weight loss

Are Peptide Stacks Safe?

by

Would You Like To Be A Guinea Pig?

Author: Dr. Stephen Chaney 

MagicPeptide stacks are all latest “magic” weight-loss potion. If you watch social media, the hype is hard to escape. If you believe the promises:

  • The weight will magically melt away.
  • Fat will disappear and be replaced with muscle.
  • You’ll have the energy to leap tall buildings in a single bound.
  • Aches & pains will disappear.

And that’s just the tip of the iceberg. What’s not to like?

Let’s start at the beginning. Peptide stacks are simply multiple peptide hormones with different benefits that are given as a single injection – usually once or twice a day.

To help you understand their benefits and risks, I will discuss:

  • Metabolism 101: How Do Peptide Hormones Work?
  • The Allure of Peptide Stacks.
  • GLP-1 Drugs: A Cautionary Tale
  • Are Peptide Stacks Safe?
  • Would You Like To Be A Guinea Pig?

Metabolism 101: How Do Peptide Hormones Work?

Peptide hormones are short chains of amino acids, usually 10 to 100 amino acids in length. You can think of them as short proteins. In fact, many peptide hormones start out as a larger precursor protein that is cleaved into several different peptide hormones.

  • Peptide hormones are released from specific cells in response to a physiological signal.
  • They bind to target tissues and produce an effect on metabolism, growth, or reproduction.
  • Once they have achieved the desired effect and the original physiological signal disappears, they are rapidly degraded and replaced by different peptide hormones that often have the opposite effect.

But that simplistic description just scratches the surface.

  • Sometimes they act like a cross between a “bucket brigade” and a spider web.

Regulation of human growth hormone (HGH) is an example.

  • Fasting caused the stomach to release the peptide hormone ghrelin, which stimulates the hypothalamus to release growth hormone releasing factor (HGRF). Low blood glucose, which is associated with fasting, also causes the hypothalamus to release HGRF.
  • Sleep, especially the early stages of deep sleep, also stimulates the hypothalamus to release HGRF.
  • HGRF binds to the pituitary and stimulates it to release HGH. HGH binds to nearly every tissue and organ in the body and has multiple effects. I’ll just mention a few of them here. For example,
  • HGH binds to the liver and causes it to release insulin-like growth factor-1 (IGF-1).
  • IGF-1 opposes the effect of insulin. It causes the liver to release glucose into the bloodstream and the liver and other tissues to release fat into the bloodstream. This helps the body get the energy it needs during the fasting state. It also provides the energy needed for growth.
  • It also stimulates the growth of muscle and bone. This is part of the growth response to HGH.
  • And, of course, all these responses support tissue repair, metabolism, and growth during sleep.

These effects of HGH are short-lived. HGH is meant to be released in short pulses as needed by the body. Once the desired effects of HGH have been realized, its production is stopped and it is rapidly degraded.

  • IGF-1 and/or high levels of blood glucose and fatty acids cause the hypothalamus to halt production of GHRF and release a peptide hormone called somatostatin instead.
  • Somatostatin binds to the pituitary and blocks the release of HGH.

This description is a simplistic view of the effects and regulation of HGH. Ghrelin, HGH and IGF-1 each have multiple other targets within the body. They influence multiple metabolic reactions. And both HGH and IGF-1 are regulated by other peptide hormones, each responding to different physiological stimuli.

So, you can see where my analogy of a bucket brigade and spider web came from.

  • The bucket brigade is: stomach → ghrelin → hypothalamus → GHRF → pituitary → HGH → liver → IGF-1
  • The spider web is the multiple other targets of ghrelin, HGH, and IGF-1 and the other peptide hormones that stimulate the release HGH and IGF-1.

But the analogy of a bucket brigade and spider web is a static representation. Each peptide hormone is constantly changing over time. Perhaps a better analogy would be an intricate dance, with dance partners constantly changing, disappearing, and reappearing.

When I look at the intricacies of metabolic regulation it seems inescapable that there must be a divine creator. This could not have happened by chance. And metabolic regulation is just one aspect of the amazing human body.

The Allure Of Peptide Stacks 

When I think of the allure of peptide stacks, the image that comes to mind is the sirens of Greek Mythology. They were variously described as bird-like or mermaid-like creatures who sat on the shoreline and sang such enchanting songs that they lured sailors to their deaths on the rocky shoals just off the coast.

In Homer’s Odyssey, he wrote about Ulysses putting earplugs in his crew and tying himself to the mast, so they could safely pass by the sirens without being lured to their death.

In this section, I will talk about the allure of peptide stacks. I’ll discuss the rocks later.

Perhaps the best way to talk about the allure of peptide stacks is to give specific examples of some of the most popular peptides included in the stacks.

Tesamorelin is a synthetic analog of growth hormone releasing factor (GHRF) that stimulates the pituitary to release growth hormone (HGH), which stimulates the liver to release insulin-like growth factor-1 (IGF-1).

  • It is associated with muscle growth and fat loss, especially abdominal fat.

Ipamorelin is a synthetic peptide that mimics the effects of ghrelin. In short, it stimulates the hypothalamus to release GHRF, which stimulates the pituitary to release HGH, which stimulates the liver to release IGF-1.

  • It is associated with muscle growth, fat loss, recovery and healing.

CJC-1295 is another synthetic analog of GHRH.

  • It is associated with muscle growth, fat loss, improved recovery and healing, increased energy, and better bone density.

AOD-9604 is a synthetic analog of HGH. However, it is only a portion of the HGH molecule. It promotes weight loss but does not increase muscle mass or help with blood sugar control.

BPC-157 is a synthetic analog of a peptide found in gastric juice.

  • It is associated with wound healing, gastrointestinal health, and reduced inflammation.

TB-500 is a synthetic analog of thymosin-beta-4, a peptide released by platelets, macrophages, and smooth muscle cells after injury.

  • It is associated with accelerated wound healing, reduced inflammation, increased flexibility and mobility, and muscle growth.

Tirzepatide is a synthetic analog of GLP-1. Like other GLP-1 it improves blood sugar control and suppresses appetite, which can lead to significant weight loss.

  • The FDA approved version of tirzepatide is sold under the trade names Mounjaro and Zepbound. However, the tirzepatide you find in peptide stacks is neither FDA approved nor FDA regulated. I will discuss what the FDA says about this below.

Of course, the “magic” of peptide stacks is that several of these peptides are combined in each injection, so you are maximizing the health “benefits”.

And when you look at the claimed health benefits – weight loss, fat loss, muscle growth, reduced inflammation, energy, improved flexibility, and much more – the allure of peptides stacks is easy to understand.

But is there a downside to peptide stacks? It’s time to examine the rocks along the shoreline. But first I should share a cautionary tale about GLP-1 drugs because that helps us understand the potential problems with peptide stacks.

GLP-1 Drugs – A Cautionary Tale 

GLP-1 is a peptide secreted by specialized cells in the intestine every time we have a meal.

  • It activates satiety cells in our brain to tell us we are full and don’t need to eat any more.
  • It also slows the emptying of our stomach and slows the transit time of food in our intestine. That helps us maximize the absorption of nutrients from our meal. It also prolongs the physical feeling of fullness.

But this effect only lasts an hour or two. Soon GLP-1 is broken down, and other peptide hormones take over to keep nutrient levels steady in the bloodstream and prepare us for the next meal. This is part of that “intricate dance” of peptide hormones that I described earlier.

Some bright scientists working for pharmaceutical companies hypothesized that if GLP-1 levels remained high for days rather than hours they could achieve long-term appetite suppression, which would help with weight loss. They created synthetic versions of GLP-1 drugs which were stable in the bloodstream for up to a week and injected them into patients at levels 10 to 100 times higher than found in nature.

Because these drugs were developed by pharmaceutical companies, they went through the complete FDA approval and inspection process. This involves:

  • Double-blind, placebo-controlled clinical studies with hundreds of patients establishing that the drugs are safe and effective. These studies are of the quality that they are published in peer-reviewed scientific journals.
  • Careful review of the clinical studies by the FDA as part of the approval process.
  • Regular inspection of the drug production facilities by the FDA to assure adherence to the highest quality and purity standards.
  • Post-Market monitoring after approval to identify any safety concerns that were missed in the approval process. Doctors and pharmaceutical companies are required to report any serious side effects to the FDA.
    • During the approval process the drugs are tested in hundreds of patients. After approval the drugs are often used by millions of patients. Also, some side effects are cumulative and do not appear until the drugs have been used for a long time. It is not unusual to identify serious side effects through this post-marketing monitoring process.

Some of the side effects were predictable and were discovered in the original clinical trials of these drugs.

  • Because the GLP-1 analogs are present at higher levels and for much longer than natural GLP-1, stomach emptying and transit times through the intestine were delayed much more than normal.
    • This results in side effects like nausea, vomiting, diarrhea, constipation, bloating, and stomach pain.

However, some of the most-concerning side effects were only discovered through the post-marketing review process. These include.

  • Increased anxiety, depression, and suicidal thoughts. These side effects, especially suicidal thoughts, are of concern to anyone who already experiences some degree of anxiety and/or depression.
  • Loss of muscle mass. This is of concern to adults over the age of 50 because many of them already suffer from sarcopenia (age-related muscle loss).

Why is this a cautionary tale, you might ask? It’s cautionary because the common side effects and the more serious side effects for GLP-1 drugs were only discovered because of the FDA drug approval and post-marketing review procedures. Spoiler alert: None of the peptide stacks have gone through this kind of review process.

Are Peptide Stacks Safe? 

danger symbolThe question I posed at the beginning of this article is, “Are peptide stacks safe?” The short answer is, “We don’t know but there are several reasons to be cautious”.

#1: Peptide hormones are not natural (And it’s not nice to fool around with Mother Nature).

Specifically, the dosage and timing of peptide stacks is not natural. In my overview of peptide hormones, I talked about the “intricate dance” peptide hormones undergo as they control human metabolism.

In short, peptide hormones are under tight control by our bodies. They are produced in the right amount, at the right time, and for the right duration (They are degraded as soon as they have completed their mission). None of this is true for peptide stacks.

  • They are injected on a fixed schedule – not when our bodies need them (not the right time).
  • They are injected at doses designed to create much higher blood levels than the body produces under normal circumstances (not the right amount).
  • They are injected with frequencies designed to achieve high blood levels far longer than seen under normal circumstances (not the right duration).

And if we have learned anything from GLP-1 drugs, it is that when we create synthetic peptide hormones and inject them at the wrong time, at the wrong amount, and for the wrong duration we create side effects and some of those side effects may have significant health consequences.

#2: We have no idea whether peptide stacks are effective and safe. These are not FDA approved treatments. That means:

  • No human clinical trials have been performed to assess efficacy and safety of peptide stacks.
  • There is no post-marketing monitoring. Simply put, that means there is no system in place to monitor the frequency and severity of side effects.

