The disease can take significant toll on emotional and social well-being. For example, people who have chronic OA pain may have to give up doing things they love, such as pickleball, gardening, or playing instruments. Difficulty participating in social and recreational activities can lead to feelings of isolation and loneliness. All this can spiral down into a sedentary life, raising risk for obesity, heart disease and diabetes. Chronic pain and physical limitations also can lead to feelings of frustration, sadness, anxiety, and depression. For these reasons and others, researchers at UCLA and elsewhere have been striving to find better treatments and cures for OA.

“There is the obvious challenge of optimizing the science of the treatment to make sure it is effective in all types of patients. But this process also requires obtaining funding in a fiercely competitive funding landscape, navigating the regulatory environment, and making the therapy available in the relatively near-term future,” explains Thomas Kremen, MD, an orthopedic surgeon, and clinician-scientist faculty member at UCLA’s David Geffen School of Medicine. “The commitment of significant funding greatly accelerates the pace of the research and allows for the implementation of therapies in my patients much faster than the traditional timeline for developing novel therapeutics.”

A MultiCenter Effort

UCLA Health is part of a multi-institution research team receiving the contract for up to $33 million from the federal Advanced Research Projects Agency for Health (ARPH-A) for the development of new treatments specifically focused on joint regeneration for OA. UCLA’s portion of the award will support the development of novel therapies, with the goal of completing an FDA phase 1 clinical trial within the next five years.

This multi-institution team, which also includes researchers from Duke University and Boston Children’s Hospital, is one of five selected to develop innovative forms of regenerative medicine–including affordable injectable and implantable therapies – that can regenerate joint tissue damaged by OA.

More Than Wear and Tear

The cause of OA has primarily been thought to be physical wear and tear, but it’s more complicated than that. “OA is multifactorial with contributions from our genetic backgrounds, environmental exposures, history of traumatic injuries, each patient’s individual activity level, medical comorbidities, and age,” explains Dr. Kremen. “While high-impact activities are generally thought to increase wear and tear in the joint, a lack of activity is also associated with joint degradation and progression of symptoms.”

Current recommendations to slow progression of OA include lifestyle behaviors such as not smoking, losing weight, and treating medical comorbidities such as diabetes. “As challenging as it is to lose weight, for each pound we lose that equates to 4 pounds of force removed from each knee joint, and patients really notice improved mobility and decreased joint pain when they do lose weight.”

While pain and stiffness also are symptoms of rheumatoid arthritis (RA), it is far less common than OA and a distinctly different disease process. RA affects about 1.3 million adults, women more than men, and tends to begin between the ages of 30 and 50.  Neither OA nor RA currently has a cure.

“With rheumatoid arthritis, an autoimmune disease in which the abnormal biology is more easily defined, there have been all sorts of advances in the last 20 years. With osteoarthritis, we haven’t made any progress,” says Dr. Kremen.

Joint replacement and surgeries for OA offer imperfect treatments. While there is no age limit for joint replacement per se, preexisting conditions may make the process and recovery more complicated for older adults. Joint injections work for some people, others not so much. And then there’s all the marketing hype surrounding regenerative stem cell treatments, of  which none are currently FDA-approved.

“We have much work to do to characterize the mechanisms by which these cells may influence the biology of healing,” says Dr. Kremen. “Like many things in life, if what a clinician is claiming about a cell-based therapy sounds too good to be true, then it probably is not true. If you are being offered a stem cell therapy or a birth product-based therapy (e.g. umbilical cord blood, placental tissue, or amniotic membrane derived products), this should only be done in the setting of a clinical trial.”

Insights Into Cartilage Regeneration

Tissue regeneration is a burgeoning field. Working alongside Dr. Kremen, the UCLA Department of Orthopaedic Surgery research team also includes Karen Lyons, PhD, professor, and vice-chair for research, and Weiguang Wang, PhD, an assistant research faculty member. All three of these investigators have developed innovative technologies that, when combined, lead to a novel multimodal treatment approach.

In the lab of Dr. Lyons, who is a developmental biologist, researchers have been studying the signaling pathways that cause cartilage to develop in utero during early development. Once Drs. Lyons, Wang and Kremen connected, the scientists wondered if they could target the same pathways to regenerate damaged cartilage and bone tissue in adult patients suffering from osteoarthritis.

“Many of the same pathways that were used during early development are redeployed when tissues try to repair themselves,” Dr. Lyons says.

While developmental biology studies offer important clues about which pathways might be best targeted to treat osteoarthritis, there are significant differences between newly formed joints and adult joints. Those include barriers like inflammatory pathways and a diminished pool of cells capable of regeneration and repair in adults.

To test how well these pathways might be employed to repair joint degeneration, the UCLA research team has used both genetic and pharmacologic approaches in mouse models to identify several drugs that have the potential to repair articular cartilage and its underlying bone.

