A New Generation of Weight Loss Drugs Makes Bold Promises, But Who Really Wins

In the months after having her second child, Sarah found herself fed up. The 40-year-old Seattle resident was cutting carbs and sugar, and exercising regularly, but couldn’t seem to shed the pounds she had put on during pregnancy. So when an email newsletter mentioned a new weight-loss drug called Wegovy, Sarah decided to give it a try. Eight months later, she is out more than $10,000—and down more than 60 lbs.

“Wegovy made losing weight almost effortless,” Sarah, whose name has been changed to protect her identity, told Quartz. “I’m not hungry often anymore and it doesn’t take any willpower to eat less. I simply don’t have any desire to overeat.”

Sarah is one of 125,000 US-based patients now taking Wegovy (whose generic name is semaglutide), a member of a new class of weight-loss drugs. These drugs work differently than the appetite suppressants popular among previous generations of dieters. They are also hitting the market at a different moment: one in which people are more eager than ever for realistic, science-based methods for addressing excess weight, even as a growing faction of activists and doctors voice skepticism of weight as an accurate measure of health.

A new class of weight-loss drug

In the mid-1990s, experiments on Gila monster venom found it contained hormones that could help lower blood sugar. That led to the diabetes drug Ozempic, which ultimately went on the market in 2018. People on that drug discovered a funny side effect: They lost weight.

In 2021, that same compound was approved by the US Food and Drug Administration (FDA) under the name Wegovy for the express purpose of weight loss. Drugs like Wegovy work in more complex ways than simply suppressing appetite, and promise fewer (though not zero) side effects.

Like Wegovy, many of these drugs were originally approved for other conditions; liraglutide (brand name Saxenda for weight loss) was also originally approved as a diabetes drug (Victoza). In fact, semaglutide and liraglutide work similarly in the body: They’re known as GLP-1 receptor agonists because they activate receptors for the glucagon-like peptide-1 (GLP-1) hormone, reducing appetite by slowing digestion and the rate at which the body takes up glucose.

Perhaps most important, the new drug promise significant weight loss. “The previous weight loss drugs were just modestly effective,” says John Buse, an endocrinologist at the University of North Carolina School of Medicine. The average patient would lose 5% of their body weight, in some cases up to 8%. But with semaglutide, he says, “we’ve gotten the kind of weight loss that makes people pay attention: 10-15% of body weight. That’s the average weight loss—half of people are losing more than that. It’s a gamechanger in the conversation…now that we have medicines for which a substantial proportion of patients can expect to lose 30 to 50 lbs.”

In one 68-week pre-approval clinical trial, patients on Wegovy did indeed lose 14.9% of their body weight on average, compared with 2.4% for people on a placebo. (Although, as several writers and scholars have pointed out, the study was funded by Novo Nordisk, which makes Wegovy.) Given the average weight of trial participants—100 kg, or 220 lbs.—that meant weight loss of about 15 kg, or 33 lbs. Other drugs in development have had similar results. In a recent trial for one called tirzepatide from Eli Lilly, more than half of patients lost at least 20% of their body weight—50 lbs. in many cases.

What it takes to lose weight

This new class of drugs is entering a market that at first glance seems ripe for breakthrough. According to the US Centers for Disease Control and Prevention (CDC), 42% of Americans—70 million people—meet the criteria for obesity (having a BMI of 30 or more). At one point or another, most of those people will try a diet and exercise regimen to lose weight.

But a growing body of research shows that diets are not an effective way to lose weight and keep it off. “Obesity is a complex disease… ​for most people, lifestyle modifications, diet, and exercise are just not enough,” says Katherine Saunders, a doctor at the Comprehensive Weight Control Center at Weill Cornell Medicine and co-founder of Intellihealth, an app-based platform that brings evidence-based obesity treatment to patients.

In part because of that complexity, bariatric surgery has since 2009 been considered the standard of care for patients looking to lose a substantial amount of weight. But these procedures can be invasive and expensive, and can come with significant and long-lasting complications.

The dearth of other options leaves some patients and doctors excited about this new generation of drugs. “Right now, the field is really looking for more efficacy, number one. People will do almost anything to lose weight,” says Buse. “We have more than just surgery now for promoting substantial weight loss. The most exciting thing is that obesity is on the ropes.”