#3: We have no idea whether peptide stacks are pure and potent. They are typically produced by compounding pharmacies or overseas manufacturers who may not use good manufacturing practices and quality controls.

The FDA has recently released a warning about one of these synthetic peptide hormones (tirzepatide) produced by compounding pharmacies and overseas manufacturers and available online. Their findings were that some of the samples they evaluated:

  • Had inaccurate label information.
  • Contained too little, too much, or no active ingredient at all.
  • Contained the wrong ingredients.
  • Contained harmful contaminants.

While this report focused on a single peptide, there is no reason to suspect that compounding pharmacies and overseas manufacturers would do a better job of producing other synthetic peptide hormones.

In short, it is buyer beware in the online peptide stack marketplace.

Would You Like To Be A Guinea Pig? 

To sum up the previous section:

  • Peptide stacks are not natural. This may result in unexpected side effects.
  • There are no published human clinical studies on peptide stacks. That means:
  • We have no idea whether they are safe and effective. There is no evidence that the claimed benefits are true, and we don’t know what the side effects might be.
  • No one is monitoring the manufacturing practices and quality controls for peptide stacks. That means:
    • We have no idea whether they are pure and potent. We don’t know how much of each peptide hormone they contain and whether the hormones are pure.

In short, using the peptide stacks currently available online is like volunteering to be a guinea pig in a long-term clinical trial with an uncertain outcome.

Now I know many of you prefer to go outside of the medical system, and it may seem to you that I am taking the side of the FDA and pharmaceutical companies.

That is not the case. I do get regular checkups, but my doctor is fully aware that I prefer natural approaches whenever possible. I’m 81, use no medications, and am in excellent health.

I choose natural approaches that are proven to be safe and effective. Peptide stacks are not there yet. I choose not to be a guinea pig.

But if the allure of peptide stacks still tempts you, the best advice I have seen is to work with licensed health professionals.

  • They normally research their sources and know which companies use good manufacturing practices and perform rigorous quality controls on their products.
    • It’s your responsibility to ask them how they choose which products they recommend.
  • They normally monitor you for side effects.
    • It’s your responsibility to ask them how they want to monitor you for side effects and to report any side effects to them as soon as you notice them.

The Bottom Line 

Peptide stacks are the latest “magic” weight-loss potion. When I think of the allure of peptide stacks, the image that comes to mind is the sirens of Greek Mythology. They were variously described as bird-like or mermaid-like creatures who sat on the shoreline and sang such enchanting songs that they lured sailors to their deaths on the rocky shoals just off the coast.

In this article I describe their allure. I also describe the rocky shoals.

  • Peptide stacks are not natural. This may result in unexpected side effects.
  • There are no published human clinical studies on peptide stacks. That means:
    • We have no idea whether they are safe and effective. There is no evidence that the claimed benefits are true, and we don’t know what the side effects might be.
  • No one is monitoring the manufacturing practices and quality controls for peptide stacks. That means:
    • We have no idea whether they are pure and potent. We don’t know how much of each peptide hormone they contain and whether the hormones are pure.

In short, using the peptide stacks currently available online is like volunteering to be a guinea pig in a long-term clinical trial with an uncertain outcome.

For more information on peptide stacks and the best recommendations if you choose to use them, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance 

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 54 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Can A Healthy Diet Help You Lose Weight?

by

What’s New About This Study?

Author: Dr. Stephen Chaney 

fad dietsNew Year’s resolutions are just around the corner. Some of you will resolve to lose weight, and some of you will resolve to eat healthier. But can you do both?

Any restrictive diet will give you short-term weight loss. And weight loss will give you improvement in blood parameters that might signal a reduced risk of heart disease, stroke, and diabetes.

The operative word here is “might”. Long-term studies are required to determine whether a diet actually reduces the risk of chronic diseases.

So, the important question becomes, “Can weight loss diets be healthy long term”. For some of them, the answer is a clear no. Others are unlikely to be healthy but have not been studied long term, so we don’t know whether they are healthy or not.

That’s the dilemma most of you face this January. If most weight loss diets are unhealthy long term, do you have to choose between weight loss and good health when you make your New Year’s resolutions?

Maybe not. What if you started from the opposite perspective? What if you asked, “Can a healthy diet help you lose weight?” The study (S Schutte et al, American Journal of Clinical Nutrition, 115: 1-18, 2022)) I will review this week suggests it can.

How Was This Study Done?

clinical studyThis was a randomized controlled trial, the gold standard of clinical studies. The investigators recruited 100 healthy, abdominally obese men and women aged 40-70. At the time of entry into the study none of the participants:

  • Had diabetes.
  • Smoked
  • Had a diagnosed medical condition.
  • Were on a medication that interfered with blood sugar control.
  • Were on a vegetarian diet.

The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • A continuation of their habitual diet.

The study lasted 12 weeks. The participants met with a dietitian on a weekly basis. The dietitian gave them all the foods they needed for the next week and monitored their adherence to their assigned diet. They were advised not to change their exercise regimen during the study.

At the beginning and end of the study the participants were weighed, and cholesterol, triglycerides, and blood pressure were measured.

Can A Healthy Diet Help You Lose Weight?

Vegetarian DietThis study compared a healthy diet to an unhealthy diet with the same degree of caloric restriction. And it compared both diets to the habitual diet of people in that area. This study was performed in the Netherlands, so both weight loss diets were compared to the habitual Dutch diet.

To put this study into context, these were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less added sugars than the “low-nutrient-quality” diet.

When the investigators measured weight loss at the end of 12 weeks:

  • Participants lost significant weight on both calorie-restricted diets compared to the group that continued to eat their habitual diet.
    • That is not surprising. Any diet that successfully restricts calories will result in weight loss.
  • Participants on the high-nutrient quality diet lost 33% more weight than participants on the low-nutrient-quality diet (18.5 pounds compared to 13.9 pounds).
  • Participants on the high-nutrient quality diet lost 50% more inches in waist circumference than participants on the low-nutrient-quality diet (1.8 inches compared to 1.2 inches).
    • Waist circumference is a direct measure of abdominal obesity.

When the investigators measured blood pressure, fasting total cholesterol levels, and triglyceride levels at 12 weeks:

Prescription for good health overhead with stethoscope, healthy fresh food and exercise equipment, with copy space.
  • These cardiovascular risk factors were significantly improved on both diets.
    • Again, this would be expected. Any diet that causes weight loss results in an improvement in these parameters.
  • However, the reduction in total serum cholesterol was 2.5-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.
  • The reduction in triglycerides was 2-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.
  • The reduction in systolic blood pressure was 2-fold greater and the reduction in diastolic blood pressure was 1.67-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose and other added sugars provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, a healthy diet can help you lose weight. Healthy eating helped them lose more weight and gave them greater improvement in their health.

What’s New About This Study?

Simply put this study confirms that:

  • Caloric restriction leads to weight loss, and…
  • Weight loss leads to improvement in cardiovascular risk factors like total cholesterol, triglycerides, and blood pressure.
    • This is not new. It is true for any diet that results in caloric restriction.

However, this study breaks new ground in that it shows a high-nutrient quality diet results in significantly better…

  • Weight loss and…
  • Reduction in cardiovascular risk factors….

…compared to a low-nutrient quality diet with the same degree of caloric restriction.

What Does This Study Mean For You?

As I said above, the distinction between a “high-nutrient-quality” diet and a “low-nutrient-quality” diet may not be Questioning Womanwhat you might have expected.

  • Both diets were whole food diets. Neither diet allowed sodas, sweets, and highly processed foods.
  • Both included fruits, vegetables, grains, and lean meats.
  • Both reduced caloric intake by 25%.
    • If you want to get the most out of your weight loss diet, this is a good place to start.

However, in this study the investigators designed their “high-nutrient-quality” diet so that it contained:

  • More plant protein in the form of soy protein.
    • In this study they did not reduce the amount of animal protein in the “high-nutrient-quality” diet. They simply added soy protein foods to the diet. I would recommend substituting soy protein for some of the animal protein in your diet.
  • More fiber.
    • The additional fiber came from substituting whole grain breads and brown rice for refined grain breads and white rice, adding soy protein foods, and adding an additional serving of fruit.
  • More healthy fats (monounsaturated and omega-3 fats) in place of saturated fats.
    • The additional omega-3s came from adding a fish oil capsule providing 700mg of EPA and DHA.
  • Less added sugar.

All these changes make great sense if you are trying to lose weight. 

ProfessorI would group these changes into 7 recommendations.

1) Follow a whole food diet. Avoid sodas, sweets, and highly processed foods.

2) Include all 5 food groups in your weight loss diet. Fruits, vegetables, whole grains, dairy, and lean proteins all play an important role in your long-term health.

3) Eat a primarily plant-based diet. My recommendation is to substitute plant proteins for at least half of your high-fat animal proteins. And this study reminds us that soy protein foods are a convenient and effective way to achieve this goal.

4) Eat a diet high in natural fiber. Including fruits, vegetables, whole grains, beans, nuts, seeds, and soy foods in your diet is the best way to achieve this goal.

5)  Substitute healthy fats (monounsaturated and omega-3 fats) for unhealthy fats (saturated and trans fats) in your diet. And this study reminds us that it is hard to get enough omega-3s in your diet without an omega-3 supplement.

6) Reduce the amount of added sugar in your diet. This is best achieved by eliminating sodas, sweets, and highly processed foods from the diet.

7) Finally, I would like to remind you of the obvious. No diet, no matter how healthy, will help you lose weight unless you cut back on calories. Fad diets achieve that by restricting the foods you can eat or the time you are allowed to eat. In the case of a healthy diet, the best way to do it is to cut back on portion sizes and choose foods with low caloric density.

The Bottom Line 

A recent study asked, “Can a healthy diet help you lose weight?” This study was a randomized controlled study, the gold standard of clinical studies. The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • Continue with their habitual diet.

These were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less fructose and other added sugars than the “low-nutrient-quality” diet.

At the end of 12 weeks:

  • Participants on the high-nutrient quality diet lost 33% more weight and had better cardiovascular markers than participants on the low-nutrient-quality diet.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose and other added sugars provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, a healthy diet can help you lose weight. Healthy eating helped them lose more weight and gave them greater improvement in their heart health.

For more details on this study, what this study means for you, and my 7 recommendations for a healthy weight loss diet, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Is It Too Late For Weight Loss Goals?

by

What Does This Study Mean For You?

Author: Dr. Stephen Chaney

It’s almost the New Year. And with the New Year comes New Year’s resolutions. Weight loss is the second most popular New Year’s resolution, trailing only exercising more.

But if you are middle-aged and have been overweight most of your adult life, is it too late to lose weight? Has the damage to your health already been done? Has that ship already sailed?

There is good evidence that people who maintain an ideal weight throughout their adult years are healthier and live slightly longer than people who are overweight.