In addition to using animal models, the researchers will be testing their strategies on a so-called “joint-on-a-chip” platform, which mimics the healthy or diseased features of joints inside of the body.

Moving Forward

Ultimately, the research team plans to develop three separate types of injectables that patients would receive once per year: one that targets joint tissues; another that targets adjacent bone; and a systemically administered drug that could treat cartilage tissues in patients who have OA in multiple joints.

At the end of five years, Dr. Kremen says, the researchers plan to have completed the testing of these treatments in phase I clinical trials, which will be conducted at UCLA.

“ARPA-H is really focused on commercialization and affordability,” Dr. Kremen says. “They have an ambitious timeline, because they, and we, want to get these therapies into people as soon as possible.”

“You gain immediate feedback from a knowledgeable physical therapy professional,” says Dr. Kremen.

Physical activity strengthens muscles and bones. If you have pain with one activity, Dr. Kreman suggests trying another activity that is known to be lower impact. For example, instead of running you try brisk walking, biking, or an elliptical machine. If those cause pain that is not tolerable, try something even lower impact like swimming or walking in the pool. 

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Blood Sugar Implications. Blood sugars can directly impact metabolism, hunger, and energy levels. Fluctuations in blood sugar can lead to cravings, overeating, and weight gain. Thus, by keeping your blood sugar stable, you may be able to reduce these nutrition challenges, making it easier to stick to a healthy diet and achieve your weight loss goals.

A Continuous Glucose Monitor (CGM) is a popular tech tool that tracks blood sugar in real time, transmitting data to an app on your phone. Originally designed for managing blood sugar levels in folks with diabetes, CGMs have gained traction in the general healthy consumer market for weight loss and habit change.

People with diabetes, prediabetes, and reactive hypoglycemia may benefit from wearing CGMs. Especially if on blood sugar-impacting medications, CGMs give crucial data to help inform about food, exercise, and medication dosing.

This data encourages gradual behavioral change, which is crucial for managing metabolic health. For instance, you may observe the impact of taking a walk after a meal or pairing a high-carb meal with fiber on your glucose levels. These insights help you develop habits that optimize both your health and may affect weight changes.

Why Use a CGM? A CGM tracks blood sugar levels in “real time,” providing information on how your body responds to different foods, activities, and stress. This can reveal patterns and help you make informed choices to maintain stable blood sugar levels, which is crucial for overall health and weight management, regardless of your diabetes status.

By understanding your unique glucose response, you can personalize your nutrition and exercise plans. CGMs can aid in developing healthier habits by showing the immediate impact of actions like taking a walk after a meal or combining high-carb foods with fiber and protein. This real-time feedback may reinforce behavior changes that optimize metabolic health and prevent potential future health issues.

Groups that may benefit from wearing a CGM who don’t have diabetes include people with:

• Prediabetes
• Hypoglycemia
• A family history of diabetes and want to prevent it
• An interest in data and want real-time feedback for habit change

Who Should Not Use a CGM for Weight Loss? While CGMs can be beneficial for many seeking weight loss, they are not suitable for everyone. Individuals with a history of eating disorders should be cautious, as the constant monitoring of blood sugar levels can be triggering to their mental health.

CGMs offer insights into blood glucose levels, but using them for weight loss may oversimplify the complex relationship between food, health, and body weight, says Kristin Draayer, MS, RDN. For individuals without diabetes, using a CGM can lead to obsession, stress, or anxiety over food choices, she notes.

Aside from diagnosed eating disorders, CGMs may cause individuals without eating disorders to develop unhealthy relationships with food. The pressure to constantly monitor and adjust dietary choices based on glucose readings can contribute to stress and an unhealthy preoccupation with eating. If you’re considering a CGM for weight loss, consult a trusted healthcare professional to ensure it is part of a balanced and personalized health plan.

Can CGMs Help with Weight Loss? Using a CGM may increase awareness of how lifestyle choices affect your body. Research indicates that self-monitoring is crucial for maintaining weight loss, and a CGM offers a high-tech way to do this. Melissa Mitri, MS, RD, explains, “Since your glucose and insulin levels can affect your weight, many people use it solely as a weight loss tool. It tracks your glucose levels throughout the day, providing insight into how your diet affects these levels.”

CGMs might help with weight loss by providing real-time data on how your body reacts to different foods and activities, although this is a new field of medicine that we don’t have conclusive evidence on yet. However, the immediate feedback allows you to understand how specific dietary choices and physical activities affect your blood sugar levels, enabling you to make more informed decisions—a concept known as self-monitoring.

Research shows that self-monitoring is a key habit for maintaining weight loss. A study published in the journal Obesity found that self-monitoring, including tracking dietary intake and physical activity, is associated with better weight loss outcomes. CGMs offer a high-tech way to implement self-monitoring, tracking glucose levels throughout the day to highlight how diet and lifestyle choices impact your glucose metabolism. Ultimately, this can indirectly encourage behaviors that promote weight loss.