A complicated picture

While hopes are high, the realities of taking these drugs can be more complicated for patients. There are often side effects—the most common for semaglutide and liraglutide are diarrhea, vomiting, and nausea. On Wegovy, Sarah says she’s experienced diarrhea so severe that a few times she had to delay her next dose.

Physicians can sometimes gloss over or downplay those effects. But a visit to dedicated Reddit pages for these drugs shows whole communities of patients struggling to adhere to the regimen when they’re feeling sick, and seeking support from a community to understand whether what seems like a severe reaction is normal. (Novo Nordisk did not respond to a request for comment.)

How well a patient can tolerate a drug “is something we think about quite a lot,” Saunders says. “We always start with lower doses and increase gradually as tolerated. Everyone is different. We keep in close touch with the patient and monitor them closely.”

And while these new drugs are relatively well-studied, there are still unknowns. They seem to help patients keep weight off more reliably than diet and exercise alone, but those benefits fade after people stop taking the drugs, and patients do often regain weight. There are also questions about long-term effects. In 1997, weight loss drug fenfluramine/phentermine (fen-phen) was pulled off the market after it was found to cause heart problems. More recently, Belviq (lorcaserin), which the FDA approved for weight loss in 2012, was pulled from the US market in 2020 because long-term use was found to increase the incidence of various types of cancers.

Even if a patient does want to go on one of these drugs, she might not be able to. Many patients keen to try Wegovy can’t access it at the moment, due to a supply chain issue that its manufacturer doesn’t expect to resolve until later this year. Even then, most US health insurers, including Medicare, do not cover drugs like Wegovy, and paying out of pocket can cost thousands of dollars per month. After Sarah’s doctor told her she doesn’t prescribe Wegovy, Sarah secured a prescription through an online health provider; she pays for it out of pocket.

The lack of insurance coverage is in spite of the fact that the American Medical Association declared obesity to be a disease in 2013. “The conversation around insurance coverage needs to be had with insurance companies, but also with employers,” says Kimberly Gudzune, the medical director for the American Board of Obesity Medicine. “It needs to be seen as an investment in your workforce.” The Treat and Reduce Obesity Act, which would expand Medicare to include obesity treatments, has been introduced to US Congress every year since 2012, but has never passed.

America’s love/hate relationship with weight

Though excess body fat was once considered a sign of wealth or fertility, over the past century a stigma has developed against larger bodies. Today doctors associate excess weight with medical conditions like heart disease, cancer, type 2 diabetes, sleep apnea, osteoarthritis, and depression. Studies also show that life is harder when you move through the world in a larger body. Fat people are less likely to be hired for a job, are paid less, are less likely to get married, and are less likely to be happy (though not if they’re living around other fat people). One 2006 study found that 46% of respondents would rather give up one year of life than be obese; 5% said they’d rather lose a limb.

The current state of research makes it impossible to unravel the full complexity of weight and health, but the conversation is starting to accommodate more nuance. Ubiquitous metrics such as body mass index are increasingly understood to be unreliable indicators (though doctors often still use them), and even the language around larger bodies is under review. Many physicians use “obese” to describe people who have excess weight or a BMI over 30, but activists are shying away from the word. “The reason…we are reluctant to use the words ‘overweight’ and ‘obesity’ is that they are made up, they can change,” says Tigress Osborn, a fat activist and chair of the National Association to Advance Fat Acceptance.

In fact, some research suggests that fat may have a protective effect on the body. “The body’s weight-regulating mechanism is about survival. It’s a system with more moving parts than we understand,” says Marilyn Wann, a fat activist and author of the book Fat!So? “Trying to remove weight from an individual or from the population is like trying to take a sledgehammer to the weather—we don’t know the unintended negative consequences we’re going to create.”

There are signs that in the future physicians may be more accepting of bodies of different sizes. But as weight loss drugs get more effective and more available, those cultural gains for body positivity (or body neutrality, or fat acceptance) may also be called into question.

