The Diabetes Drugs That Can Cut Asthma Attacks By 70%

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Asthma, obesity, and type 2 diabetes are closely linked, with the latter two greatly increasing asthma attack risk.

While bronchodilators / corticosteroids can have immediate adverse effects due to sympathetic nervous system activation, and lasting adverse effects due to the damage it does to metabolic health, diabetes drugs, on the other hand, can improve things with (for most people) fewer unwanted side effects.

Great! Which drugs?

Metformin, and glucagon-like peptide-1 receptor agonists (GLP-1RAs).

Specifically, researchers have found:

  • Metformin is associated with a 30% reduction in asthma attacks
  • GLP-1RAs are associated with a 40% reduction in asthma attacks

…and yes, they stack, making for a 70% reduction in the case of people taking both. Furthermore, the results are independent of weight, glycemic control, or asthma phenotype.

In terms of what was counted, the primary outcome was asthma attacks at 12-month follow-up, defined by oral corticosteroid use, emergency visits, hospitalizations, or death.

The effect of metformin on asthma attacks was not affected by BMI, HbA1c levels, eosinophil count, asthma severity, or sex.

Of the various extra antidiabetic drugs trialled in this study, only GLP-1 receptor agonists showed a further and sustained reduction in asthma attacks.

Here’s the study itself, hot off the press, published on Monday:

JAMA Int. Med. | Antidiabetic Medication and Asthma Attacks

“But what if I’m not diabetic?”

Good news:

More than half of all US adults are eligible for semaglutide therapy ← this is because they’ve expanded the things that semaglutide (the widely-used GLP-1 receptor agonist drug) can be prescribed for, now going beyond just diabetes and/or weight loss 😎

And metformin, of course, is more readily available than semaglutide, so by all means speak with your doctor/pharmacist about that, if it’s of interest to you.

Take care!

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  • Should I get a weighted vest to boost my fitness? And how heavy should it be?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Exercise training while wearing a weighted vest is undergoing somewhat of a renaissance. Social media posts and trainers are promoting them as a potential strategy for improving fitness and health.

    Exercising with additional weight attached to the body is nothing new. This idea has been used with soldiers for many centuries if not millennia – think long hikes with a heavy pack.

    The modern weighted vest comes in a range of designs that are more comfortable and can be adjusted in terms of the weight added. But could one be helpful for you?

    ZR10/Shutterstock

    What the research says

    One of the earliest research studies, reported in 1993, followed 36 older people wearing weighted vests during a weekly exercise class and at home over a 20-week period. Wear was associated with improvements in bone health, pain and physical function.

    Since then, dozens of papers have evaluated the exercise effects of wearing a weighted vest, reporting a range of benefits.

    Not surprisingly, exercise with a weighted vest increases physiological stress – or how hard the body has to work – as shown by increased oxygen uptake, heart rate, carbohydrate utilisation and energy expenditure.

    Adding weight equal to 10% of body weight is effective. But it doesn’t appear the body works significantly harder when wearing 5% extra weight compared to body weight alone.

    Does more load mean greater injury risk?

    A small 2021 study suggested additional weights don’t alter the biomechanics of walking or running. These are important considerations for lower-limb injury risk.

    The safety considerations of exercising with weighted vests have also been reported in a biomechanical study of treadmill running with added weight of 1% to 10% of body weight.

    While physiological demand (indicated by heart rate) was higher with additional weight and the muscular forces greater, running motion was not negatively affected.

    To date no research studies have reported increased injuries due to wearing weighted vests for recreational exercise. However a 2018 clinical study on weight loss in people with obesity found back pain in 25% of those wearing such vests. Whether this can be translated to recreational use in people who don’t have obesity is difficult to say. As always, if pain or discomfort is experienced then you should reduce the weight or stop vest training.

    Better for weight loss or bone health?

    While wearing a weighted vest increases the energy expenditure of aerobic and resistance exercise, research to show it leads to greater fat loss or retaining muscle mass is somewhat inconclusive.

    One older study investigated treadmill walking for 30 minutes, three times a week in postmenopausal women with osteoporosis. The researchers found greater fat loss and muscle gain in the participants who wore a weighted vest (at 4–8% body weight). But subsequent research in obese older adults could not show greater fat loss in participants who wore weighted vests for an average of 6.7 hours per day.

    There has been considerable interest in the use of weighted vests to improve bone health in older people. One 2003 study reported significant improvements in bone density in a group of older women over 32 weeks of weighted vest walking and strength training compared to a sedentary control group.