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Hiatal hernias are common. Approximately 55 percent to 60 percent of adults over 50 have this condition, which occurs when part of the stomach pushes through the diaphragm— the muscle separating the chest from the abdomen. As women age, diaphragm muscles can weaken, increasing the risk of a hiatal hernia. Additionally, postmenopausal women often experience changes in abdominal pressure related to weight gain and this is a risk factor, as well.

A small hiatal hernia can become larger over time due to aging, increased abdominal pressure, or repetitive strain. To prevent a small hiatal hernia from worsening, maintain a healthy weight, lose weight if you have overweight or obesity, and avoid heavy lifting to minimize abdominal muscle strain. A small hiatal hernia is often symptom-free, whereas a larger one can cause stomach acid to back up into the esophagus, causing heartburn and chest pain. To prevent hiatal hernia symptoms, eat smaller, more frequent meals; avoid eating close to bedtime; and steer clear of alcohol, spicy foods, citrus fruits, coffee, chocolate, and tomatoes. To treat hiatal hernia symptoms, several medications can be used:

Antacids: These help neutralize stomach acid and provide quick relief. Examples include: Rolaids, Tums, and Mylanta.

H-2 Receptor Blockers: These reduce acid production. Examples include Pepcid, Tagamet, and Zantac.

Proton Pump Inhibitors (PPIs): These also reduce acid production, but are more potent than H-2 blockers. Examples include Nexium, Prilosec, and Aciphex.

If medications fail, surgery may be recommended. Discuss your concerns with a health-care provider, so you can get personalized advice.

I am considering trying a Pilates class. I’m 65 and have arthritis and lower back pain. Can Pilates help alleviate my pain?

Pilates, developed by Joseph Pilates in the early 1900s, focuses on strengthening core abdominal and back muscles, which support the rest of the body. It can improve flexibility and balance, making it beneficial for individuals with arthritis and lower back pain. Exercises are performed on a mat or a machine called a “reformer” that uses resistance for a low-impact workout. Due to its low-impact nature, Pilates is often easier on the joints and less strenuous compared with other exercises.

When researchers performed an analysis of several studies in an effort to find out if Pilates was helpful for older adults with chronic musculoskeletal conditions, they gave it a thumbs up. Their review of seven studies that included close to 400 adults over age 50 (about 75 percent were female) showed that Pilates was quite effective for reducing back pain, as well as other osteoarthritis and osteoporosis pain.

Many senior centers, health clubs, and YMCAs offer Pilates classes tailored to older adults. Attend classes led by a qualified instructor to ensure proper technique, and be sure to inform the instructor about your arthritis and back pain in case position or equipment modifications are warranted. It sounds like Pilates will be an excellent choice for you, but just as with any new fitness program, it’s a good idea to check with your doctor to make sure that this form of exercise is appropriate for you.

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But, when you talk to different people about protein, and the odds are good that you’ll hear plenty of contradictory statements. It seems many of us are confused about everything from how much protein we need to whether all sources are created equal.

Let’s clear up some confusion on this mighty macro.

Myth #1: We All Need the Same Amount. For adults, the US Recommended Dietary Allowance (RDA) for protein is 0.8 grams per kilogram of body weight. “This should not be considered an optimal amount for many people,” says Susie. “The RDA is the lowest bar to prevent deficiency.” As with most things in nutrition, there’s no simple answer when it comes to protein requirements. Susie explains that your ideal intake depends on many factors including your activity level, age, and whether you are pregnant or lactating. “As we age we start to lose muscle mass so can benefit by eating more protein,” Susie notes. All this is to say that you need to individualize your protein intake based on your specific needs.

Myth #2: All Plants are Created Equal. With the rising popularity of plant-based eating, you may have heard that foods like beans and nuts are great sources of non-meat protein. Not necessarily. A cup of cooked black beans has 15 grams of protein, but 41 grams of carbs, so should be considered more carbs than protein. An ounce of almonds has 6 grams of protein, yet double the amount of fat, so should be thought of as a fat source and protein secondary. “You need to be more aware with plant-based eating that you are getting all the protein you require,” Susie says. There are plant options like tofu, tempeh, and seitan that tend to be more protein-dense. 

But as long as you are meeting your total protein requirements, which as a reminder varies among individuals, Susie explains that it does not matter much if they mostly (or all) come from plants.

Myth #3: Eat Only Lean Protein. You’ve probably heard that if you are eating animal-based proteins you should focus mostly on “lean proteins.” What does lean protein mean? The loose definition of a lean protein is one that has no more than three grams of fat per ounce. That would include items like chicken breast and pork tenderloin. Salmon, full-fat yogurt, and eggs, on the other hand, would not be considered lean proteins. Some of the focus on lean proteins is a holdover from the days when fat was the enemy.