A new relationship between doctors and patients

Overweight patients who come to see Shelly Crane might have an experience they’ve never had before. “I don’t initiate a weight-loss conversation with a patient,” says Crane, a family physician at Advocate Aurora Health in Milwaukee, Wisconsin. Most weight-loss programs come with more risk of harm than good, she says, and there’s not enough evidence that people who do lose weight are healthier in the end.

Crane doesn’t regularly prescribe new drugs for weight loss, though she says more patients are coming in and asking for them lately. Instead, she prefers to keep conversations focused on goals of care. “Patients say, ‘I know I need to lose weight,’ and I say, ‘Why do you think you need to lose weight? What would change in your life if your weight was lower?’” That gives her an opening to talk about health more broadly—how is the patient’s sleep? Their diet? Their mobility? “I try to stay in my sphere of what I’m able to do as a family doctor and really address the root of the health issue as much as I can.”

Crane was drawn to this approach by listening to her patients talk about experiencing size discrimination, and by following the work of fat activists such as Ragen Chastain and Aubrey Gordon. Though she’s been trained in a more integrative style of medicine, her approach toward body acceptance was also shaped by her discovery of intuitive eating during medical school. Since then, she’s been working on deprogramming herself and her colleagues from anti-fat bias.

Crane is part of a burgeoning movement among doctors to improve the treatment of larger patients. For some, that means skipping the dreaded weigh-in, a practice that is somewhat controversial within medicine. Medical organizations like the Association of American Medical Colleges also offer guidelines to reduce anti-fat bias among clinicians.

For doctors, the updated approach at least engenders trust, which can in turn get patients to seek medical care more frequently and improve their overall health. At most, it broadens the definition of what “healthy” means, and looks like.

Some fat activists see this shift as an important step. “The thing we hear most often from the public is, ‘I thought I had this thing, but all the doctor wanted to talk to me about is weight loss, and now the thing is worse,’” Osborn says. “It’s progress to have people in the medical establishment recognizing that there are other healthcare concerns besides weight, if weight is a healthcare concern.”

The hope is that this evolution continues. Activists want more people, in the medical profession and outside of it, to respect their autonomy. That becomes even more pressing in a possible future filled with weight-loss drugs—a future where a person can simply take a drug and stop being fat. “The ease with which I could become smaller—why should I? That should be up to me. Just like, if you believe it’s a medical disorder, the treatment I choose should be up to me,” Osborn says. “Like with anything else, if you believe fat is a disorder, we should let people decide whether people will get treated or not.”

“Fatness isn’t a problem to be solved in and of itself. It is not the root cause of all ills, as much as [medicine] would like to think it is,” Crane says. “We can help people live full, rich lives when we focus on goals of care and not on weight.”

By Alexandra Ossola

Source: A new generation of weight loss drugs makes bold promises, but who really wins? — Quartz

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What Happens to Your Body When You Don’t Get Enough Sleep?

We’ve all been there before: You promise yourself just a few more minutes—and suddenly, it’s 2 a.m. and you’re still wide awake. Perhaps you’re binging a new favorite Netflix series or fretting over a morning meeting— whatever the root cause, you’re tossing and turning in bed all night, instead of getting the shut-eye you so desperately need.

What most of us don’t understand, however, is what really happens to our bodies when we don’t achieve that optimal level of sleep, which for most adults clocks in between seven and eight hours. Ahead, we asked a few doctors to explain how are bodies react to too-little sleep—and their answers might surprise you.

It becomes more difficult to focus on mental and physical tasks.

According to Dr. Jan K. Carney, MD, MPH, the Associate Dean for Public Health & Health Policy, and Professor of Medicine at Larner College of Medicine at the University of Vermont and the National Institutes of Health, sleep is essential for health at every age. “When we don’t get enough sleep, it is harder to stay alert, focus on school or work, and react quickly when driving,” Dr. Carney says.

Your memory and mood suffers—and your appetite increases.

Sleep physician Dr. Abhinav Singh, MD, FAASM, the Medical Director of the Indiana Sleep Center, and Sleep Foundation Medical Review Panel member, says that, believe it or not, losing precious hours of sleep and drinking excessive amounts of alcohol have similar physical consequences. “Sleep loss is linked to memory impairment, poor mood, increased appetite (think obesity and diabetes), and reduced reflexes,” he says. “Increased reaction time and some studies have compared it to being worse than being intoxicated with alcohol.”

