can make himself comfortable in any circumstances❞
~ British Army maxim
This goes for more than just physical stuff, too
If you want to learn a new skill, the initial learning curve can be anxiety-inducing, especially if you are taking a course and worried about keeping up or “not being good enough”.
So, “secretly” study in advance, at your leisure, get yourself a head start. Find a degree of comfort in what you’ve learned so far, and then bring that comfort with you into your entry-level course that is now less intimidating.
Discomfort isn’t a badge of honor (and impedes growth)
Take that extra rest stop on the highway. Bring your favorite coffee with you. Use that walking stick, if it helps.
Whatever it takes to bring your comfort with you, bring it.
Trust us, you’ll get further that way.
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Feel Better In 5 – by Dr. Rangan Chatterjee
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We’ve featured Dr. Rangan Chatterjee before, and here’s a great book of his.
The premise is a realistic twist on a classic, the classic being “such-and-such, in just 5 minutes per day!”
In this case, Dr. Chatterjee offers many lifestyle interventions that each take just 5 minutes, with the idea that you implement 3 of them per day (your choice which and when), and thus gradually build up healthy habits. Of course, once things take as habits, you’ll start adding in more, and before you know it, half your lifestyle has changed for the better.
Which, you may be thinking “my lifestyle’s not that bad”, but if you improve the health outcomes of, say, 20 areas of your life by just a few percent each, you know much better health that adds up to? We’ll give you a clue: it doesn’t add up, it compounds, because each improves the other too, for no part of the body works entirely in isolation.
And Dr. Chatterjee does tackle the body systematically, by the way; interventions for the gut, heart, brain, and so on.
As for what these interventions look like; it is very varied. One might be a physical exercise; another, a mental exercise; another, a “make this health 5-minute thing in the kitchen”, etc, etc.
Bottom line: this is the most supremely easy of easy-ins to healthier living, whatever your starting point—because even if you’re doing half of these interventions, chances are you aren’t doing the other half, and the idea is to pick and choose how and when you adopt them in any case, just picking three 5-minute interventions each day with no restrictions. In short, a lot of value to had here when it comes to real changes to one’s serious measurable health.
Click here to check out Feel Better In 5, and indeed feel better in 5!
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Pomegranate vs Cranberries – Which is Healthier?
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Our Verdict
When comparing pomegranate to cranberries, we picked the pomegranate.
Why?
Starting with the macros: pomegranate has nearly 4x the protein (actually quite a lot for a fruit, but this is not too surprising—it’s because we are eating the seeds!), and slightly more carbs and fiber. Their glycemic indices are comparable, both being low GI foods. While both of these fruits have excellent macro profiles, we say the pomegranate is slightly better, because of the protein, and when it comes to the carbs and fiber, since they balance each other out, we’ll go with the option that’s more nutritionally dense. We like foods that add more nutrients!
In the category of vitamins, pomegranate is higher in vitamins B1, B2, B3, B5, B6, B9, K, and choline, while cranberry is higher in vitamins A, C, and E. Both are very respectable profiles, but pomegranate wins on strength of numbers (and also some higher margins of difference).
When it comes to minerals, it is not close; pomegranate is higher in calcium, copper, iron, magnesium, phosphorus, potassium, selenium, and zinc, while cranberry is higher in manganese. An easy win for pomegranate here.
Both of these fruits have additional “special” properties, though it’s worth noting that:
- pomegranate’s bonus properties, which are too many to list here, but we link to an article below, are mostly in its peel (so dry it, and grind it into a powder supplement, that can be worked into foods, or used like an instant fruit tea, just without the sugar)
- cranberries’ bonus properties (including: famously very good at reducing UTI risk) come with some warnings, including that they may increase the risk of kidney stones if you are prone to such, and also that cranberries have anti-clotting effects, which are great for heart health but can be a risk of you’re on blood thinners or have a bleeding disorder.
You can read about both of these fruits’ special properties in more detail below:
Want to learn more?
You might like to read:
- Health Benefits Of Cranberries (But: You’d Better Watch Out)
- Pomegranate’s Health Gifts Are Mostly In Its Peel
Take care!
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Quick Healthy Recipe Ideas
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
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
“It was superb !! Just loved that healthy recipe !!! I would love to see one of those every day, if possible !! Keep up the fabulous work !!! ”
We’re glad you enjoyed! We can’t promise a recipe every day, but here’s one just for you:
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What Size Breakfast Is Best, By Science?
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“Breakfast is the most important meal of the day”, the popular wisdom goes. But, what should it consist of, and how much should we be eating for breakfast?
It has been previously established that it is good if breakfast is the largest meal of the day:
…with meals getting progressively smaller thereafter.
Of course, very many people do the inverse: small (or skipped) breakfast, moderate lunch, larger dinner. This, however, is probably more a result of when eating fits around the modern industrialized workday (and thus gets normalized), rather than actual health considerations.
So, what’s the latest science?
A plucky band of researchers led by Dr. Karla-Alejandra Pérez-Vega investigated the importance of breakfast in the context of heart health. This research was done as part of a larger study into the effects of the Mediterranean Diet on cardiovascular health, so if anyone wants a quick recap before we carry on, then:
The Mediterranean Diet: What Is It Good For? ← the answer, by the way, is “pretty much everything”
…and there are also different versions that each use the Mediterranean Diet as the core, while focussing extra on a different area of health, including one to make it extra heart-healthy:
Four Ways To Upgrade The Mediterranean ← most anti-inflammatory / gut-healthiest / heart-healthiest / brain-healthiest
What they found
In their sample population (n=383) of Spanish adults aged 55–75 with pre-diagnosed metabolic syndrome who, as part of the intervention of this 36-month interventional study, had now for the past 36 months been on a Mediterranean diet but without specific guidance on portion sizes:
- Participants with insufficient breakfast energy intake had the highest adiposity (which is a measure of body fat expressed as a percentage of total mass)
- Participants with low or high (but not moderate) breakfast energy intake had the larger BMI and waist circumference over time
- Participants with low or high (but not moderate) breakfast energy intake had higher triglyceride and lower HDL (good) cholesterol levels
- Participants who consumed 20–30% of their daily calories at breakfast enjoyed the greatest improvements in lipid profiles, with lower triglycerides and higher HDL (good) cholesterol levels
- Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had higher blood pressure levels
- Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had higher blood sugar levels
- Participants with lower breakfast quality (lower adherence to Mediterranean Diet) had lower estimated glomerular filtration rate (which is an indicator of kidney function)
- Participants with higher breakfast quality (higher adherence to Mediterranean Diet) had lower waist circumference, higher HDL cholesterol, and better kidney function
You can see the paper itself here in the Journal of Nutrition, Health, and Aging:
What this means
According to this research, the heart-healthiest breakfast is:
- not skipped
- Mediterranean Diet adherent
- within the range of of 20–30% of the total calories for the day
Want to make it even better?
Consider:
Before You Eat Breakfast: 3 Surprising Facts About Intermittent Fasting
Enjoy!
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