Semaglutide Now Available to Help With Weigh Loss

Potential customers

Semaglutide was originally FDA-approved as a treatment for type diabetes. The drug mimics a natural hormone called glucagon-like peptide-1 (GLP-1). It will be sold under the trade name Wegovy. The dose of this injectable medication must be increased gradually over 16 to 20 weeks to 2.4 mg once weekly to reduce gastrointestinal side effects. I have no idea how much it will cost. From the FDA:

Today, the U.S. Food and Drug Administration approved Wegovy (semaglutide) injection (2.4 mg once weekly) for chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), for use in addition to a reduced calorie diet and increased physical activity. This under-the-skin injection is the first approved drug for chronic weight management in adults with general obesity or overweight since 2014. The drug is indicated for chronic weight management in patients with a body mass index (BMI) of 27 kg/m2 or greater who have at least one weight-related ailment or in patients with a BMI of 30 kg/m2 or greater. 

Click for the FDA news release.

The most common side effects of semaglutide include nausea, diarrhea, vomiting, constipation, abdominal (stomach) pain, headache, fatigue, dyspepsia (indigestion), dizziness, abdominal distension, eructation (belching), hypoglycemia (low blood sugar) in patients with type 2 diabetes, flatulence (gas buildup), gastroenteritis (an intestinal infection) and gastroesophageal reflux disease (a type of digestive disorder).  

Steve Parker, M.D.

Eat Chicken Brains for Longer life

Photo by Pixabay on Pexels.com

Dexter Kruger, a retired cattle rancher, is Australia’s oldest-ever living man. He’s 111 now. He attributes his longevity (only in part?) to eating chicken brains. The article doesn’t say whether the brains are cooked or raw. I’m heading over to Allrecipes lickety split.

Steve Parker, M.D.

PS: The Mediterranean dIet is famous for prolonging life. No chicken brains involved.

Mediterranean Diet Decreased Hospital Length of Stay, Reduced Mortality, and Cut Medical Costs of Elderly Patients

Somewhere on on the Mediterranean Sea

The study at hand involved 183 patients in Greece.

In multivariate analyses, hospital LOS [length of stay] decreased by 0.3 d for each unit increase of MedDiet score (P < 0.0001), 2.1 d for each 1 g/dL increase of albumin (P = 0.001) and increased 0.1 d for each day of previous admissions (P < 0.0001). Extended hospitalization (P < 0.0001) and its interaction with MedDiet score (P = 0.01) remained the significantly associated variables for financial cost. Mortality risk increased 3% per each year increase of age (hazard ratio [HR], 1.03; P = 0.02) and 6% for each previous admission (HR, 1.06; P = 0.04); whereas it decreased 13% per each unit increase of MedDiet score (HR, 0.87; P < 0.0001).

Conclusion

Adoption of the MedDiet decreases duration of admission and long-term mortality in hospitalized patients >65 y of age, with parallel reduction of relevant financial costs.

Steve Parker, M.D.

Source: Effects of Mediterranean diet on hospital length of stay, medical expenses, and mortality in elderly, hospitalized patients: A 2-year observational study – ScienceDirect

Lack of Related Coronavirus Antibodies Linked to Severe Illness from COVID-19

artist rendition of coronavirus
Antibodies against human coronavirus OC43 help suppress COVID-19

My colleagues and I often wonder why we see otherwise healthy 35- to 50-year-olds come into the hospital pretty sick with COVID-19. After all, isn’t it the 65 and older crowd with multiple chronic illnesses the ones that develop critical COVID-19? A recent study provides at least a partial explanation why some folks get much sicker than others.

First off, note that 30-40% of head colds are caused by coronaviruses. Most of us get one or two colds a year. SARS-CoV-2 is the particular coronavirus that causes COVID-19. Another human coronavirus, called OC43, commonly causes infection, which leads to antibody production. It turns out that these antibodies help protect us from severe disease caused by the COVID-19 coronavirus. Some of these otherwise healthy but now critically ill middle-aged COVID-19 patients just don’t have antibodies to OC 43. So SARS-CoV-2 spreads through them more virulently.

Steve Parker, M.D.

More Evidence for Effectiveness of Ivermectin Against COVID-19

No, you don’t have to inject the vaccine yourself

The May-June 2021 issue of American Journal of Therapeutics has a meta-analysis of various experiments using ivermectin both as prophylaxis against and treatment for COVID-19. I’m starting to think ivermectin is effective. Not only that, it’s inexpensive and relatively non-toxic.