Long-term sleep shortage could lead to chronic physical and mental health concerns.

While Dr. Carney says the short-term risks of sleep loss are things we’re all familiar with—feeling drowsy and having trouble concentrating—the real risk is what a compounded lack of sleep can do over time. “Longer-term sleep shortage is associated with increased risks for chronic health conditions such as high blood pressure, heart disease, obesity, stroke, and depression.”

You can’t make up for lost sleep.

Unfortunately, you can’t “catch up” on sleep—once those hours are gone, they’re gone for good. “It is best to develop and keep regular sleep habits over the long term,” shares Dr. Carney, adding that you also can’t “learn to live” with less sleep. “The best way to ensure both adequate sleep and high-quality sleep is to develop good sleep habits.”

This means implementing a routine with a consistent bedtime and wake time each day—even on weekends. “Regular exercise helps, as does avoiding caffeine or alcohol near bedtime,” Carney says. “Our environment is essential—we need a calm, quiet, dark, and cool location where we sleep regularly.”

By:

Source: What Happens to Your Body When You Don’t Get Enough Sleep?

How Much Sleep Do You Need?

These guidelines serve as a rule-of-thumb for how much sleep children and adults need while acknowledging that the ideal amount of sleep can vary from person to person.

For that reason, the guidelines list a range of hours for each age group. The recommendations also acknowledge that, for some people with unique circumstances, there’s some wiggle room on either side of the range for “acceptable,” though still not optimal, amount of sleep.

Deciding how much sleep you need means considering your overall health, daily activities, and typical sleep patterns. Some questions that you help assess your individual sleep needs include:

  • Are you productive, healthy, and happy on seven hours of sleep? Or have you noticed that you require more hours of sleep to get into high gear?
  • Do you have coexisting health issues? Are you at higher risk for any disease?
  • Do you have a high level of daily energy expenditure? Do you frequently play sports or work in a labor-intensive job?
  • Do your daily activities require alertness to do them safely? Do you drive every day and/or operate heavy machinery? Do you ever feel sleepy when doing these activities?
  • Are you experiencing or do you have a history of sleeping problems?
  • Do you depend on caffeine to get you through the day?
  • When you have an open schedule, do you sleep more than you do on a typical workday?

Start with the above-mentioned recommendations and then use your answers to these questions to home in on your optimal amount of sleep.

How Were the Recommendations Created?

To create these recommended sleep times, an expert panel of 18 people was convened from different fields of science and medicine. The members of the panel reviewed hundreds of validated research studies about sleep duration and key health outcomes like cardiovascular disease, depression, pain, and diabetes.

After studying the evidence, the panel used several rounds of voting and discussion to narrow down the ranges for the amount of sleep needed at different ages. In total, this process took over nine months to complete.

Other organizations, such as the American Academy of Sleep Medicine (AASM) and Sleep Research Society (SRS) have also published recommendations for the amount of sleep needed for adults2 and children3. In general, these organizations closely coincide in their findings as do similar organizations in Canada.4

Improve Your Sleep Today: Make Sleep a Priority

Once you have a nightly goal based on the hours of sleep that you need, it’s time to start planning for how to make that a reality.

Start by making sleep a priority in your schedule. This means budgeting for the hours you need so that work or social activities don’t trade off with sleep. While cutting sleep short may be tempting in the moment, it doesn’t pay off because sleep is essential to being at your best both mentally and physically.

Improving your sleep hygiene, which includes your bedroom setting and sleep-related habits, is an established way to get better rest. Examples of sleep hygiene improvements include:

If you’re a parent, many of the same tips apply to help children and teens get the recommended amount of sleep that they need for kids their age. Pointers for parents can help with teens, specifically, who face a number of unique sleep challenges.

Getting more sleep is a key part of the equation, but remember that it’s not just about sleep quantity. Quality sleep matters5, too, and it’s possible to get the hours that you need but not

feel refreshed because your sleep is fragmented or non-restorative. Fortunately, improving sleep hygiene often boosts both the quantity and quality of your sleep.