There is also good evidence that weight loss at any age provides short-term improvements to biomarkers of good health such as:

  • lower blood pressure.
  • lower cholesterol levels.
  • better blood sugar control.
  • reduction in chronic inflammation.

But surprisingly there are very few studies to show that weight loss results in long-term health benefits, especially for people who have been overweight through their 40s and 50s. To date there is only a single Chinese study of midlife weight loss, and that study suggested that health benefits were only apparent if the weight loss was maintained for 30 years or more.

The study (TE Strandberg et al, JAMA Network Open, 2025, 8(5); e2511825) I will describe today was designed to fill that gap.

How Was This Study Done?

Clinical StudyThe investigators used data from three large studies that followed healthy individuals in midlife for 10 years or more. None of these studies were designed as weight loss studies, but they measured weight, chronic disease incidence or mortality at multiple points during the study.

The first study was the Whitehall II Study (WHII). This study enrolled 10,308 British civil servants (Whitehall is the district where the British Civil Service is located) between 1985 and 1988 and is still ongoing. The data for this investigation was taken from clinical examinations that occurred around 1991 and 2013.

  • These exams provided information on weight and height, BMI, and risk factors like smoking, high blood pressure, high cholesterol, and insulin resistance and/or high blood sugar (indicative of prediabetes or diabetes).
  • The data set was linked to National Health Service records for diagnosed chronic diseases (type 2 diabetes, heart attack, stroke, cancer, asthma, and chronic obstructive pulmonary disease).

The study I am describing today included 4118 men and women aged 37-42 years (average = 39 years) from the WHII dara set who were free of chronic disease at the time of the 1991 clinical evaluation.

The second study was the Helsinki Businessmen Study (HBS). In this study 3490 White men, mostly businessmen and executives aged 38-45 years (average 42 years) underwent voluntary health checkups starting in 1964. Cardiovascular risk factors were assessed and the men received health education on diet, exercise, and weight control. Between 1974 and 1975 these men were offered a voluntary follow-up health checkup, and 2335 men completed both checkups.

  • In this study, BMI was measured at both health checkups and all-cause mortality data were obtained from the National Health Registry.

The third study was the Finnish Public Sector Study (FPS). In this study 77,111 men and women in public service were enrolled in 2,000. BMI was measured in 4-year intervals and health data were collected from the European Health Records. The data for this investigation used data from 16,696 men and women who were 34-43 (average age = 39) at the first assessment, had data from at least 3 consecutive assessments, and had no diagnosed chronic disease at the first assessment.

  • As with the WHII study, BMI and chronic disease were measured in at least 2 consecutive assessments.

The average follow-up for the three studies was 22.8 years between the first and last assessment.

In all three cases the study participants were divided into 4 groups:

  • Those who remain overweight (defined as a persistent BMI>25).
  • Those who gained weight – they went from a healthy weight to being overweight (defined as BMI<25 to BMI>25).
  • Those who lost weight – they went from overweight to a healthy weight (defined as BMI>25 to BMI<25).
    • The average weight loss was 11.5 pounds or 6.5% of body weight and was remarkably consistent in all 3 studies.
  • Those who remained at a healthy weight (defined as a persistent BMI<25).

In the WHII and FPS studies, weight differences were correlated with the diagnosis of a chronic disease between the first and last assessment.

In the HBS study, weight differences were correlated with all-cause mortality between the first and last assessment.

In all three cases, the data were corrected for major risk factors like smoking, high blood pressure, high cholesterol, and insulin resistance and/or high blood sugar.

In terms of the risk of developing a chronic disease (WHII and FPS studies) or risk of dying (HBS study) the always overweight group was assigned a risk of 1.0 and the other groups were compared to it.

The authors noted that all three studies were performed before surgical and pharmacological interventions were available. And people with pre-existing conditions were excluded from these studies, so disease-related weight loss was unlikely. Thus, the authors felt that the group who lost weight probably did so because of a conscious effort to change their diet and lifestyle, although this was not specifically measured in these studies.

Is It Too Late For A Weight Loss Goal?

If you remember the introduction, this question did not refer to short-term biomarkers of health. Multiple studies have shown that weight loss at any age will improve blood sugar control and lower blood pressure, cholesterol, and inflammation.

This study asked whether weight loss can be shown to have long-term health benefits – namely reduction in the risk of chronic diseases and increase in longevity.

And more specifically, it asked whether weight loss in middle age (the age of participants in these studies ranged from 39 to 42) can be shown to have long-term health benefits – even if they had been overweight for most of their adult life up to that point.

Or as the title of this segment suggested, “Is it too late to set a weight loss goal if you are middle aged.”

The answer from these studies was clear cut:

  • In the WHII study the risk of developing a chronic disease decreased by 48% compared to the always overweight group.
    • And when diabetes was excluded from the analysis the decreased risk was still significant (42%). This is important because diabetes is the most prevalent obesity related disease. The means that weight loss also significantly reduced the risk of the other chronic diseases measured in this study – such as cardiovascular disease and cancer.
  • In the FPS study the risk of developing a chronic disease decreased by 57% compared to the always overweight group.
  • Again, when diabetes was excluded from the analysis the decreased risk was still significant (45%).
  • Finally, in the HBS study, the risk of premature death decreased by 19% compared to the always overweight group.

In each of these studies:

  • The group that gained weight in their middle years did almost as poorly as the always overweight group.

The authors concluded, “Findings from 3 prospective cohort studies support maintaining a healthy weight (BMI<25) throughout life as the best option for overall health. [However] sustained midlife weight loss compared with persistent overweight was associated with a decreased risk of [diabetes and other chronic diseases] and decreased all-cause mortality.”

Simply put, this analysis of three long-term studies shows that weight loss can help you be healthier and live longer in your golden years – even if you waited until you were middle-aged to lose the weight.

What Does This Study Mean For You?

cruise shipAt the beginning of this article I posed the questions: If you are middle-aged and have been overweight most of your adult life, is it too late to set a weight loss goal this January? Has the damage to your health already been done? Has that ship already sailed?

This study shows that the answer to this question is clearly, “No. It’s not too late.” Sustained weight loss can still provide significant long-term benefits.

Three major studies show that sustained weight loss initiated by adults in their forties can reduce the risk of chronic disease by around 50% and reduce the risk of mortality by about 20% twenty years later. The authors of this study said that evidence from one of those studies suggests that the long-term health benefits are still apparent 30 years later.

Of course, these studies represent a single time point – weight loss initiated at age 40.

  • The benefits of sustained weight loss may wane if you delay longer, but we don’t know because those studies have not been done. However, it is likely that sustained weight loss at any age will have significant long-term health benefits.
  • The benefits of sustained weight loss may be even greater if you lose weight at a younger age. Again, we can’t predict how much greater the benefit will be because those studies also haven’t been done yet.
  • However, as the authors of this study said, “Maintaining a healthy weight throughout life is the best option for overall health.” That conclusion is supported by multiple studies.

There are a couple of other important points.

  • These benefits (a 50% reduction in chronic diseases and a 20% increase in longevity) do not require massive weight loss. The subjects in these studies only lost around 11-12 pounds (6.5% of their weight). You have previously heard that as little as 5% weight loss has significant short-term benefits. This study confirms that statement and indicates if the weight loss is sustained, it will significantly improve long-term health outcomes.
  • Weight loss has a bigger effect on quality of life (absence from chronic diseases) than it does on longevity. That is true of every healthy lifestyle improvement that has been studied. I’m sorry to say that losing weight will not help you live as long as Methuselah. But it will help you live your last years in good health.

Of course, losing weight is easy. There are many fad diets that can help you do that. But keeping the weight off is hard. This is where every diet eventually fails. Maintaining weight loss requires lifestyle change. It also requires a change in mindset. It requires that you change how you think about food and how you think about your ability to control what you eat.

This is why I created my online lifestyle change course, “Create Your Personal Health Zone”. If this is the year you have resolved to lose weight and keep it off, check out my course.

What About Weight Loss Surgery and GLP-1 Drugs? 

Weight loss surgery and GLP-1 drugs result in faster and greater weight loss than diet and lifestyle changes alone. For example, clinical trials show that GLP-1 drugs can result in 15-20% body weight loss within the first year. [Subsequent studies suggest that real-life weight loss is often much smaller because of drug discontinuation due to side effects or cost.]

But assuming the 15-20% number, the question becomes whether these interventions have the same or greater benefits than the 6.5% body weight loss due to diet and lifestyle change seen in these studies.

The short answer is that we don’t know because we don’t have any long-term studies of these interventions. However, the authors of this study were skeptical. They said, “It remains uncertain whether the long-term benefits observed in our study extend to these interventions, where greater weight loss may be accompanied by a concurrent and potentially significant loss of lean body mass, which could pose challenges over time.”

I have discussed the importance of muscle mass for health and longevity in a previous issue  of “Health Tips From the Professor”. This article shows why the accelerated loss of muscle mass seen with GLP-1 drugs is so concerning.

The Bottom Line 

The time to set your New Year’s goals is just a few weeks away. If you are middle-aged and have been overweight most of your adult life, is it too late to set a weight loss goal this January? Has the damage to your health already been done? Has that ship already sailed?

A recent study examined that question. The study used data from three earlier studies on the long-term effects of sustained weight loss (20 years or more). These studies show that sustained weight loss initiated by adults in their 40s reduces the risk of:

  • Chronic disease by around 50%.
  • Mortality by about 20%.
  • Data from one of those studies suggests that the long-term health benefits were still apparent 30 years later.

For more information on this study, what it means for you, and where weight loss surgery and GLP-1 drugs fit into the picture, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 ______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading Biochemistry textbooks for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Can Omega-3s Improve Weight Loss Diets?

by

The Unexpected Benefits of Omega-3s

Author: Dr. Stephen Chaney 

Weight LossOmega-3s have become the latest “super food”. Wherever you get your news, you are constantly seeing articles about the latest “miracle results” obtained by adding omega-3s to your diet.

There is good evidence that omega-3s:

  • Lower blood pressure.
  • Reduce triglycerides (fatty particles in your bloodstream).
  • Reduce chronic inflammation.
  • Slow the buildup of plaque in the arteries (which combined with lowering blood pressure, reducing triglycerides, and reducing inflammation likely lowers heart disease risk).
  • Reduce the risk of depression and anxiety.
  • Improve neurodevelopment (cognitive function, memory, and learning) in infants and children.
  • Reduce inflammation in joints.

In addition, omega-3s may:

  • Reduce the risk of cognitive decline and Alzheimer’s as we age.
  • Reduce the risk of arrhythmias (irregular heartbeats).
  • Protect against age-related macular degeneration.
  • Improve immune function.
  • Reduce the risk of certain cancers.
  • Improve blood sugar regulation.

Because obesity is associated with chronic inflammation and inflammation is associated with many of the health risks associated with obesity, the authors of the study I will be describing today (J Torres-Vanegas et al. Healthcare, 13:103, 2025) decided to look at the effect of supplementation with 1.8 grams of long-chain omega-3s (fish oil capsules) on the beneficial effects of a weight loss diet in a double-blind, placebo-controlled, 8 week study.