    But a 2012 study found no difference in bone metabolism between groups of postmenopausal women with osteoporosis walking on a treadmill with or without a weighted vest.

    Making progress

    As with any exercise, there is a risk of injury if it is not done correctly. But the risk of weighted vest training appears low and can be managed with appropriate exercise progression and technique.

    If you are new to training, then the priority should be to simply start exercising and not complicate it with wearing a weighted vest. The use of body weight alone will be sufficient to get you on the path to considerable gains in fitness.

    Once you have a good foundation of strength, aerobic fitness and resilience for muscles, joints and bones, using a weighted vest could provide greater loading intensity as well as variation.

    It is important to start with a lighter weight (such as 5% bodyweight) and build to no more than 10% body weight for ground impact exercises such as running, jogging or walking.

    For resistance training such as squats, push-ups or chin-ups, progression can be achieved by increasing loads and adjusting the number of repetitions for each set to around 10 to 15. So, heavier loads but fewer repetitions, then building up to increase the load over time.

    While weighted vests can be used for resistance training, it is probably easier and more convenient to use barbells, dumbbells, kettle bells or weighted bags.

    group of women exercising indoors using stretchy bands to add resistance
    The benefits of added weight can also be achieved by adding repetition or duration. Geert Pieters/Unsplash

    The bottom line

    Weighted vest training is just one tool in an absolute plethora of equipment, techniques and systems. Yes, walking or jogging with around 10% extra body weight increases energy expenditure and intensity. But training for a little bit longer or at a higher intensity can achieve similar results.

    There may be benefits for bone health in wearing a weighted vest during ground-based exercise such as walking or jogging. But similar or greater stimulus to bone growth can be achieved by resistance training or even the introduction of impact training such as hopping, skipping or bounding.

    Exercising with a weighted vest likely won’t increase your injury risk. But it must be approached intelligently considering fitness level, existing and previous injuries, and appropriate progression for intensity and repetition.

    Rob Newton, Professor of Exercise Medicine, Edith Cowan University

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

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  • Pinch of Nom – by Kate Allinson & Kay Allinson

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    “Home-style recipes”, because guess where most readers live!

    And: slimming, because trimming the waistline a little is a goal for many after holiday indulgences.

    The key idea here is healthy recipes that “don’t taste like diet food”—often by just switching out a couple of key ingredients, to give a significantly improved nutritional profile while remaining just as tasty, especially when flavors are enhanced with clever spicing and seasoning.

    The food is simple to prepare, while being “special” enough that it could be used very credibly for entertaining too. For that matter, a strength of the book is its potential for use as a creative springboard, if you’re so inclined—there are lots of good ideas in here.

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    Bottom line: if you’ve ever wanted to cook healthily but you need dinner on the table in the very near future and are stuck for ideas, this book is exactly what you need.

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  • Avocado Oil vs Olive Oil – Which is Healthier?

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    When comparing avocado oil to olive oil, we picked the olive oil.

    Why?

    Avocados and olives are both very healthy foods. However, when they are made into oils, there’s an important distinguishing factor:

    Olive oil usually retains a lot of the micronutrients from the olives (including vitamins E and K), whereas no measurable micronutrients usually remain in avocado oil.

    So while both olive oil and avocado oil have a similar (excellent; very heart-healthy!) lipids profile, the olive oil has some bonuses that the avocado oil doesn’t.

    We haven’t written about the nutritional profiles of either avocados or olives yet, but here’s what we had to say on the different kinds of olive oil available:

    Is “Extra Virgin” Worth It?

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    Ageism is rife, as is misogyny. And those can be internalized too, and compounded as they intersect.

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  • Chia Seeds vs Sunflower Seeds – Which is Healthier?

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  • How do I handle it if my parent is refusing aged care? 4 things to consider

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    It’s a shock when we realise our parents aren’t managing well at home.

    Perhaps the house and garden are looking more chaotic, and Mum or Dad are relying more on snacks than nutritious meals. Maybe their grooming or hygiene has declined markedly, they are socially isolated or not doing the things they used to enjoy. They may be losing weight, have had a fall, aren’t managing their medications correctly, and are at risk of getting scammed.

    You’re worried and you want them to be safe and healthy. You’ve tried to talk to them about aged care but been met with swift refusal and an indignant declaration “I don’t need help – everything is fine!” Now what?