If you or a family member are experiencing symptoms such as significant sleepiness during the day, chronic snoring, leg cramps or tingling, difficulty breathing during sleep, chronic insomnia, or another symptom that is preventing you from sleeping well, you should consult your primary care doctor or find a sleep professional to determine the underlying cause.

You can try using our Sleep Diary or Sleep Log to track your sleep habits. This can provide insight about your sleep patterns and needs. It can also be helpful to bring with you to the doctor if you have ongoing sleep problems.

By: Eric Suni  – SleepFoundation

Restricting Calories Leads To Weight Loss, Not Necessarily The Window of Time You Eat Them In

1

Results of a new weight loss study were published this week, leading to headlines proclaiming intermittent fasting “isn’t a magic diet trick after all”.The researchers aimed to test whether adding a restriction on what time of day you were allowed to eat (or not) to the usual low calorie (or kilojoule) diet led to greater weight loss compared to just following a low calorie diet. They recruited 139 adults whose average weight was 88 kilograms and age 32 years.

The participants were randomised to follow either the low calorie diet that had reduced their usual daily energy intake by 25%, or the same low calorie diet with the addition of a time period during which they were allowed to eat in an eight-hour window between 8am and 4pm each day.This approach is called “time-restricted eating” or a “16-hour intermittent fast”. Both groups received support from health coaches to follow their diets for 12 months.

Results showed that after one year, people in both groups lost 7-10% of their baseline body weight. While the low calorie group lost an average of 6.3 kilograms, the low calorie plus time restricted eating group lost 8 kilograms. Although there was a 1.8 kilogram difference between the groups, it was not a statistically significant difference.

Participants in both groups also had better blood sugar and blood fat levels and improved insulin sensitivity, but again there was no significant differences between groups.

1. It wasn’t based in the US

Most intermittent fasting studies have been conducted in the United States. This trial was done in China and recruited people in Guangzhou, so it provides important data using a culturally sensitive, prescribed calorie restriction over 12 months.

2. It showed small extra time restrictions on eating don’t make much difference

In their normal lives, the participants in Guangzhou had a usual window for daily eating of about 10.5 hours. Studies in other populations, particularly the US, show about 90% of adults have an eating window of 12 hours, with only 10% of adults having an overnight fasting period greater than 12 hours.

For more than 50% of people in countries like the US, the overnight fast is less than nine hours, meaning they eat over a 15 hour time period each day. So in the current study, the time restriction on eating was only minor – at about two hours less per day than what’s usual for people in China. This would not have been too big a difference from usual.

The researchers also reported that in China, the biggest meal is usually eaten in the middle of the day, so that was not influenced by the time restriction. In countries where the evening meal is the biggest or people snack all evening, then time restriction may still be a beneficial way to reduce intake.

A 2020 review of 19 studies that used time-restricted intermittent fasting found it was an effective treatment for adults with obesity, leading to greater loss of body weight and body fat, with significantly lower systolic blood pressure and blood glucose.

3. It showed support is imperative

Both groups in this trial were given a lot of support to adhere to the kilojoule-restricted diet. They were provided with one meal replacement shake per day for the first six months, to make it easier to follow the kilojoule restriction and help improve adherence to the diet.

They also received dietary counselling from trained health coaches for the 12 months of the trial. They received dietary information booklets that included advice on portion size and sample menus. They were encouraged to weigh foods to improve their accuracy in reporting kilojoule intakes and were required to keep a daily log with photographs of foods eaten and the time, using the study app.

They also received follow-up calls or app messages twice a week and met with the health coach individually every two weeks for the first six months. In the second six months, they continued to fill out their dietary records for three days per week and received weekly follow-up telephone calls and app messages and met with a health coach monthly. They also attended monthly health-education sessions.

This was a lot of support and is very important. Receiving long-term support to achieve health behaviour changes typically achieves a weight loss of 3–5% of body weight, which significantly lowers risk of weight-related health conditions, including a 50% lower risk of developing type 2 diabetes over eight years.

4. Even with good adherence, individual weight loss varies

Individual weight loss responses were very variable, even though adherence was high in this trial.