There were two interesting wrinkles to this study.

  • Previous studies have suggested that a 5:1 ratio of omega-6 fats to omega-3 fats is optimal for these effects, but the typical American has an omega-6 to omega-3 ratio of between 15:1 and 20:1. So, the authors designed their study so that participants achieved a 5:1 omega-6 to omega-3 ratio.
  • Because short-chain omega-3s (found in plant foods) have little effect on inflammation, they were used as the “active” placebo instead of omega-6 fats.
    • In short, both groups received an omega-3 supplement. The “intervention” group received long-chain omega-3s from fish oil, and the “placebo control” group received short-chain omega-3s from vegetable oils (chia and flaxseed oil).

[Note: Short-chain omega-3s have many health benefits. However, their conversion to long-chain omega-3s in the human body is very inefficient, and they do not have all the health benefits associated with long-chain omega-3s.]

How Was This Study Done?

clinical studyThe authors of this study enrolled 40 obese (BMI≥30) adults (40% females, 60% males), aged 30-50 in a randomized, active placebo-controlled, double-blind weight loss study for 8 weeks.

The estimated caloric expenditure was determined for each participant prior to the study. Based on that estimate calories were reduced by 200 calories/day for the first 4 weeks and 400 calories/day for weeks 5-8.

Dietitians designed a recipe book of 3 main meals and 2 snacks for each day. The diets were designed to achieve the caloric restriction described above and to achieve a 5:1 ratio of omega-6 to omega-3.

Participants completed a 3-day food frequency questionnaire including 2 weekdays and 1 weekend day at the start of the study and at week 8. Participants were guided in this by a dietitian using food models to help them assess portion sizes.

Half of the participants were given a long-chain omega-3 supplement containing 1080 mg of EPA plus 720 mg of DHA (1,800 mg total) from fish oil. The other half of the participants were given a short-chain omega-3 supplement consisting of 1,600 mg of ALA from chia and flaxseed oil. The dietary assessments showed that both groups were successful in achieving a 5:1 omega-6 to omega-3 ratio when the supplements were included in the calculation.

Can Omega-3s Improve Weight Loss Diets? 

InflammationBecause both groups had equal caloric restriction. Therefore, as expected, both groups experienced decreased:

  • Body weight.
  • BMI.
  • Percent body fat.
  • Total cholesterol.
  • Triglycerides.
  • VLDL.

However, when the scientists measured markers of inflammation, a different picture was observed.

  • IL-6 (Interleukin 6) and RvD1 (resolving D1) are inversely associated with inflammation (They increase when inflammation decreases).
    • IL-6 and RVD1 increased only in the group supplementing with long-chain omega-3s (EPA + DHA).
  • IL-10 and MCP-1 (monocyte chemoattractant protein-1) are directly associated with inflammation (They decrease when inflammation decreases).
    • IL-10 and MCP-1 decreased only in the group supplementing with long-chain omega-3s.
  • These differences were highly significant.

The authors concluded, “A diet supplemented with marine n-3 (long-chain omega-3s from fish oil) improves inflammatory markers by increasing systemic levels of Resolvin D1 and IL-10 and decreasing IL-6 and MCP-1.”

“These results could provide a guide for future nutritional intervention strategies aimed to…reduce chronic low-grade inflammation by considering the omega-6 to omega-3 ratio content as a necessary calculation for a proper diet.”

[I would note that both diets achieved an omega-6 to omega-3 ratio of 5:1, but only the diet containing long-chain omega-3s reduced inflammation. So, the author’s statement is only true for long-chain omega-3s.]

In short, weight loss is known to help reduce chronic inflammation. Both groups lost weight, but only the group supplementing with long-chain omega-3s had a significant improvement in inflammatory markers.

  • These data suggest that supplementation with long-chain omega-3s while on a weight loss diet greatly enhances the reduction in inflammation associated with weight loss.
  • These data also suggest that short-chain omega-3s do not significantly reduce inflammation.
  • Both findings are consistent with earlier studies.

The Unexpected Benefits Of Omega-3s 

The study also found that:

  • Abdominal obesity was reduced by 35% in the long-chain omega-3 group compared to 5.6% in the short-chain omega-3 group, and these differences were highly significant.
  • Weight loss for men in the long-chain omega-3 group was 9.25 pounds compared to 4.8 pounds in the short-chain omega-3 group, and these differences were significant.
  • Reductions in percent body fat and waist circumference were also greater for men in the long-chain omega-3 group, but these differences were not statistically significant in this small study.

In short, these data suggest that long-chain omega-3 supplementation may have enhanced weight loss. This is an intriguing finding that needs to be confirmed by future studies.

What Does This Study Mean For You? 

Question MarkThis study is a randomized, double-blind, placebo-controlled trial, which is the gold standard for clinical studies. But it is also a very small study, so we need to carefully consider the validity of the study.

It had three major findings.

#1: Omega-3s enhance the anti-inflammatory effect of weight loss diets.

#2: This effect is only seen for the long-chain omega-3s EPA and DHA found in fish oil. The short-chain omega-3 ALA found in vegetable oils and other plant foods had no significant effect on inflammation.

The anti-inflammatory effect of long-chain omega-3s and the lack of an effect of short-chain omega-3s on inflammation are consistent with many previous studies. The only novel aspect of this study was the finding that the same effects occurred when omega-3 supplementation was added to a weight loss diet.

That is an important consideration because many weight loss diets focus on plant foods or red meats. Fish are often missing from the diet plan and long-chain omega-3 supplementation is seldom recommended.

That’s unfortunate because chronic inflammation is associated with obesity. And chronic inflammation increases the risk of heart disease, diabetes, cancer, and all the “itis” diseases. Omega-3 supplementation should be an important part of any weight loss diet.

#3: This study also suggests that long-chain omega-3 supplementation may increase the effectiveness of weight loss diets.

At this point I consider this finding as possible, but not probable. Previous studies have reported conflicting results. Some studies have suggested omega-3s aid weight loss. Others have found no effect.

We need many more studies before I would be ready to recommend omega-3 supplementation as an aid to weight loss. However, omega-3s have many proven benefits. If they also happen to make weight loss diets more effective, this would be an unexpected benefit.

The Bottom Line 

A recent study looked at the effect of omega-3 supplementation during a weight loss diet. The study had three main findings.

#1: Omega-3 supplementation enhances the anti-inflammatory effect of weight loss diets.

#2: This effect is only seen for the long-chain omega-3s EPA and DHA found in fish oil. The short-chain omega-3 ALA found in vegetable oils and other plant foods had no significant effect on inflammation.

#3: This study also suggests that long-chain omega-3 supplementation may increase the effectiveness of weight loss diets.

For more information on this study and what it means for you, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 ____________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

Can Protein Supplements Increase GLP-1?

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What Is GLP-1 And What Does It Do?

Author: Dr. Stephen Chaney

I don’t need to tell you that GLP-1 (glucagon-like peptide 1) drugs are all the rage. Total spending on GLP-1 drugs in the United States exceeded $71 billion in 2023, a 500% increase in just 5 years. There are 15 million Americans on GLP-1 drugs at any one time. And most of this increase has been driven by the weight-loss market.

Let me be clear. These drugs work. For people with poorly controlled type 2 diabetes or severe obesity-related health issues, they can be a godsend. But like any “quick fix” weight loss drugs they are overprescribed.

And when you have millions of people taking a drug, you need to take a serious look at side effects. The most frequent side effects are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Increased heart rate.
  • Hypoglycemia
  • Allergic reactions

These are side effects that aren’t life threatening and are easily detected. When someone experiences these side effects, they usually give their doctor a call, and their doctor either takes them off the drug or modifies the dosage.

However, more recent studies have identified two additional side effects that are much more troubling.

  • The first is depression, anxiety, and suicidal thoughts.
    • These are symptoms that many patients may not associate with the drug, especially if they already have these tendencies.
    • And the consequences can be life threatening. There have already been reports of suicides of people on GLP-1 medications.
  • The second is loss of muscle mass.
    • This is a particular concern for seniors who struggle to maintain muscle mass as they age.
    • And this is a silent symptom. Most seniors don’t realize they are losing muscle mass until it significantly affects their quality of life.

And, of course, the biggest drawback of GLP-1 drugs is that they are only a temporary fix. Unless someone changes their lifestyle, the weight comes roaring back as soon as they quit using GLP-1.

So. It’s no wonder some people are asking whether it is possible to increase their GLP-1 levels naturally without the side effects associated with GLP-1 drugs. I will discuss this below, but first I should review what GLP-1 is and what it does.

What Is GLP-1 And What Does It Do? 

Let me start by reviewing the hormones insulin and glucagon to create a proper perspective for understanding the role of GLP-1.

Insulin: Almost everyone has heard of insulin. It is released by the pancreas whenever we eat, and blood sugar levels start to rise. Its role is to lower blood sugar levels.

Glucagon: Glucagon is less well known, but you can think of it as the Yin to insulin’s Yang. It is released by the pancreas when blood sugar levels fall and continues to be present until the next meal. Its role is to increase blood sugar levels and make sure that our cells get the food they need until the next meal.

GLP-1: GLP-1 stands for glucagon-like peptide 1. With a name like that, you might expect GLP-1 to have significant sequence homology with glucagon, bind to the same receptors, and have a similar effect on our metabolism. You would be wrong!

Both peptide hormones are derived from a much larger peptide called proglucagon. This is the only way that GLP-1 is “like” glucagon.

One portion of proglucagon is processed to give glucagon in pancreatic alpha cells. Another portion is processed to give GLP-1 in intestinal L cells. [L cells are endocrine (hormone producing cells) found in the intestinal mucosa.] There is very little sequence or structural homology between glucagon and GLP-1.

Their function is also very different. You can think of GLP-1 as a partner to insulin. It is released by intestinal L cells in response to the presence of nutrients (primarily protein, fat, and carbohydrate) in the intestine. It binds to GLP-1 receptors on the…

  • Pancreas to stimulate insulin release and inhibit glucagon release. This is why it helps type 2 diabetics control their blood sugar levels.
  • Stomach to reduce the rate of gastric emptying. This prolongs the feeling of fullness after each meal.
  • Small intestine to reduce gut motility, which increases transit time through the small intestine. This also prolongs the feeling of fullness after a meal. But it can also lead to gastrointestinal side effects.
  • Brain to turn down your “appestat”. This reduces feelings of hunger between meals. But at high doses, it can affect the brain in negative ways (anxiety, depression, and suicidal thoughts).

Can Protein Supplements Increase GLP-1? 

Questioning WomanYou may be wondering, “Is it possible to increase GLP-1 levels naturally without side effects?” The answer is clearly, “Yes”. Every time you eat a meal, your GLP-1 levels increase naturally.