    Here are four things to consider.

    1. Start with more help at home

    Getting help and support at home can help keep Mum or Dad well and comfortable without them needing to move.

    Consider drawing up a roster of family and friends visiting to help with shopping, cleaning and outings. You can also use home aged care services – or a combination of both.

    Government subsidised home care services provide from one to 13 hours of care a week. You can get more help if you are a veteran or are able to pay privately. You can take advantage of things like rehabilitation, fall risk-reduction programs, personal alarms, stove automatic switch-offs and other technology aimed at increasing safety.

    Call My Aged Care to discuss your options.

    An older man with a serious expression on his face looks out a window.
    Is Mum or Dad OK at home?
    Nadino/Shutterstock

    2. Be prepared for multiple conversations

    Getting Mum or Dad to accept paid help can be tricky. Many families often have multiple conversations around aged care before a decision is made.

    Ideally, the older person feels supported rather than attacked during these conversations.

    Some families have a meeting, so everyone is coming together to help. In other families, certain family members or friends might be better placed to have these conversations – perhaps the daughter with the health background, or the auntie or GP who Mum trusts more to provide good advice.

    Mum or Dad’s main emotional support person should try to maintain their relationship. It’s OK to get someone else (like the GP, the hospital or an adult child) to play “bad cop”, while a different person (such as the older person’s spouse, or a different adult child) plays “good cop”.

    3. Understand the options when help at home isn’t enough

    If you have maximised home support and it’s not enough, or if the hospital won’t discharge Mum or Dad without extensive supports, then you may be considering a nursing home (also known as residential aged care in Australia).

    Every person has a legal right to choose where we live (unless they have lost capacity to make that decision).

    This means families can’t put Mum or Dad into residential aged care against their will. Every person also has the right to choose to take risks. People can choose to continue to live at home, even if it means they might not get help immediately if they fall, or eat poorly. We should respect Mum or Dad’s decisions, even if we disagree with them. Researchers call this “dignity of risk”.

    It’s important to understand Mum or Dad’s point of view. Listen to them. Try to figure out what they are feeling, and what they are worried might happen (which might not be rational).

    Try to understand what’s really important to their quality of life. Is it the dog, having privacy in their safe space, seeing grandchildren and friends, or something else?

    Older people are often understandably concerned about losing independence, losing control, and having strangers in their personal space.

    Sometimes families prioritise physical health over psychological wellbeing. But we need to consider both when considering nursing home admission.

    Research suggests going into a nursing home temporarily increases loneliness, risk of depression and anxiety, and sense of losing control.

    Mum and Dad should be involved in the decision-making process about where they live, and when they might move.

    Some families start looking “just in case” as it often takes some time to find the right nursing home and there can be a wait.

    After you have your top two or three choices, take Mum or Dad to visit them. If this is not possible, take pictures of the rooms, the public areas in the nursing home, the menu and the activities schedule.

    We should give Mum or Dad information about their options and risks so they can make informed (and hopefully better) decisions.

    For instance, if they visit a nursing home and the manager says they can go on outings whenever they want, this might dispel a belief they are “locked up”.

    Having one or two weeks “respite” in a home may let them try it out before making the big decision about staying permanently. And if they find the place unacceptable, they can try another nursing home instead.

    An older Asian woman sits with her daughter.
    You might need to have multiple conversations about aged care.
    CGN089/Shutterstock

    4. Understand the options if a parent has lost capacity to make decisions

    If Mum or Dad have lost capacity to choose where they live, family may be able to make that decision in their best interests.

    If it’s not clear whether a person has capacity to make a particular decision, a medical practitioner can assess for that capacity.

    Mum or Dad may have appointed an enduring guardian to make decisions about their health and lifestyle decisions when they are not able to.

    An enduring guardian can make the decision that the person should live in residential aged care, if the person no longer has the capacity to make that decision themselves.

    If Mum or Dad didn’t appoint an enduring guardian, and have lost capacity, then a court or tribunal can appoint that person a private guardian (usually a family member, close friend or unpaid carer).

    If no such person is available to act as private guardian, a public official may be appointed as public guardian.

    Deal with your own feelings

    Families often feel guilt and grief during the decision-making and transition process.

    Families need to act in the best interest of Mum or Dad, but also balance other caring responsibilities, financial priorities and their own wellbeing.The Conversation

    Lee-Fay Low, Professor in Ageing and Health, University of Sydney

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

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