“You want to limit your intake of saturated fat from meats like beef, but you still can eat animal-based protein foods that are higher in fat,” says Susie. For instance, she zeroes in on salmon, a serving of which has three times as much fat as a serving of ham. But a big chunk of fat in salmon is in the form of heart-healthy omega-3s. Eggs provide not just fat and cholesterol, but also a range of essential micronutrients as well as very high-quality protein.  “Fat in yogurt can make it more satiating,” notes Susie. You need to look at the whole nutrition picture of non-lean proteins. And there’s nothing wrong with enjoying meat that’s higher in fat, as long as it fits into your total fat, saturated fat, and calorie budget for the day. 

Myth #4: You Need Protein Powder. Today, you can find countless types of protein powders on store shelves and online. And, no doubt, they are a convenient way to add protein to your diet. While powders are a great protein source, Susie stresses they shouldn’t act as a substitute for whole food sources, both animal and plant alike. “Food is so much more than protein and can provide valuable nutrients that you don’t get in powders,” Susie says. And she believes most people can meet their protein needs without using powders. So don’t make powders your primary protein source but rather a small part of a varied protein diet.

Myth #5: High Protein Diets are Best for Weight Loss. By increasing both the thermic effect of eating—the energy (calories) you need to spend to process what you eat—and satiety, protein is often heralded as the macro you need more of to shed pounds. And, yes, some research suggests that focusing on eating a bit more protein can help with weight loss efforts. But, Susie cautions that there is a limit to this effect and simply adding a lot more protein to your diet is not a weight loss guarantee. “Too much of anything is excess calories that can contribute to weight gain.” She recommends taking a more personalized approach to your nutrition and finding what works for you instead of just assuming eating large amounts of protein is what you should be doing. And, yes, it is possible to lose weight and keep it off on a diet that contains a good balance of carbohydrates, protein, and fat.

The post 5 Protein Myths to Stop Believing appeared first on University Health News.

Building and Maintenance.

The two key mechanisms for keeping your brain healthy are: 1) building brain capacity (cognitive reserve), and 2) preserving that capacity by protecting the brain from detrimental changes.

It’s thought that people with larger cognitive reserves are better able to maintain their cognitive function for longer. Simply put, the more neurons and connections we have in our brains, the more losses we can sustain without noticeable effects. Anything that damages the brain or its blood vessels can take away some of that cognitive reserve.

Let’s take a look at everyday actions you can take to build and maintain cognitive reserve:

Be careful.

Numerous studies have found an association between head injuries and subsequent development of dementia. Wear a helmet when biking and appropriate protective gear when playing sports. Use a seatbelt every time you’re in a car. Keep walkways clear of clutter, secure the ends of area rugs, use non-slip mats and grab bars in tubs and showers, and have good lighting in your home to minimize the risk of falling.

Rest up.

Poor sleep is associated with increased risk for cognitive decline and dementia. It may also increase risk for many of the other dementia risk factors discussed here, including cardiovascular disease, high blood pressure, high blood sugar, obesity, and depression, and falls. The current recommendation is that most adults get seven to nine hours of sleep each night.

Experts recommend going to sleep and waking up around the same time every day, staying off screens and away from caffeine in the hours before bed, and adjusting the light, temperature, and any other environmental conditions so you are as comfortable as possible. If insomnia, sleep apnea, anxiety, or urinary problems are disrupting your sleep, seek help from a healthcare provider.

Avoid tobacco.

Studies have found smoking and vaping increase the risk for cognitive decline and, possibly, dementia. The chemicals can also damage blood vessels, including those feeding the brain. This results in the build-up of cholesterol-laden plaque in the carotid arteries, causing narrowing. The good news is, quitting smoking lowers these risks. Air pollution may have similar effects.

If you smoke, make a plan to quit. “Quitlines” and smoking cessation programs can help. Seek help from your healthcare provider if necessary. If you don’t smoke, try to limit your exposure to second-hand smoke. If you live in an area with high air pollution, filter indoor air and limit outdoor exercise.

Increase physical activity.

Regular physical activity has been associated with lower risk of cognitive decline. Getting your heartrate up increases blood flow, which may benefit brain cells by delivering more oxygen and nutrients, but some studies have shown even engaging in less vigorous activities—such as walking or strength training—is associated with brain benefits. Being active also helps prevent or control high blood pressure and type 2 diabetes, both of which increase risk for dementia, and it can lower your risk of falling.

The current recommendation is to aim for 150 minutes a week of moderate activity (like gardening or brisk walking) or 75 minutes of more vigorous activity (like jogging or pickleball) every week. Engaging in resistance training at least two days a week is also recommended. But any activity, in any amount, at any age is good.

Nourish yourself.

Regularly consuming a healthy dietary pattern can reduce your risk of heart disease, stroke, diabetes, and obesity—all of which are associated with increased risk for cognitive decline and dementia. A healthy diet is also associated with lower risk for Alzheimer’s disease as well as Parkinson’s disease (which can cause dementia).