When you eat a meal, GLP-1 levels rise within 10 minutes and remain elevated for 1-2 hours. Then enzymes present in the bloodstream digest GLP-1 and it disappears. This is the way nature intended. There are no side effects to the natural rise and fall of GLP-1 after a meal.

And protein appears to play an important role in this process. High-protein meals result in higher and more prolonged GLP-1 levels than high-fat or high-carbohydrate meals. That’s because protein is digested to amino acids in the intestine. And some of those amino acids bind to receptors in intestinal L-cells and stimulate GLP-1 release.

You may be wondering what this has to do with protein supplements. Theoretically, protein supplements should offer the same benefit as a high-protein meal with fewer calories.

This hypothesis has been tested with a few protein supplements, and they have been shown to increase GLP-1 levels naturally. And, based on the limited data available, it appears that the increase in GLP-1 is proportional to the protein content of the supplement.

So, it appears that the answer I posed at the beginning of this article is,

  • Yes, it appears that protein supplements can increase protein levels naturally.
  • And it appears that the higher the protein content of the supplement, the greater the increase in GLP-1 levels.

However, there are many variations in the formulation of protein supplements, and we don’t know how these variations influence the effect of protein supplements on GLP-1 levels. Therefore,

  • We can’t yet say that all protein supplements increase GLP-1 levels equally.
  • When choosing a protein supplement, you should ask for clinical studies with their product showing it increases GLP-1 levels.

What Does This Mean For You?

If you can raise your GLP-1 levels naturally with high-protein meals and protein supplements, you might be asking, “What makes the GLP-1 drugs different?” To understand the answer to that question, you first need to know what GLP-1 drugs are.

  • GLP-1 drugs mimic the natural GLP-1 peptide.
  • However, GLP-1 drugs have been genetically modified to make them resistant to enzymatic digestion. They can stay in the bloodstream for up to 24 hours.

This is what makes them so effective as weight loss drugs. But it’s not nice to fool with mother nature. This is also why they have side effects.

And let’s remember that while GLP-1 drugs are effective, you will need to take them for the rest of your life unless you change your diet and lifestyle. And with long-term usage of the drugs, you are likely to experience one or more of their side effects at some point.

So, if you are willing to change your diet and lifestyle, it may be worthwhile looking at increasing your GLP-1 levels naturally. The effect may not be as strong as with the GLP-1 drugs, but it may help you suppress your appetite enough to successfully implement your lifestyle changes. You have lots of options.

  • Every time you eat a meal your GLP-1 levels increase. And the bigger the meal, the bigger the increase. But the bigger the meal, the greater the calories. So, that’s not an optimal way to increase GLP-1 levels.
  • That’s where protein supplements come in.
  • And since you are trying to maximize GLP-1 levels with the minimum calories, I recommend a 20–40-gram protein supplement with a minimum of carbohydrate and fat. Just be sure the manufacturer has done a clinical study to demonstrate their protein supplement raises GLP-1 levels.

The Bottom Line

In this article I asked the question, “Can protein supplements increase GLP-1 levels naturally without the side effects of GLP-1 drugs?” The answer is, “Yes”. In this article I tell you:

  • What GLP-1 is and what it does.
  • Why GLP-1 drugs have side effects.
  • How protein supplements can raise your GLP-1 levels naturally without the side effects of GLP-1 drugs.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 ______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

 

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

The Chocolate Myth

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Can Chocolate Help You Lose Weight? 

Author: Dr. Stephen Chaney 

chocolateSometimes you come across news that just seems too good to be true. The claims that you can lose weight just by eating chocolate are a perfect example. Your first reaction when you heard that was probably “Sure, when pigs fly!”

But it’s such an enticing idea – one might even say a deliciously enticing idea. And, in today’s world enticing ideas like this quickly gain a life of their own. Two popular books have been written on the subject.

Chocolate diet plans are springing up right and left. A quick scan of the internet even revealed a web site saying that by investing a mere $1,250 in a training course you could become a “Certified Chocolate Weight Loss Coach” earning $50,000/year.

If you like chocolate as much as most people you are probably wondering, “Could it possibly be true, or is it just another myth?

Can Chocolate Help You Lose Weight?

Happy woman on scaleThe idea that chocolate could help you lose weight does have some support. There are three published clinical studies suggesting that chocolate consumption is associated with lower weight (European Journal of Clinical Nutrition, 62: 247-253, 2008; Nutrition Research, 31: 122-130, 2011; Archives of Internal Medicine, 172: 519-521, 2012).

While that sounds impressive, they were all cross-sectional studies. That means they looked at a cross section of the population and compared chocolate intake with BMI (a measure of obesity). Cross sectional studies have a couple of very important limitations:

  • Cross sectional studies merely measure associations. They don’t prove cause and effect. Was it chocolate that caused the lower weight, or was it something else that those populations were doing? We don’t really know.
  • Cross sectional studies don’t tell us why an association occurs. In many ways, this is the old chicken and egg conundrum. Which comes first? In this case the question is whether the people in the studies became obese because they ate less chocolate – or did they eat less chocolate because they were obese and were trying to control their calories? Again, we have no way of knowing.

The Chocolate Myth

Chocolate is relatively rich in fat and high in calories. It’s not your typical diet food. On the surface, it seems implausible that eating chocolate could help you lose weight. When you first saw those headlines you probably thought, “When pigs fly!” You weren’t the only one. Lot’s of scientists had similar thoughts.

And scientists love to poke holes in implausible hypotheses, so it is no surprise that a recent study (JA Greenberg and B Buijsse, PLOS ONE, 8(8) e70271) has poked some huge holes in the “chocolate causes weight loss” hypothesis.

This study analyzed data from over 12,000 participants in the Atherosclerosis Risk in Community (ARIC) Study. This was also a cross-sectional study, but it was a prospective, cross-sectional study (That’s just a fancy scientific term which means that the study followed a cross section of the population over time, rather than just asking what that population group looked like at a single time point).

The authors of the study assessed frequency of chocolate intake and weight for each individual in the study at two separate times 6 years apart. The results were very interesting:

  • When they looked at a cross section of the population at either time point, their results were the same as the previous three studies – namely those who consumed the most chocolate weighed less. So, the cross-sectional data were consistent. Overweight people consumed less chocolate. But that still doesn’t tell us why they consumed less chocolate.
  • However, when they followed the individuals in the study over 6 years, those who consumed the most chocolate gained the most weight. The chocolate eaters were skinnier than the non-chocolate eaters at the beginning of the study, but they gained more weight as the study progressed. And the more chocolate they consumed the more weight they gained over the next 6 years. [No surprise here. Calories still count.]
  • When they specifically looked at the population who had developed an obesity-related illness between the first and second time point, they found that by the end of the study those participants had:
  • Decreased chocolate intake by 37%
  • Decreased fat intake by 4.5%
  • Increased fruit intake by 20%
  • Increased vegetable intake by 17%
  • In short, this study is more consistent with the “obesity causes reduced chocolate intake” model than the “reduced chocolate intake causes obesity” model. Simply put, if you are trying to lose weight, sweets like chocolate are probably among the first things to go.

Of course, even prospective cross-sectional studies have their limitations. Double blind, placebo-controlled studies are clearly needed to resolve this question. The only published study of this type has reported a slight weight gain associated with 25 g/day of dark chocolate, but the study was too small and too short in duration to draw firm conclusions.

In summary, more studies are needed, but the current evidence does not support the “miracle diet food” claims for chocolate. This appears to be another food myth. Pigs are flying!

The Bottom Line: 

  • Pigs still haven’t learned how to fly. As enticing as it may sound, the weight of current evidence does not support the claims that chocolate is a miracle diet food or that eating chocolate every day is a sensible strategy for losing weight.
  • On the other hand, dark chocolate is probably one of the healthier dessert foods. There is no reason not to enjoy an occasional bite of chocolate as part of a healthy, calorie-controlled diet.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 ___________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance 

____________________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.  Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”. Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

 

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

Increasing GLP-1 Levels Naturally

by

What Is GLP-1 And What Does It Do?

Author: Dr. Stephen Chaney

I don’t need to tell you that GLP-1 (glucagon-like peptide 1) drugs are all the rage. Total spending on GLP-1 drugs in the United States exceeded $71 billion in 2023, a 500% increase in just 5 years. There are 15 million Americans on GLP-1 drugs at any one time. And most of this increase has been driven by the weight-loss market.

Let me be clear. These drugs work. For people with poorly controlled type 2 diabetes or severe obesity-related health issues, they can be a godsend. But like any “quick fix” weight loss drug they are overprescribed.

And when you have millions of people taking a drug, you need to take a serious look at side effects. The most frequent side effects are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Increased heart rate.
  • Hypoglycemia
  • Allergic reactions

These are side effects that aren’t life threatening and are easily detected. When someone experiences these side effects, they usually give their doctor a call, and their doctor either takes them off the drug or modifies the dosage.

However, more recent studies have identified two additional side effects that are much more troubling.

  • The first is depression, anxiety, and suicidal thoughts.
    • These are symptoms that many patients may not associate with the drug, especially if they already have these tendencies.
    • And the consequences can be life threatening. There have already been reports of suicides of people on GLP-1 medications.
  • The second is loss of muscle mass.
    • This is a particular concern for seniors who struggle to maintain muscle mass as they age.
    • And this is a silent symptom. Most seniors don’t realize they are losing muscle mass until it significantly affects their quality of life.

And, of course, the biggest drawback of GLP-1 drugs is that they are only a temporary fix. Unless someone changes their lifestyle, the weight comes roaring back as soon as they quit using GLP-1.

So. It’s no wonder some people are asking whether it is possible to increase their GLP-1 levels naturally without the side effects associated with GLP-1 drugs. I will discuss this below, but first I should review what GLP-1 is and what it does.

What Is GLP-1 And What Does It Do? 

ProfessorLet me start by reviewing the hormones insulin and glucagon to create a proper perspective for understanding the role of GLP-1.

Insulin: Almost everyone has heard of insulin. It is released by the pancreas whenever we eat, and blood sugar levels start to rise. Its role is to lower blood sugar levels. It does this by:

  • Increasing glucose uptake by our cells. In the fed state almost all our cells use glucose as an energy source.
  • Converting any glucose in excess of immediate energy needs to storage forms.
    • In the muscle and liver, it is converted to a glucose polymer called glycogen. Our ability to create glycogen stores is limited.
    • In muscle it is also converted to amino acids, and it stimulates the use of those amino acids to make new protein. Our ability to increase muscle stores is also limited, but it can be increased by exercise.
    • In adipose tissue, it is converted to fat. As you may have noticed, our ability to create fat stores is unlimited. Even worse, when we become obese, fat starts accumulating in muscle and liver, which has severe health consequences.