From the aforementioned article:

Background: 

After COVID-19 emerged on U.S shores, providers began reviewing the emerging basic science, translational, and clinical data to identify potentially effective treatment options. In addition, a multitude of both novel and repurposed therapeutic agents were used empirically and studied within clinical trials.

Areas of Uncertainty: 

The majority of trialed agents have failed to provide reproducible, definitive proof of efficacy in reducing the mortality of COVID-19 with the exception of corticosteroids in moderate to severe disease. Recently, evidence has emerged that the oral antiparasitic agent ivermectin exhibits numerous antiviral and anti-inflammatory mechanisms with trial results reporting significant outcome benefits. Given some have not passed peer review, several expert groups including Unitaid/World Health Organization have undertaken a systematic global effort to contact all active trial investigators to rapidly gather the data needed to grade and perform meta-analyses.

Data Sources: 

Data were sourced from published peer-reviewed studies, manuscripts posted to preprint servers, expert meta-analyses, and numerous epidemiological analyses of regions with ivermectin distribution campaigns.

Therapeutic Advances: 

A large majority of randomized and observational controlled trials of ivermectin are reporting repeated, large magnitude improvements in clinical outcomes. Numerous prophylaxis trials demonstrate that regular ivermectin use leads to large reductions in transmission. Multiple, large “natural experiments” occurred in regions that initiated “ivermectin distribution” campaigns followed by tight, reproducible, temporally associated decreases in case counts and case fatality rates compared with nearby regions without such campaigns.

Conclusions: 

Meta-analyses based on 18 randomized controlled treatment trials of ivermectin in COVID-19 have found large, statistically significant reductions in mortality, time to clinical recovery, and time to viral clearance. Furthermore, results from numerous controlled prophylaxis trials report significantly reduced risks of contracting COVID-19 with the regular use of ivermectin. Finally, the many examples of ivermectin distribution campaigns leading to rapid population-wide decreases in morbidity and mortality indicate that an oral agent effective in all phases of COVID-19 has been identified.

Parker here again. My understanding of Emergency Use Authorization, which applies to all COVID vaccines used in the U.S. today, is that they are authorized only if there are no other proven effective treatments available. In which case, the Big Pharma vaccine manufacturers may want to suppress the study at hand.

Steve Parker, M.D.

PS: There is no consensus on the dose of ivermectin for the patients I see, i.e, those sick enough to be in the hospital. Single dose of 0.4 to 0.15 mg/kg? Subsequent dose seven days later “if needed”? I see multiple different dosing regimens in the article.

Resistance Training Improves Insulin Resistance in Overweight Men

Didn’t we already know this?

Insulin is a blood-borne hormone that the pancreas gland secretes in order to keep blood sugar levels from getting too high. (Insulin does many other things, but table that for now.) Insulin triggers certain body cells to absorb glucose from the bloodstream. “Insulin resistance” means that these cells don’t respond to insulin as well as they should, so either the pancreas secretes even more insulin (hyperinsulinemia) or blood sugar levels rise. Insulin resistance is a harbinger of type 2 diabetes mellitus. Most overweight or obese type 2 diabetics have insulin resistance. Many experts think hyperinsulinemia causes disease by itself, regardless of blood sugar levels. So it may be best to avoid insulin resistance and hyperinsulinemia.

The aim of the study was to investigate the effects of 6 weeks of resistance exercise training, composed of one set of each exercise to voluntary failure, on insulin sensitivity and the time course of adaptations in muscle strength/mass. Ten overweight men (age 36 ± 8 years; height 175 ± 9 cm; weight 89 ± 14 kg; body mass index 29 ± 3 kg m−2) were recruited to the study. Resistance exercise training involved three sessions per week for 6 weeks. Each session involved one set of nine exercises, performed at 80% of one‐repetition maximum to volitional failure. Sessions lasted 15–20 min. Oral glucose tolerance tests were performed at baseline and post‐intervention. Vastus lateralis muscle thickness, knee‐extensor maximal isometric torque and rate of torque development (measured between 0 and 50, 0 and 100, 0 and 200, and 0 and 300 ms) were measured at baseline, each week of the intervention, and after the intervention. Resistance training resulted in a 16.3 ± 18.7% (P < 0.05) increase in insulin sensitivity (Cederholm index). Muscle thickness, maximal isometric torque and one‐repetition maximum increased with training, and at the end of the intervention were 10.3 ± 2.5, 26.9 ± 8.3, 18.3 ± 4.5% higher (P < 0.05 for both) than baseline, respectively. The rate of torque development at 50 and 100 ms, but not at 200 and 300 ms, increased (P < 0.05) over the intervention period. Six weeks of single‐set resistance exercise to failure results in improvements in insulin sensitivity and increases in muscle size and strength in young overweight men.