Fill your plate with whole or minimally processed fruits, vegetables, beans, lentils nuts, seeds, whole grains, seafood, poultry, lean meats, low fat or fat free dairy, and healthy plant oils in place of foods high in saturated fat (fatty meats, full fat dairy, and tropical oils) and ultraprocessed foods (UPFs). A study that looked at the dietary intake of nearly 11,000 adults in Brazil found that dietary patterns containing more UPFs (like white bread, baked goods, processed meats, desserts and sugar-sweetened and artificially sweetened drinks) were associated with a higher rate of cognitive decline in six to 10 years of follow-up. (The study did not determine if this was due to the UPFs or the fact that they replaced healthier choices.)

It’s never too late to adopt a healthy diet. Studies show making these changes even in later life can benefit brain health.

Hear well.

Hearing loss has been associated in some research with higher risk of developing dementia. One reason is hearing loss can cause social isolation, which means less time interacting with others and learning new things.

In a study of over 430,000 adults aged 40 to 69 years, uncorrected hearing loss was associated with a higher risk of developing dementia compared to not having hearing loss or wearing hearing aids. A randomized controlled trial involving nearly 500 participants found a connection between hearing loss and cognitive decline only in participants already at higher risk for cognitive decline.

If you suspect you or someone close to you suspects you have trouble hearing, it is important to be tested. If it is determined a hearing aid will help, get one!

Evaluate health conditions.

Several common health conditions can increase dementia risk. Mid-life high blood pressure, for example, is associated with dementia later in life. Studies have also shown an association between type 2 diabetes and increased risk of cognitive decline and possibly dementia. High blood levels of LDL cholesterol can lead to hardening of the arteries, which contributes to vascular dementia by restricting blood flow to the brain and causing ischemic stroke. There is some evidence of a link between depression and cognitive decline as well, but not all research agrees.

Get regular check-ups, consume a healthy dietary pattern, be physically active, and take medications as prescribed if you have these conditions.

Avoid excessive alcohol use.

Heavy drinking is associated with cognitive impairment and dementia. (Research has found this association with weekly intake of the amount of alcohol in around two 750 milliliter bottles of wine, nine typical beers, or two cups of liquor or more.) While the impact of moderate drinking is unclear and some studies have found light drinking to have a possible protective effect, it is best to stick to the recommendation of no more than one alcoholic drink a day for women and two for men (and, if you don’t drink, don’t start.)

Lose weight (if you have obesity).

A mid-life body mass index (BMI) of 30 or above (defined as obesity) has been associated with increased dementia risk. Having an “overweight” BMI in midlife (25 to 30) has not. In fact, a 2023 study of older adults found that reduced BMI and waist circumference was associated with an increased risk of dementia in participants who did not have obesity.

If you have obesity, make healthy dietary choices, be as active as you can, work to address stress and emotional issues, try to get at least seven hours of quality sleep a night, and talk to your healthcare provider or a weight loss specialist to get help and support.

Train your brain.

Education builds cognitive reserve. Less education in early life (age 20 and under) is strongly associated with risk of developing dementia. While it has not been proven that continuing education later in life reduces risk for cognitive decline or dementia, taking an adult class in your community (or online), studying a new language, or learning a new skill is highly recommended.

Based on research to date, experts recommend regularly challenging your brain. This increases blood flow to the brain and builds new connections. Choose activities for which you need to make an intellectual effort and focus. Learn a new language or skill, be creative, take up an instrument or hobby, travel, or regularly play strategy games or do puzzles. Be aware that, while some so-called “brain-training” games may be beneficial, many make unsubstantiated claims. There is no “app” that has been proven to prevent Alzheimer’s disease or any other form of dementia.

Have fun!

Social isolation has been associated with higher risk of developing dementia. It can be hard to disentangle this from dementia increasing social isolation, but experts agree socializing is important. So, call a friend or, better yet, get out, get moving, register for an adult course, join a walking group, volunteer, and stimulate your brain with others!

The post Taking Care of Your Brain appeared first on University Health News.

Expanded Approval

Wegovy was approved by the FDA in 2021 specifically for weight loss in adults who were overweight or obese and had at least one weight-related condition (such as type 2 diabetes or high blood pressure). The drug—given as a once-weekly injection— contains a higher dose of semaglutide than its close cousin, Ozempic.

Studies that followed the approval of Ozempic indicated that it lowered the risk of major cardiovascular events in people with diabetes. Recent research (New England Journal of Medicine, Dec. 14, 2023) showed that the higher dose of semaglutide contained in Wegovy also reduced the risk of cardiovascular events, even in people who did not have diabetes. The study included 17,604 people; about 30 percent were ages 65 and older, and 8 percent were ages 75 and older. All of the participants were overweight or obese and had established cardiovascular disease but no history of diabetes. At the end of an average three-year follow-up, people treated with semaglutide had a 20 percent lower risk of major adverse cardiovascular events (cardiovascular death, nonfatal heart attack and nonfatal stroke), compared with those who took a placebo (inert substance). The FDA took note—on March 8, it expanded its approval of Wegovy to include reducing the risk of cardiovascular death, heart attack, and stroke in people who have cardiovascular disease and are either overweight or obese. On March 21, CMS announced that it now will cover Wegovy for Medicare recipients who are at increased risk of heart attacks or stroke.