About 84% of participants adhered to the prescribed daily calorie targets and time restricted eating period. Weight loss at 12 months varied from 7.8 to 4.7 kilograms in the low calorie only group, and 9.6 to 6.4 kilograms in the low calorie plus time-restricted eating group.

As we have seen many times previously, this study confirms there is no one best diet for weight loss. It also shows small decreases in the window of time you’re eating probably won’t make a difference to weight loss.

By:

Laureate Professor in Nutrition and Dietetics, University of Newcastle

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Why Walking Might Be One of The Best Exercises For Health

To walk is to be human. We’re the only species that gets around by standing up and putting one foot in front of the other. In the 6 million years humans have been bipedal, our ability to walk upright has allowed humankind to travel great distances and survive changing climates, environments and landscapes.   

But walking is more than just transportation — it also happens to be really good for us. Countless scientific studies have found that this simple act of moving our feet can provide a number of health benefits and help people live longer. In fact, a walking routine — if done properly — might be the only aerobic exercise people need.

Many people have taken up strolls around the neighborhood and in nature to pass the time during the pandemic — and there are many reasons to keep it up, says Emmanuel Stamatakis, a professor of physical activity, lifestyle and population health at the University of Sydney.

“Regular walking has all the standard benefits of aerobic exercise, such as improvements in the heart and circulatory systems, better blood glucose control, normalization of blood pressure and reduction of anxiety and depression,” Stamatakis says.

The beauty of walking is that it’s free, it doesn’t require a lot of special equipment and can be done almost anywhere. Most people can maintain a walking practice throughout their lifetime. Yet, in the age of CrossFit and high-intensity cardio, walking is perhaps an under-appreciated way to get the heart pumping and muscles working. It also happens to be one of the most studied forms of exercise there is.   

Do You Really Need to Walk 10,000 Steps a Day?

In general, walking is good exercise because it puts our large muscle groups to work, and has a positive effect on most bodily systems, Stamatakis says.

But for the sake of efficiency — how much walking should one aim for? Public health experts have drilled into us the idea that we need 10,000 steps a day — or about five miles. But contrary to popular belief, this recommendation doesn’t come from science. Instead, it stems from a 1960s advertising campaign to promote a pedometer in Japan.

Perhaps because it’s a round number and easy to remember, it stuck. Countries like the U.S. began to include it in broader public health recommendations. Today, it’s often a default step count to reach on walking apps on smartphones and fitness trackers.

Since the 1960s, researchers have studied the 10,000-steps-a day standard and have turned up mixed results. Although clocking 10,000 steps or more a day is certainly a healthy and worthwhile goal — it’s not a one-size-fits-all fitness recommendation.

“Several studies have consistently shown that significant health benefits accrue well below 10,000 steps per day,” Stamatakis says.  

For instance, a recent Harvard study involving more than 16,000 older women found that those who got at least 4,400 steps a day greatly reduced their risk of dying prematurely when compared with less active women. The study also noted that the longevity benefits continued up to 7,500 steps but leveled off after that number. Put simply, 7,500 is also an ideal daily goal with comparable benefits to 10,000 steps.

Stamatakis notes that 7,500 steps also tend to be in line with common public health recommendations, such as the Centers for Disease Control and Prevention’s recommendation of 150 minutes of moderate physical activity a week for adults.

But picking up the pace might be a good idea. As with any exercise, the physical benefits one gains from walking depends on three things: duration, intensity and frequency. Put simply: walk often, walk fast and walk long. The goal is to walk fast enough to raise your heart rate — even if just for a short burst.

 “Any pace is OK, but the faster the walking pace the better,” Stamatakis says. “It’s ideal for 3,000 to 3,500 [of those steps] to be completed at a brisk or fast pace.”

Walk Faster, Live Longer

In a recent review study involving around 50,000 walkers, Stamatakis and his colleagues linked faster walking speeds to a reduced risk of dying from almost everything except cancer. How much you walk, rather than how fast you walk, might be more important for reducing cancer mortality, the review noted.

Similar boosts to longevity have been found in other studies. Recent work published in Mayo Clinic Proceedings analyzed the life expectancy of nearly 475,000 men and women who self-reported as slow or brisk walkers. The faster walkers — around a speed of 3 miles per hour (or, a 20-minute mile) — could expect to live roughly 15 to 20 years longer than slower walkers, or those who clocked 2 mph (a 30-minute mile.)