Glucagon: Glucagon is less well known, but you can think of it as the Yin to insulin’s Yang. It is released by the pancreas when blood sugar levels fall and continues to be present until the next meal. Its role is to increase blood sugar levels and make sure that our cells get the food they need until the next meal.

Most tissues in our bodies switch to fat as an energy source in the fasting state. However, our red blood cells, kidney medulla, and brain continue to require glucose [Note: The brain can adapt to ketone bodies as an energy source after several days of glucose deprivation, but that’s another discussion for another time.] Glucagon supports our tissues by:

  • Signaling the liver to break down its glycogen stores and release glucose into the bloodstream. These stores are limited, but they can supply enough glucose to keep blood sugar levels constant for a few hours.
  • However, the brain uses lots of glucose, so the glycogen stores are rapidly depleted. When this happens, glucagon signals our muscles to break down muscle protein and convert the amino acids to glucose. We have enough muscle tissue to supply our brain with glucose for weeks. But we are using that muscle protein for other important things.
  • Finally, glucagon signals adipose tissue to break down its fat stores and release fat into the bloodstream to feed all our tissues that no longer depend on glucose.

GLP-1: GLP-1 stands for glucagon-like peptide 1. With a name like that, you might expect GLP-1 to have significant sequence homology with glucagon, bind to the same receptors, and have a similar effect on our metabolism. You would be wrong!

Both peptide hormones are derived from a much larger peptide called proglucagon. This is the only way that GLP-1 is “like” glucagon.

One portion of proglucagon is processed to give glucagon in pancreatic alpha cells. Another portion is processed to give GLP-1 in intestinal L cells. [L cells are endocrine (hormone producing cells) found in the intestinal mucosa.] There is very little sequence or structural homology between glucagon and GLP-1.

Their function is also very different. You can think of GLP-1 as a partner to insulin. It is released by intestinal L cells in response to the presence of nutrients (primarily protein, fat, and carbohydrate) in the intestine. It binds to GLP-1 receptors on the…

  • Pancreas to stimulate insulin release and inhibit glucagon release. This is why it helps type 2 diabetics control their blood sugar levels.
  • Stomach and reduces the rate of gastric emptying. This prolongs the feeling of fullness after each meal.
  • Small intestine and reduces gut motility, which increases transit time through the small intestine. This prolongs the feeling of fullness after a meal. But it can also lead to gastrointestinal side effects.
  • Brain and turns down your “appestat”. This reduces feelings of hunger between meals. But at high doses, it can affect the brain in negative ways (anxiety, depression, and suicidal thoughts).

Increasing GLP-1 Levels Naturally 

At the beginning of this article, I asked the question, “Is it possible to increase GLP-1 levels naturally without side effects?” The answer is clearly, “Yes”. Every time you eat a meal, your GLP-1 levels increase naturally.

GLP-1 levels rise within 10 minutes after consuming a meal and remain elevated for 1-2 hours. Then enzymes present in the bloodstream digest GLP-1 and it disappears. This is the way nature intended. There are no side effects to the natural rise and fall of GLP-1 after a meal.

“What makes the GLP-1 drugs different?”, you might ask.

  • In the first place significantly higher doses of GLP-1 are used.
  • More importantly, GLP-1 drugs have been genetically modified to make them resistant to enzymatic digestion. They can stay in the bloodstream for up to 24 hours.

This is what makes them so effective as weight loss drugs. But it’s not nice to fool with mother nature. This is also why they have side effects.

What Does This Mean For You?

Questioning WomanLet’s start by remembering that while GLP-1 drugs are effective, you will need to take them for the rest of your life unless you change your diet and lifestyle. And with long-term usage of the drugs, you are likely to experience one or more of their side effects at some point.

So, if you are willing to change your diet and lifestyle, it may be worthwhile looking at increasing your GLP-1 levels naturally. You have lots of options.

  • Every time you eat a meal your GLP-1 levels increase. And the bigger the meal, the bigger the increase. But the bigger the meal, the greater the calories. So, that’s not an optimal way to increase GLP-1 levels.
  • The macronutrients fat, carbohydrate, and protein all increase GLP-1 levels.
    • But if you are trying to lose weight, you want the greatest increase in GLP-1 with the fewest calories. That leaves out fatty foods.
    • You could try high carbohydrate meals, but there are lots of reasons why that’s not a good choice.
    • That leaves protein. And since you are trying to maximize GLP-1 levels with the minimum calories, I recommend a 20–40-gram protein supplement with a minimum of carbohydrate and fat. Just be sure the manufacturer has done a clinical study to demonstrate their protein supplement raises GLP-1 levels.

The Bottom Line

In this article I asked the question, “Is it possible to increase GLP-1 levels naturally without the side effects of GLP-1 drugs?” The answer is, “Yes”. In this article I tell you:

  • What GLP-1 is and what it does.
  • Why GLP-1 drugs have side effects.
  • How to raise your GLP-1 levels naturally without the side effects of GLP-1 drugs.

For more details read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

_______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Are GLP-1 Users Getting Enough Nutrients?

by

What Does This Mean For Your Future Health?

Author: Dr. Stephen Chaney

Most people want to lose weight so they can get trimmer and healthier. I don’t know of anyone who wants to be leaner and less healthy. But if they are not getting the essential nutrients their body needs while they are losing weight, they may well end up both lean and unhealthy.

I don’t need to tell you that GLP-1 (glucagon-like peptide 1) drugs are all the rage. Total spending on GLP-1 drugs in the United States exceeded $71 billion in 2023, a 500% increase in just 5 years. There are 15 million Americans on GLP-1 drugs at any one time. And most of this increase has been driven by the weight-loss market.

GLP-1 drugs do work. They target the intestine and the brain, increasing satiety (feeling of fullness) and decreasing appetite.

However, like any other drug, they have side effects. The most frequent are:

  • Nausea
  • Vomiting
  • Diarrhea
  • Constipation
  • Increased heart rate.
  • Hypoglycemia
  • Allergic reactions

In a previous issue of “Health Tips From the Professor” I discussed a serious side effect that is often overlooked, namely increased risk of depression, anxiety, and suicidal thoughts. My recommendations were:

  • If you suffer from depression, anxiety, or suicidal thoughts, GLP-1 drugs may not be the best choice for you. At the very least you should discuss the risks and benefits with your doctor before using them.
  • If you are using GLP-1 drugs and experience an increase in depression, anxiety, or suicidal tendencies, you should discontinue the drug immediately and report your side effects to your doctor.

Another question that has not been addressed previously is whether people using GLP-1 drugs are getting the essential nutrients their bodies need for optimal health. Today’s study (B Johnson et al, Frontiers in Nutrition, published online in April 2025) was designed to measure the nutritional adequacy of GLP-1 user’s diets.

How Was This Study Done? 

clinical studyThe investigators enrolled 69 people who had been using a GLP-1 drug for at least a month in their study using an online research platform through the University of Turin in Italy.

The characteristics of the study participants were:

  • Weight:
    • 5% normal weight
    • 27% overweight
    • 18% Obese Class I
    • 20% Obese Class II
    • 30% Morbidly Obese
  • Age = 49.6 ± 12.3
  • Ethnicity:
    • 82% Caucasian
    • 6% Hispanic
    • 8% African American
    • 1% Asian
    • This is similar to the ethnic distribution of GLP-1 users in this region.
  • Length of GLP-1 use:
    • 7% <3 months
    • 29% 4-6 months
    • 25% 7-12 months
    • 39% >1 year

The participants were trained on how to use an online dietary recall instrument and then recorded their dietary intake for 3 consecutive days.

Are GLP-1 Users Getting Enough Nutrients?

Question MarkThe results of the 3-day dietary recalls from the GLP-1 users were:

  • Their diets were high in fat (39% of calories) and saturated fat (13%).
  • Their diets were low in fruit, vegetables, grains, and dairy foods.
  • Their diets were low in fiber (14 grams). This is half the recommended intake of fiber.
  • Their diets were sufficient for B-vitamins, copper, phosphorous, selenium, and zinc.
  • Their diets were deficient for calcium, iron, magnesium, potassium, choline, vitamin A, vitamin C, vitamin K, vitamin D, vitamin E, and fiber. For example:
    • 99% of participants were not getting enough Vitamins D and K from their diet.
    • 94% weren’t getting enough choline.
    • 90% weren’t getting enough magnesium.
    • 88% weren’t getting enough iron.

The study did not report the intake of omega-3 fats, but the participants were likely deficient in that as well.

The study participants averaged 0.8 gm/kg of protein, which is the recommended intake for sedentary adults who are not on a weight loss diet. However, 0.8 gm/kg of protein is not sufficient for maintaining muscle mass on weight loss diets, especially weight loss diets aided by GLP-1 drugs. Most experts recommend 1.2gm/kg to 1.6 gm/kg to prevent loss of muscle mass, with a few recommending as high as 2 gm/kg.

Most of the participants in this study did not meet the increased protein recommendations for weight loss.

  • Only 43% consumed at least 1.2 gm/kg of protein.
  • Only 10% consumed at least 1.6 gm/kg of protein.
  • Only 5% consumed at least 2.0 gm/kg of protein.

The authors concluded, “Participants on a GLP-1 drug are not meeting the DRI [daily recommended intake] for several vital nutrients through their diet or the higher protein needs during weight loss. Patient-centered nutritional guidance is essential to optimize health outcomes and prevent unintended health consequences.

What Does This Mean For Your Future Health?

QuestionsThe results of this study are both appalling and expected. Weight loss diets often result in nutritional insufficiencies. However, GLP-1-aided weight loss is worse.

That’s because GLP-1 is a drug, not a diet plan. It’s dispensed like any other drug.

  • Your doctor gives you a GLP-1 prescription. If you are lucky, they may give you a “one-size-fits-all” handout on how to lose weight while you are using it. For example, in this study:
    • Only 51% of participants received information from their doctor on how to manage side effects of GLP-1.
    • Only 20% were referred to a dietitian. The other 80% received no information on how to change their diet and lifestyle.
  • When you pick up the drug from the pharmacy, you get a package insert listing the side effects but no information on how to change your diet.

The results were predictable:

From a medical point of view the results were a big success:

  • The participants in the study reduced their caloric intake by 20%.
  • Most of the participants in the study felt the GLP-1 drug was helping them lose weight.

But from a nutritional point of view the study raises a red flag. Most of the participants were not told to change their diet or lifestyle, and they didn’t. Their diet was still:

  • High in total fat and saturated fat and probably low in healthy fats, although that was not assessed.
  • Low in fruits, vegetables, grain, dairy, and fiber.

The typical American diet is bad enough as it is. But when you eat the same diet and decrease calories, the nutritional inadequacies of the American diet are magnified. That is why the diets of the GLP-1 users were deficient in fiber plus 10 essential vitamins and minerals and did not contain enough protein to prevent loss of muscle mass.

Most (52%) of the participants were planning to be on GLP-1 drugs for a short period of time – just long enough to reach their weight loss goals. But the reality is far different.