Semaglutide and Weight Loss

Semaglutide is a glucagon-like peptide-1 (GLP- 1) receptor agonist. “These drugs mimic the action of GLP-1, a hormone that stimulates the body to produce more insulin, a hormone that lowers blood sugar,” Beizer says. “GLP-1 also plays a role in regulating appetite, partly by suppressing cravings and partly by slowing the movement of food from the stomach to the small intestine. This helps you feel full for longer and may reduce the amount of food you eat.”

Numerous studies have shown that excess weight harms cardiovascular health, and that losing weight may help mitigate or even reverse those harms. But is it weight loss alone that underpins the cardiovascular benefits seen with semaglutide? Possibly not. “Animal studies have shown that GLP-1 receptor agonists reduce systemic inflammation, which is associated with a wide range of health conditions, including cardiovascular disease,” Beizer observes. “The drugs also appear to limit the development of cholesterol plaques that otherwise might narrow or even block arteries and reduce the risk of blood clots.”

What to Know About Taking Wegovy

If you meet Medicare’s prescribing criteria and have been struggling to maintain a normal weight, Wegovy might be helpful. “But keep in mind that you will have to keep taking the drug to benefit from its weight-loss properties,” Beizer says. “If you stop taking the medication, you likely will regain the weight you lost.” Also try not to see the drug as a “miracle cure” that relieves you of the need to follow lifestyle strategies that can help limit weight gain. Instead, view it as just one element in a trifecta that includes a healthy reduced-calorie diet and increased physical activity.

It also is important to be aware of common side effects that can accompany Wegovy, including nausea, vomiting, diarrhea, constipation, and headaches. In the study we reference, about one-third of participants who took Wegovy reported side effects, and about 17 percent left the study due to those effects. “Side effects do typically ease once you get used to the medication, and you may be able to lessen or avoid them by starting on a low dose and gradually increasing it,” Beizer says. More serious side effects are extremely rare and may include kidney problems, vision changes, pancreatitis, increased heart rate, depression, and certain cancers.

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In a survey conducted in 2008—but equally relevant today—the University of North Carolina Chapel Hill’s Center for Excellence for Eating Disorders, in partnership with SELF Magazine, asked 4,023 American women between the ages of 25 and 45 detailed questions about their eating habits. They found that 65 percent of the women reported at least one disordered eating behavior. These behaviors included trying to lose weight even when already at a healthy weight, finding that concerns about food and weight interfered with their happiness, regularly skipping meals to try to lose weight, becoming “extremely upset” over gaining five pounds, cutting out entire food groups, and eating 1,000 calories or less per day.

These behaviors are not unusual—just consider current diet trends such as Paleo, intermittent fasting, and clean eating—but they are examples of disordered eating, which the study authors defined as “endorsing unhealthy or maladaptive eating behaviors, such as restricting, binging, purging, or use of other compensatory behaviors, without meeting criteria for an eating disorder.”

The Eating Behavior Spectrum. It’s easy to see why restricting food intake is “unhealthy or maladaptive” in the context of a clinical eating disorder such as anorexia nervosa. It’s not so easy to see why restricting food is a problem in the context of trying to lose weight through dieting or “lifestyle changes,” especially when health is one of your reasons. Many things exist on a spectrum—and one spectrum includes dieting, disordered eating, and clinical eating disorders.

“A lot of my clients began looking into nutrition with great intentions to become ‘healthier,’ and tracking macros or abiding to ‘eat this, not that’ type of rules may have felt initially supportive to their lives,” says Mya Kwon, MPH, RD, CD, a Seattle-based registered dietitian nutritionist and owner of Food+Body Peace. “However, in many cases, it soon becomes an obsession ridden with control, guilt, and fear.”

If you find yourself consumed by thoughts of food and obsessively meal planning, those are signs that the diet is becoming harmful, says Maria Adams, MS, MPH, RDN, LDN, Boston-based registered dietitian nutritionist and owner of Hälsa Nutrition. “Diets that are restrictive from the start—whether by counting macros or calories, limiting when you can eat, or restricting what you can eat—are more likely to become problematic.”

When someone manipulates their eating and exercise to try to change their body, maybe because they want to “get healthy,” lose the Freshman 15, look better in their wedding dress, regain their pre-pregnancy body, start dating again after a divorce, or shed menopausal weight gain, they often view it as self-care or a self-improvement project. When they see results, they feel successful and maybe better about their bodies—but these feelings are dependent on maintaining those changes, and most people who intentionally lose weight regain most or all of it. This sets the stage for yo-yo dieting, feelings of failure with each round of weight regain, and increased food and body obsession. This is where “just a diet” can move along the spectrum into disordered eating or beyond, harming mental and physical health.