Participants who considered themselves brisk walkers had an average life expectancy of nearly 87 years for men and 88 years for women. Increases in lifespan were observed across all weight groups the study included.

What’s considered a quick pace is relative to an individual’s fitness level, but it generally falls somewhere between 3 and 5 mph. A cadence of 100 steps per minute or greater is a commonly accepted threshold for turning a walk into a moderately intense exercise.  

While we know walking is good for the body, research is also beginning to reveal how it impacts brain function. Particularly, walking might be an effective way to slow or decrease the cognitive declines that come with growing older.

A study of older, sedentary adults found that walking for six months improved executive functioning, or the ability to plan and organize. Studies also have found that that walking and other aerobic exercises can increase the size of the hippocampus, the brain area involved in memory and learning.

Researchers think exercises like brisk walking might improve brain plasticity, or the ability to grow new neurons and form new synaptic connections.  

Can You Lose Weight By Walking?

If walking can help you live healthier and longer, can it also help you shed excess pounds? Not exactly. A common misconception is that working out in and of itself can help someone lose weight. Diet is a far more important piece of the weight-loss equation, research suggests.  

At least one study illustrates that daily walks make little difference in weight management. Weight gain is common among first-year college students. Researchers wanted to determine if walking could ward off the pounds. Their study, published in the Journal of Obesity, monitored 120 freshman women over six months. Over the course of 24 weeks, the students walked either 10,000, 12,500 or 15,000 steps a day, six days a week. Researchers tracked their caloric intake and weight — and found that step count didn’t seem to influence the number on the scale. Even students who walked the most still gained around the same amount of weight. 

Often, when someone increases physical activity, some of the body’s normal physiological responses kick in to make up for the calories burned. One might start getting hungry more often and may eat more, without realizing it.

Even if with a tight control on daily caloric intake, it takes a lot of walking to accumulate a meaningful deficit. To put this in perspective, a 155-pound person would burn roughly 500 calories walking for 90 minutes at a rate of 4.5 mph.

However, walking does seem to influence a person’s body composition. Where a person carries fat might be a more important indicator of disease risk than body mass index. Avid walkers tend to have smaller waist circumferences. Waist measurements that are more than 35 inches for women and 40 inches for men have been linked with a higher risk for heart disease and Type 2 diabetes.

So a walk in the park maybe won’t make you “ripped” — but it sure beats sitting.

By Megan Schmidt

Source: https://www.discovermagazine.com

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Sweeteners May Be Linked To Increased Cancer Risk

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Sweeteners have long been suggested to be bad for our health. Studies have linked consuming too many sweeteners with conditions such as obesity, type 2 diabetes and cardiovascular disease. But links with cancer have been less certain.

An artificial sweetener, called cyclamate, that was sold in the US in the 1970s was shown to increase bladder cancer in rats. However, human physiology is very different from rats, and observational studies failed to find a link between the sweetener and cancer risk in humans. Despite this, the media continued to report a link between sweeteners and cancer.

But now, a study published in PLOS Medicine which looked at over 100,000 people, has shown that those who consume high levels of some sweeteners have a small increase in their risk of developing certain types of cancer.

To assess their intake of artificial sweeteners, the researchers asked the participants to keep a food diary. Around half of the participants were followed for more than eight years.

The study reported that aspartame and acesulfame K, in particular, were associated with increased cancer risk – especially breast and obesity-related cancers, such as colorectal, stomach and prostate cancers. This suggests that removing some types of sweeteners from your diet may reduce the risk of cancer.

Cancer risk

Many common foods contain sweeteners. These food additives mimic the effect of sugar on our taste receptors, providing intense sweetness with no or very few calories. Some sweeteners occur naturally (such as stevia or yacon syrup). Others, such as aspartame, are artificial.

Although they have few or no calories, sweeteners still have an effect on our health. For example, aspartame turns into formaldehyde (a known carcinogen) when the body digests it. This could potentially see it accumulate in cells and cause them to become cancerous.