Source: The effect of short‐duration resistance training on insulin sensitivity and muscle adaptations in overweight men – Ismail – 2019 – Experimental Physiology – Wiley Online Library

Steve Parker, M.D.

Scientists say new vaccines needed within a year

face mask, young woman
She’s at little risk of serious illness if she’s generally healthy

The problem is that the virus mutates over time, perhaps to the point that the vaccinated immune system doesn’t recognize the new mutant. Learn the word endemic; you’ll be hearing it more often.

From The Guardian in March, 2021:

The planet could have a year or less before first-generation Covid-19 vaccines are ineffective and modified formulations are needed, according to a survey of epidemiologists, virologists and infectious disease specialists.

* * *

The grim forecast of a year or less comes from two-thirds of respondents, according to the People’s Vaccine Alliance, a coalition of organisations including Amnesty International, Oxfam, and UNAIDS, who carried out the survey of 77 scientists from 28 countries. Nearly one-third of the respondents indicated that the time-frame was likely nine months or less.

Source: Covid: new vaccines needed globally within a year, say scientists | Coronavirus | The Guardian

Another issue is that we don’t know how long the vaccine’s effectiveness lasts. Pfizer’s CEO recently suggested a booster by be needed as soon as six months after the last shot.

Steve Parker, M.D.

Celebrity Culture Promotes Consumerism

h/t Fanatic Cook

Trainer Mark Rippetoe On the Impact of the Pandemic

young woman, exercise, weight training, gym
Not enough weight!
<p value="<amp-fit-text layout="fixed-height" min-font-size="6" max-font-size="72" height="80">Mark Rippetoe posted an interesting <a rel="noreferrer noopener" href="https://startingstrength.com/article/the-new-fitness-industry&quot; data-type="URL" data-id="https://startingstrength.com/article/the-new-fitness-industry&quot; target="_blank">article on changes in the fitness industry precipitated by the coronavirus pandemic</a>. He also appreciates the difference between exercise/recreation and <em>training</em>:Mark Rippetoe posted an interesting article on changes in the fitness industry precipitated by the coronavirus pandemic. He also appreciates the difference between exercise/recreation and training:

When the opportunity to expand the government’s control in the name of Public Health or Safety or Your Continued Well-being or Not Overwhelming the Healthcare System or whatever comes along next, suddenly your having fun is not nearly as important as obeying the commands of the petty little fucks that enjoy telling other people what to do. Fun is “non-essential,” you see. Your obedience isessential. And that is why your globogym is now closed. 

Depending on where you live and how much cash the corporation has on hand, it may be closed for a long time, or it might be closed permanently. Because it is viewed as Recreation, and is therefore “non-essential,” the petty fucks in charge feel no responsibility to ensure your fun – as if the kind of innocent fun a person has is their decision to make. 

And the government has already described their ideas about exercise. I wrote an article about this several years ago that shows you how completely divorced from our particular reality these fools are. It could be argued that their version of exercise is so utterly wasteful of time that you would in fact be better off locked in your house. And that is what they intend to do.

So it’s time for a paradigm shift. Training – the process we employ to intentionally increase our strength and our health over time – is fundamentally different than stopping by the club on the way home, catching a pump, catching a sweat, catching a shower, and finishing the trip having had fun. Training may actually be no fun at all. The results of training are enjoyable, but the process is hard, and it requires commitment, patience, and eventually the courage to do things you’re not sure you can do. It is an educational process, of teaching both your body and mind to be stronger.

Steve Parker, M.D.

Mediterranean Diet Lowers Parkinson’s Disease Risk for Women

  • santorini, greece

Investigators studied a female Swedish population.

Women who adhere closely to a Mediterranean diet in their 30s and 40s have a lower risk of Parkinson’s disease later in life, particularly once they reach their mid-60s, a large population-based Swedish study found.The study, “Mediterranean Dietary Pattern at Middle Age and Risk of Parkinson’s Disease: A Swedish Cohort Study,” was published in the journal Movement Disorders.Diet is increasingly recognized for its potential influence on a person’s risk of several diseases. With Parkinson’s, for instance, studies have suggested that dairy products could be a risk factor for its development.

Source: Holding to Mediterranean Diet Lowers Parkinson’s Risk for Women, Study Finds

Steve Parker, M.D.