“The biggest sign to me that suggests that a diet has become harmful or maladaptive is when it’s become rigid and controlling of someone’s life, inducing a lot of fear and guilt,” Kwon says. “Food is meant to nourish your life physically and emotionally, and support your life—not limit your life or become your entire life.”

What is “Healthy”? Kwon says the reasons why you’re eating what you’re eating provide a bigger clue to whether your eating plan has become harmful than simply what you’re eating, even if your initial motivation was the desire to live a healthier life. If that motivation starts to cause severe anxiety because you start to feel you must always follow your eating plan perfectly, Kwon asks, is that healthy? What if the plan’s rigidity limits participation in social events, interferes with relationships, or induces fear of eating instead of joy of eating?

She says when the nervous system is in “fight-or-flight” mode, it’s not an optimal physiological state for the body to digest food, “but this is the system you are triggering when eating in a state of anxiety and fear.”

Adams agrees that even a “healthy” diet may be unhealthy if it’s having a negative effect on mental and emotional well-being. “Is it really healthy if you’re missing out on your aunt’s famous BBQ dinner, which you love, because you’re following, say, a Mediterranean diet plan? Having flexibility around eating and an overall good relationship with food is arguably just as important—if not more important—than what you eat.”

The post Is it a Diet or is it Disordered Eating? Here’s How to Tell appeared first on University Health News.

One well-recognized approach is Health at Every Size^® (HAES^®), which is housed by the Association for Size Diversity and Health (ASDAH) and “…affirms a holistic definition of health, which cannot be characterized as simply the absence of physical or mental illness, limitation, or disease. Rather, health exists on a continuum that varies with time and circumstance for each individual.” In short, the HAES^® approach does not focus on body weight, shape, or size but instead highlights and encourages a meaningful lifestyle that includes eating based on body cues (hunger and fullness) and by participating in reasonable and appropriate levels of physical activity.

Due to HAES^®, certain key assumptions that follow traditional weight management paths have been challenged, including:

• That the only way for a person living with obesity to improve their health is to lose weight;
• That adiposity (being overweight or obese) in and of itself poses a significant risk of disease and death;
• That anyone (if they are determined) can lose weight and keep it off through diet and exercise.

None of the above assumptions have been solidly backed by scientific evidence which may pique the interests of those going through a journey to improve health (possibly focusing on weight loss). As always, talk with your doctor before making significant changes to your eating plan and exercise regimen.

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First, metabolism refers to the processes that take place as your body converts food into usable energy. Your basal metabolic rate is the minimum number of calories your body burns just to stay alive, keeping your brain, lungs, blood vessels, and every cell in your body running 24/7. This accounts for between 50 and 75 percent of the total calories you “burn,” with the rest coming from energy used through activity. Research suggests that metabolic rates are similar among family members.

“Genetics plays a strong role in how many calories you burn throughout the day,” says Philadelphia-based registered dietitian nutritionist, Colleen Tewksbury, PhD, RD, a spokesperson for the Academy of Nutrition and Dietetics. “Genetics account for anywhere from 40-70 percent of an individual’s body weight, so it is not determinative, but a very strong factor.”

Does Metabolism Slow with Age? A 2021 study helped debunk the idea that metabolism automatically slows at middle age. Researchers obtained measurements of daily energy use from 6,421 people from 29 countries spanning ages 8 days to 95 years. They found that total energy use rises rapidly after birth, peaking at about 1 year of age—which makes sense given how much growth and development happens in the first year of life. It then declines slowly through childhood and adolescence, plateaus between about ages 20 and 60, then starts to decline again. By age 90, total energy use is about 26 percent less than that of middle-aged adults.

“Much of the effect of decreasing calorie burning as someone gets older can be attributed to loss of lean body, or muscle, mass as someone gets older,” Tewksbury says. “This trend emphasizes the importance of resistance training and prevention.” It’s estimated that resting metabolic rate slows by one to two percent per decade, mostly due to age-related muscle loss.

But can slower metabolism lead to weight gain? A 2022 study by the same research team looked at total energy use in 347 adults and 47 children. They found that in adults, having a fast or slow metabolism is an individual characteristic that persists over time. They also found no evidence that adults with slow metabolism are likely to have more body fat, or that adults with fast metabolism are likely to have less body fat, debunking both “common wisdom” and previous research.

Movement Matters. The researchers also concluded that exercise may have an effect on how many calories we burn, but only a modest one. That’s in line with previous research suggesting that when we increase physical activity, our bodies slow basal metabolism to keep total energy use within a relatively narrow range. In other words, while exercise is great for overall health, it might not contribute much to higher metabolism, or to weight loss, over time.