Our cells are hard-wired to self-destruct when they become cancerous. But aspartame has been shown to “switch off” the genes that tell cancer cells to do this. Other sweeteners, including sucralose and saccharin, have also been shown to damage DNA, which can lead to cancer. But this has only been shown in cells in a dish rather than in a living organism.

Sweeteners can also have a profound effect on the bacteria that live in our gut. Changing the bacteria in the gut can impair the immune system, which could mean they no longer identify and remove cancerous cells.

But it’s still unclear from these animal and cell-based experiments precisely how sweeteners initiate or support cancerous changes to cells. Many of these experiments would also be difficult to apply to humans because the amount of sweetener was given at much higher doses than a human would ever consume.

The results from previous research studies are limited, largely because most studies on this subject have only observed the effect of consuming sweeteners without comparing against a group that hasn’t consumed any sweeteners. A recent systematic review of almost 600,000 participants even concluded there was limited evidence to suggest heavy consumption of artificial sweeteners may increase the risk of certain cancers. A review in the BMJ came to a similar conclusion.

Although the findings of this recent study certainly warrant further research, it’s important to acknowledge the study’s limitations. First, food diaries can be unreliable because people aren’t always honest about what they eat or they may forget what they have consumed. Although this study collected food diaries every six months, there’s still a risk people weren’t always accurately recording what they were eating and drinking.

Though the researchers partially mitigated this risk by having participants take photos of the food they ate, people still might not have included all the foods they ate. Based on current evidence, it’s generally agreed that using artificial sweeteners is associated with increased body weight – though researchers aren’t quite certain whether sweeteners directly cause this to happen.

Although this recent study took people’s body mass index into account, it’s possible that changes in body fat may have contributed to the development of many of these types of cancers – not necessarily the sweeteners themselves.

Finally, the risk of developing cancer in those who consumed the highest levels of artificial sweeteners compared with those who consumed the lowest amounts was modest – with only at 13% higher relative risk of developing cancer in the study period. So although people who consumed the highest amounts of sweetener had an increased risk of developing cancer, this was still only slightly higher than those with the lowest intake.

While the link between sweetener use and diseases, including cancer, is still controversial, it’s important to note that not all sweeteners are equal. While sweeteners such as aspartame and saccharin may be associated with ill health, not all sweeteners are.

Stevia, produced from the Stevia rebaudiana plant, has been reported to be useful in controlling diabetes and body weight, and may also lower blood pressure. The naturally occurring sugar alcohol, xylitol, may also support the immune system and digestion. Both stevia and xylitol have also been shown to protect from tooth decay, possibly because they kill bad oral bacteria.

So the important choice may be not the amount of sweetener you eat but the type you use.

By:

James is an Associate Professor in Biosciences in the School of Life and Health Sciences at Aston University, UK and a broadcaster with a number of television companies. James’s broadcasting includes work on BBC2’s Trust Me I’m a Doctor where he is the programmes most used contributor

Source: Sweeteners may be linked to increased cancer risk – new research

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Critics:

Artificial sweeteners (particularly aspartame and acesulfame-K) are associated with increased cancer risk, according to a study published online March 24 in PLOS Medicine. Charlotte Debras, from the Sorbonne Paris Nord University, and colleagues examined the associations between artificial sweetener intakes and cancer risk, overall and by site, among 102,865 adults from the French population-based cohort NutriNet-Santé (2009 to 2021), with a median follow up of 7.8 years.

The researchers found that higher consumers of total artificial sweeteners (above the median exposure) had increased risk of overall cancer compared with nonconsumers (hazard ratio, 1.13). Aspartame and acesulfame-K was associated with increased cancer risk (hazard ratios, 1.15 and 1.13, respectively). Risks were elevated for breast cancer (hazard ratio, 1.22 for aspartame) and obesity-related cancers (hazard ratios, 1.13 and 1.15 for total artificial sweeteners and aspartame, respectively).

“Our findings do not support the use of artificial sweeteners as safe alternatives for sugar in foods or beverages and provide important and novel information to address the controversies about their potential adverse health effects,” the authors write. “These results are particularly relevant in the context of the ongoing in-depth re-evaluation of artificial sweeteners by European Food Safety Authority and other agencies globally.”

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