Studies show that when people lose weight on GLP-1 drugs without changing their diet and lifestyle, the weight comes roaring back as soon as they get off the drugs. The reality is that those people will need to stay on GLP-1 drugs for a lifetime if they want to keep the weight off.

That’s when the nutritional inadequacies shown in this study start to have real health consequences. For example,

  • Long term inadequacies of calcium, magnesium, and vitamin D increase the risk of osteoporosis.
  • Long term muscle loss due to inadequate protein intake leads to frailty and metabolic diseases as we age.

I could go on, but you get the point. GLP-1 drugs are not a panacea. Without diet and lifestyle change, they are just a temporary and expensive solution to weight loss.

The Bottom Line

A recent study looked at the nutritional intake of GLP-1 users. It found:

  • Their diets were high in fat (39% of calories) and saturated fat (13%).
  • Their diets were low in fruit, vegetables, grains, and dairy foods.They were deficient in fiber plus 10 essential vitamins and minerals.

 

  • They were not getting enough protein to prevent the loss of muscle mass associated with GLP-1 use for weight loss.

The authors concluded, “Participants on a GLP-1 drug are not meeting the DRI [recommended intake] for several vital nutrients through their diet or the higher protein needs during weight loss. Patient-centered nutritional guidance is essential to optimize health outcomes and prevent unintended health consequences.

For details about the study and the health consequences of these nutrient deficiencies, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_____________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 53 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Why Is Keeping Weight Off So Hard?

by

Can You Achieve Permanent Weight Loss? 

Author: Dr. Stephen Chaney 

Why is the dreaded yo-yo rearing its ugly head again? You tried a new diet this year, and it worked really well. The weight came off easily. But the diet is over, and the pounds are starting to creep up once again.

You are beginning to wonder if this diet was just like all the other yo-yo diets you’ve tried in the past. You are wondering whether those pounds you lost will come back and bring their friends with them. If so, you’ll be like 156 million Americans who lose weight and gain it all back each year.

And it’s so frustrating. You are trying to be good. You are still exercising and trying to eat healthily. Why isn’t it working?

Could it be that your fat cells have a memory? Could it be they like to be big and bulky with lots of stored fat? While that description is a bit fanciful, a new study (LC Hinte et al, Nature Online, 2024) suggests your fat cells may have a memory, which could explain why it is so hard to keep the weight off.

This is a highly technical study. So, before I discuss how the study was done, I should perhaps review a little bit of Biochemistry 101.

Biochemistry101: Epigenetics and Gene Activity

EpigeneticsWhat Is Epigenetics? When I was a young graduate student (which is more than just a few years ago), I was taught that all genetic information resided in our DNA. During conception, we picked up some DNA from our dad and some from our mom, and that DNA was what made us a unique individual.

In recent years, the hype has centered on DNA sequencing. It seems like everyone is offering to sequence your genome and tell you what kind of diet is best for you, what foods to eat, and what supplements to take. But can DNA sequencing fulfill those promises?

The problem is that DNA sequencing only tells you what genes you have. It doesn’t tell you whether those genes are active. Simply put, it doesn’t tell you whether those genes are turned on or turned off.

This is where epigenetics comes in. Epigenetics is the science of modifications that alter gene expression. In simple terms, both DNA and the proteins that bind to DNA can be modified. This does not change the DNA sequence. But these modifications can determine whether a gene is active (turned on) or inactive (turned off).

This sounds simple enough, but here is where it really gets interesting. These modifications are affected by our diet, our lifestyle (body weight and exercise, for example), our microbiome (gut bacteria), and our environment.

And if that weren’t complicated enough, some of these epigenetic changes (DNA modifications) can be transitory and others are long-lasting.

The authors of this study hypothesized that obesity causes long-lasting epigenetic changes to certain critical genes in our fat cells that slow metabolism and promote fat accumulation, even after we have lost weight. In other words, these epigenetic changes “prime” our fat cells to regain all the weight we’ve lost.

How Do You Measure the Effect of Epigenetic Changes? As you might expect this study measured epigenetic modifications to critical genes in fat cells. But that’s only part of the story. Epigenetic modification can turn genes on, turn them off, or have no effect on gene activity.

So, the investigators also needed to monitor the activity of the genes to determine the effect of the epigenetic modifications. Fortunately, one fact you may have learned in high school or college biology is mostly unchanged by the passage of time.

It is that the genetic sequence of DNA is translated into messenger RNA and that messenger RNA is used to code for proteins. If epigenetic modifications turned on a gene, we would expect higher levels of the corresponding messenger RNA and corresponding protein in those cells. Conversely, if epigenetic modifications turned off a gene, we would expect the opposite.

It turns out that it is much easier to measure changes in messenger RNA levels than individual protein levels that correspond to specific genes. So, the investigators used cellular messenger levels to measure the effect of epigenetic modifications on gene activity.

How Was This Study Done?

clinical studyThe investigators measured the effect of obesity and subsequent weight loss on fat cell gene expression in a limited set of human subjects and supplemented those results with a more expansive set of experiments with mice.

I don’t normally report on animal studies or very small human studies because these studies often lead to misleading results that are not supported by subsequent long-term, large clinical studies.

However, I am making an exception for this study because it leads to an interesting paradigm shift which, if true, changes the way we think about how to keep weight off long term.

Human Study: The investigators determined messenger RNA levels for key genes in fat cells from human volunteers who were:

  • At a healthy weight.
  • Obese both before and 2 years after bariatric surgery that resulted in at least 25% weight loss.

The groups were small (10-16 total), in part because obtaining fat cell samples is an invasive and painful procedure.

Mouse study: The investigators determined both messenger RNA levels and epigenic modifications for key genes in fat cells from 6-week-old male mice who were:

  • Fed either a low-fat or high-fat chow diet for 25 weeks. As expected, the mice fed the low-fat diet remained lean and the mice fed the high-fat diet became obese.
  • Subsequently, the obese mice were put on low-fat chow for 8 weeks during which time their weight returned to normal.
  • Finally, both the ‘always lean’ and ‘formerly obese’ mice were put on high-fat chow to compare how rapidly they gained weight.

What Happens To Fat Cells During Obesity And Weight Loss?

This study is best viewed as a story of what happens to fat cells during obesity and subsequent weight loss. There are two parts – what happens to human fat cells and what happens to mouse fat cells:

 Human Fat Cells: When obese individuals were compared to lean individuals:

  • Genes coding for fat storage and inflammation (which is known to be associated with obesity) were more active.
  • Fat-burning genes were less active.
  • These changes in gene expression were retained even after the obese individuals lost substantial weight through bariatric surgery.

[Note: The measurements of gene expression were based on the amount of messenger RNA produced by those genes.]

The human study had a couple of important limitations, which is why the investigators also did a similar study with mice.

#1: Because the study did not include a habitually lean group who became obese after going on a high-fat diet (no clinical review board would approve such a study), it could not determine whether the differences in gene expression were caused by the onset of obesity or whether they caused obesity.

Simply put, we know some individuals are genetically predisposed to obesity. The differences in gene expression between lean and obese individuals could have simply represented a genetic predisposition to obesity.

The mouse experiments did not suffer from that limitation because it was possible to put lean mice on a high fat diet until they became obese.

#2: The study did not measure epigenetic changes that may have caused the changes in gene expression. That is because humans are genetically heterogeneous. Consequently, you need population studies with hundreds of individuals to reliably determine epigenetic differences between groups.

The mouse experiments did not suffer from that limitation because laboratory mice are genetically homogeneous.

Mouse Fat Cells:

When the investigators looked at the physical effects of obesity:

  • When mice became obese on a high-fat diet:
    • Blood glucose levels rose.
    • Insulin levels rose, indicating the mice had become insulin resistant.
    • Fat accumulated in their livers.
  • When the obese mice lost the excess weight on a low-fat diet all these parameters returned to normal.
  • When the ‘always lean’ and ‘previously obese’ mice were put back on a high fat diet at the end of the study, the previously obese mice gained weight more quickly than the always lean mice.

In other words, mice responded to obesity in the same way that humans do except none of these effects could be explained by genetics. This strain of mice was genetically homogeneous.

When the investigators compared gene expression (as measured by messenger RNA levels) in mice who had become obese to ‘always lean’ mice:

  • Genes coding for fat storage and inflammation were more active.
  • Fat-burning genes were less active.
  • These changes in gene expression were retained even after the obese mice lost weight.

In other words, mice responded to obesity in the same ways as humans with respect to gene expression. However, in this case it was clear that obesity caused the changes in gene expression.

When the investigators looked at epigenetic modifications:

  • They identified epigenetic modifications to the regulatory regions of genes whose activity was increased or decreased when the mice became obese.
  • These epigenetic modifications were retained even after the mice lost weight.

These data suggest, but do not prove, that the epigenetic modifications were responsible for the changes in gene activity.

The authors concluded, “We show that both human and mouse adipose tissues retain transcriptional changes after appreciable weight loss.

Furthermore, we find persistent obesity induced alterations in the epigenome of mouse adipocytes that negatively affect their function and response to metabolic stimuli. Mice carrying this obesogenic memory show accelerated rebound weight gain…in response to high-fat diet feeding.

In summary, our findings indicate the existence of an obesogenic memory, largely on the basis of stable epigenetic changes, in mouse adipocytes and probably other cell types. These changes seem to prime cells for pathological response [weight gain] in an obesogenic environment, contributing to the problematic ‘yo-yo’ effect often seen with dieting.”

More simply put, the investigators concluded that obesity causes epigenetic modifications to the DNA of fat cells that prime them to regain their fat stores. They said that this may contribute to the ‘yo-yo’ effect often seen with dieting and explain why keeping weight off is so hard.

Why Is Keeping Weight Off So Hard?

Question MarkYou are not alone. You are like millions of other Americans. You lose weight effectively, but you struggle to keep it off. You just look at a donut and the fat jumps from the donut to your hips. You try to eat right, but the pounds keep creeping back on.

Experts have told us for years that our fat cells (and perhaps other cells in our body) are the culprit. Those cells have switched from a fat burning mode to a fat storage mode. There have been lots of attempts to explain that phenomenon, but my favorite is one that hypothesizes that our metabolism was designed for paleolithic times when it was either feast or famine.

Simply put, the theory is that our bodies were designed to store energy reserves in times of plenty and hold on to those energy reserves as long as possible in times of famine. Holding on to energy reserves was essential for prehistoric man to survive cold winters when food was hard to come by. And our number one energy reserve is, you guessed it, fat.

That is an appealing hypothesis, but it doesn’t tell us how our bodies manage to do that.

That’s what makes this study so intriguing. It may be wrong. It needs to be substantiated by large scale clinical trials. But the idea that epigenic changes occur during obesity and persist after substantial weight loss is novel. More importantly, it may explain the “feast or famine” response and why it is so hard to keep weight off after substantial weight loss.

Can You Achieve Permanent Weight Loss?