As we age, social and work demands can cause us to change our physical activity patterns, especially if we have jobs that require sitting at a desk for most of the day. Staying active with aerobic exercise and strength exercise can help prevent muscle loss from sedentary jobs and leisure activities, which can help improve the “metabolism hand” dealt to you by genetics.

Anything that increases your breathing, heart rate, and core temperature requires your body to use more energy. But are specific types of activity best? Tewksbury says it depends. “If your goal is to increase calorie burning when exercising, intensity matters. Cardiovascular activity can increase caloric expenditure for the time exercising. Strength training can increase lean body mass and, in turn, the amount of calories your body burns just to function day-to-day.”

The Role of Nutrition. Contrary to claims that one food or another will “kickstart” your metabolism, “There are no known dietary changes that significantly and consistently change the amount of calories someone burns in a day,” Tewksbury says. “Studies of foods that increase calorie burning are typically temporary effects and have not been shown to translate to weight changes or major shifts in energy balance.”

What about eating several small meals a day to keep the metabolic fires stoked? It’s true that when you eat, your body burns about 10 percent of those calories to fuel the effort of digestion—but that’s true whether your calories are spread over three meals or six. Another thing to keep in mind is because our bodies adjust our metabolisms to meet our needs, eating too few calories can slow your metabolism, as your body tries to ensure your survival on less fuel.

The Bottom Line. The next time you see an article touting “easy ways to boost your metabolism,” look away. And instead of exercise based on predicted calorie burn, consider instead about how exercise might make you stronger overall, enhance mobility, manage stress, and generally make you feel better.

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Why Our Bodies Need Water. How much of the human body is water? It might surprise you to learn that water makes up about 60 percent of our body weight.

And what does water do for the body? The benefits of drinking water are many: It’s vital for almost every function in the body. Water acts as a building block, a solvent for chemical reactions, and a transport material for nutrients and waste.

Water also helps maintain blood volume and allows proper circulation, helps regulate our body temperature, and acts as a shock absorber for our joints and our brain. There are still more health benefits of water: It helps lubricate the linings of our inner organs and maintains healthy kidney function.

Water Your Body: Six Benefits. Drinking plenty of water can help keep your body healthy and functioning at its highest capacity. Staying hydrated will help you to:

1. Improve physical performance. During physical activity, our bodies use up a lot of water. Staying hydrated before, during, and after exercise helps to protect your body from harm, and helps you to perform better. Proper hydration can reduce fatigue, improve endurance, lower your maximum heart rate, and more. It can also help you to be less sore after exercise.

2. Help you to lose weight. Are you having trouble with your weight loss efforts? Increasing your water intake may help you achieve better results. Studies show that people who are on diets lose more weight when they also increase their water intake. In one study, people on weight loss diets who drank 500 milliliters of water before each of their three daily meals for 12 weeks lost 4.6 more pounds on average than people who did not drink the additional water.

3. Boost your mood. People who drink more water also tend to have better moods. One study found that when people who regularly drank less than 1.2 liters of water per day increased their intake to 2.5 liters per day, the participants experienced significantly less confusion, bewilderment, fatigue, and sleepiness. On the other hand, for people who regularly drank two to four liters of water per day who were then restricted to one liter per day, the reduced water intake led to negative effects on mood, including decreased contentedness, calmness, and positive emotions.

4. Boost your brainpower. When you drink more water, you may improve your cognitive performance, too. Several studies have shown that people drinking water during cognitive tasks performed much better than those people who did not drink water during the tasks. These results have been found in both adults and children. Studies suggest that even mild dehydration can impair cognitive function in the short-term. So next time you need to focus, take a test, or use all of your brainpower, keep a glass of water next to you and keep sipping.

5. Prevent headaches. Water deprivation is a very common cause of headache. In most cases, rehydrating can provide relief from a headache. For some people, dehydration can also trigger a migraine, so be sure to keep your water intake regular if you are prone to getting migraines or headaches.

6. Protect against disease. One of the most important answers to the question “Why is water important?” is its role in disease prevention. Proper hydration may be a useful tool in preventing a variety of health conditions and diseases. Staying hydrated may protect against kidney stones, constipation, asthma, urinary tract infections, coronary heart disease, and even possibly some cancers.

How Much Water Should You Drink a Day? The amount of water you need to drink will depend on several factors, including your age, gender, activity level, and more. However, here’s a good general guideline when it comes to recommended daily water intake: Women should drink at least 2.21 liters per day and men should drink three liters per day.

Increase your daily water intake as you increase your activity level. Be sure to drink filtered water to avoid toxins that may be found in tap water.

As you age, you will likely feel less thirsty and thus be prone to drinking less fluid. However, hydration is as important as ever in old age, so be sure to keep water on hand and drink regularly throughout the day, even if you don’t feel thirsty.

Need help drinking more water? Keep track of your water intake by measuring your progress with a cup or water bottle placed in a spot you will see it throughout the day. Set goals for yourself at time points throughout the day to make sure you are drinking enough.

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