By now you may be thinking, “I thought my weight loss woes were due to my genetics. Now you’re telling me that they could be due to my epigenetics. Am I doubly cursed? Is there nothing I can do to keep my weight off?”

I can tell you science doesn’t have a simple answer, but there are two big clues that offer hope.

#1: Slow and steady wins the race. Obesity experts have known for years that slow weight loss often results in permanent weight loss.

  • If you are counting calories, that means a reduction of around 500 calories per week (That’s 71 calories per day, which is equivalent to one small apple, one hard-boiled egg, or 1.5 ounces of chicken breast). And a 500-calorie deficit maintained each week for a year can lead to a 20-25 pound weight loss.
  • If you are thinking of diets, it could amount to switching to a diet of unprocessed or minimally processed foods consisting of fruits, vegetables, whole grains, and primarily plant-based proteins without worrying about calories or serving sizes. Again, clinical studies show that switching from the typical American diet to this kind of diet can lead to substantial weight loss over a period of years.

Neither approach is popular in the weight loss world, but they work. Why do they work? It could be because the daily reduction in calories is so small that it never triggers the famine response.

If we look at the two parts of the study I reported on above:

  • In the human study weight loss was achieved through bariatric surgery which causes a huge reduction in caloric intake and rapid weight loss.
  • In the mouse study going from high-fat chow to low-fat chow represented a large decrease in calories. And again, weight loss was very rapid. It took the mice 25 weeks to become obese and only 4-8 weeks to lose the weight they had gained.

When viewed from this perspective, the epigenetic modifications observed after weight loss in this study may have been due to the famine response rather than a retention of the modifications observed during obesity.

And when you think about it, most popular diets feature major restrictions (calories, fats, carbs, forbidden foods, time of eating) and cause rapid weight loss. They are likely to trigger a famine response as well.

#2: The secrets of the National Weight Control Registry. There are some people who manage to keep their weight off and avoid the yo-yo effect. They don’t have any genetic or epigenetic advantage over the rest of us. They have lost weight on every diet imaginable – including rapid weight loss fad diets.

Yet they have managed to keep the weight off. What are their secrets? How did they avoid regaining their weight? How did they avoid the yo-yo diet effect?

An organization called the National Weight Control Registry was established to answer that question. It has enrolled more than 10,000 people who have lost weight and kept it off. On average people in this group have lost 66 pounds and kept it off for at least 5 years.

The National Weight Control Registry kept track of what they did to keep the weight off. Everyone’s approach was a little different, but the National Weight Control Registry summarized the ones that were most frequently mentioned. Here is what they do that you may not be doing:

#1: They consume a reduced calorie, whole food diet.

#2: They get lots of exercise (around 1 hour/day).

#3: They have internalized their eating patterns. In short, this is no longer a diet. It has become a permanent part of their lifestyle. This is the way they eat without even thinking about it.

#4: They monitor their weight regularly. When they gain a few pounds, they modify their diet until they are back at their target weight.

#5: They eat breakfast on a regular basis.

#6: They watch less than 10 hours of TV/week.

#7: They are consistent (no planned cheat days).

The good news is that participants in the National Weight Control Registry reported that while maintaining weight loss was difficult at first, it became easy after 2 years.

Of course, we don’t know whether is due to epigenic modifications being reset to “lean” by these behaviors or whether the new behaviors became automatic and overrode epigenetics.

It doesn’t matter. It means you can end the ‘yo-yo’ cycle forever. You can keep weight off, and you know how to do it.

The Bottom Line

A recent study in both humans and mice suggests that epigenetic modifications to key genes in your fat cells make it hard to keep weight off. These epigenetic changes may explain why so many people struggle with yo-yo dieting.

 

For more details on this study and how you may be able to override these epigenetic modifications and prevent weight regain read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure or prevent any disease.

 _____________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

_______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

Does Diet Matter For Weight Loss?

by

Who Benefits Most From A Healthy Diet?

Author: Dr. Stephen Chaney 

fad dietsFad diets abound. High protein, low carb, low fat, vegan, keto, paleo – the list is endless. They all claim to be backed by scientific studies showing that you lose weight, lower your cholesterol and triglycerides, lower your blood pressure, and smooth out your blood sugar swings.

They all claim to be the best. But any reasonable person knows they can’t all be the best. Someone must be lying.

My take on this is that fad diet proponents are relying on “smoke and mirrors” to make their diet look like the best. I have written about this before, but here is a brief synopsis:

  • They compare their diet with the typical American diet.
    • Anything looks good compared to the typical American diet.
    • Instead, they should be comparing their diet with other weight loss diets. That is the only way we can learn which diet is best.
  • They are all restrictive diets.
    • Any restrictive diet will cause you to eat fewer calories and to lose weight.
    • And as little as 5% weight loss results in lower cholesterol & triglycerides, lower blood pressure, and better control of blood sugar levels.

Simply put, any restrictive diet will give you short-term weight loss and improvement in blood parameters linked to heart disease, stroke, and diabetes. But are these diets healthy long term? For some of them, the answer is a clear no. Others are unlikely to be healthy but have not been studied long term. So, we don’t know whether they are healthy or not.

What if you started from the opposite perspective? Instead of asking, “Is a diet that helps you lose weight healthy long term?”, what if you asked, “Does the diet you choose matter for weight loss? Can healthy eating help you lose weight?” The study (S Schutte et al, American Journal of Clinical Nutrition, 115: 1-18, 2022)) I will review this week asked these question.

This was an excellent study. It compared a healthy diet to an unhealthy diet with the same degree of caloric restriction. And it compared both diets to the habitual diet of people in that area. This study was performed in the Netherlands, so both weight loss diets were compared to the habitual Dutch diet.

How Was The Study Done?

clinical studyThis was a randomized controlled trial, the gold standard of clinical studies. The investigators recruited 100 healthy, abdominally obese men and women aged 40-70. At the time of entry into the study none of the participants:

  • Had diabetes.
  • Smoked.
  • Had a diagnosed medical condition.
  • Were on a medication that interfered with blood sugar control.
  • Were on a vegetarian diet.

The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • A continuation of their habitual diet.

The study lasted 12 weeks. The participants met with a dietitian on a weekly basis. The dietitian gave them all the foods they needed for the next week and monitored their adherence to their assigned diet. They were advised not to change their exercise regimen during the study.

At the beginning and end of the study the participants were weighed, and cholesterol, triglycerides, and blood pressure were measured.

Does Diet Matter For Weight Loss?

Vegetarian DietThis study compared a healthy diet to an unhealthy diet with the same degree of caloric restriction. And it compared both diets to the habitual diet of people in that area. This study was performed in the Netherlands, so both weight loss diets were compared to the habitual Dutch diet.

To put this study into context, these were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less fructose and other added sugars than the “low-nutrient-quality” diet.

When the investigators measured weight loss at the end of 12 weeks:

  • Participants lost significant weight on both calorie-restricted diets compared to the group that continued to eat their habitual diet.
    • That is not surprising. Any diet that successfully restricts calories will result in weight loss.
  • Participants on the high-nutrient quality diet lost 33% more weight than participants on the low-nutrient-quality diet (18.5 pounds compared to 13.9 pounds).
  • Participants on the high-nutrient quality diet lost 50% more inches in waist circumference than participants on the low-nutrient-quality diet (1.8 inches compared to 1.2 inches).
    • Waist circumference is a direct measure of abdominal obesity.

When the investigators measured blood pressure, fasting total cholesterol levels, and triglyceride Heart Healthy Dietlevels at 12 weeks:

  • These cardiovascular risk factors were significantly improved on both diets.
    • Again, this would be expected. Any diet that causes weight loss results in an improvement in these parameters.
  • However, the reduction in total serum cholesterol was 2.5-fold greater and the reduction in triglycerides was 2-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.
  • And the reduction in systolic blood pressure was 2-fold greater and the reduction in diastolic blood pressure was 1.67-fold greater in the high-nutrient quality diet group than in the low-nutrient-quality diet group.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose and other added sugars provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, diet does matter for weight loss. Healthy eating helped them lose more weight and gave them greater improvement in their health.

Who Benefits Most From A Healthy Diet?

obesity vs. overweightNone of the participants in this study had been diagnosed with diabetes when the study began. However, all of them were middle-aged, overweight, and had abdominal obesity. That means many of them likely had some degree of insulin resistance.

Because of some complex metabolic studies that I did not describe, the investigators suspected that insulin resistance might influence the relative effectiveness of the two energy-restricted diets.

To test this hypothesis, they used an assay called HOMA-IR (homeostatic model assessment of insulin resistance). Simply put, this assay measures how much insulin is required to keep your blood sugar under control.

They used a HOMA-IR score of 2.5 to categorize insulin resistance among the participants.

  • Participants with a HOMA-IR score >2.5 were categorized as insulin-resistant. This was 55% of the participants.
  • Participants with a HOMA-IR score ≤2.5 were categorized as insulin-sensitive. This was 45% of the participants.

When they used this method to categorize participants they found:

  • Insulin-resistant individuals lost about the same amount of weight on both diets.
  • Insulin-sensitive individuals lost 66% more weight on the high-nutrient-quality diet than the low-nutrient-quality diet (21.6 pounds compared to 13.0 pounds).

The investigators concluded, “Overweight, insulin-sensitive subjects may benefit more from a high- than a low-nutrient-quality energy-restricted diet with respect to weight loss…”

What Does This Study Mean For You?

Questioning WomanSimply put this study confirms that:

  • Caloric restriction leads to weight loss, and…
  • Weight loss leads to improvement in cardiovascular risk factors like total cholesterol, triglycerides, and blood pressure.
    • This is not new.
    • This is true for any diet that results in caloric restriction.

However, this study breaks new ground in that it shows a high-nutrient quality diet results in significantly better…

  • Weight loss and…
  • Reduction in cardiovascular risk factors….

…compared to a low-nutrient quality diet with the same degree of caloric restriction.

As I said above, the distinction between a “high-nutrient-quality” diet and a “low-nutrient-quality” diet may not be what you might have expected.

  • Both diets were whole food diets. Neither diet allowed sodas, sweets, and highly processed foods.
  • Both included fruits, vegetables, grains, and lean meats.
  • Both reduced caloric intake by 25%.
    • If you want to get the most out of your weight loss diet, this is a good place to start.

However, in this study the investigators designed their “high-nutrient-quality” diet so that it contained:

  • More plant protein in the form of soy protein.
    • In this study they did not reduce the amount of animal protein in the “high-nutrient-quality” diet. They simply added soy protein foods to the diet. I would recommend substituting soy protein for some of the animal protein in the diet.
  • More fiber.
    • The additional fiber came from substituting whole grain breads and brown rice for refined grain breads and white rice, adding soy protein foods, and adding an additional serving of fruit.
  • More healthy fats (monounsaturated and omega-3 fats).
    • The additional omega-3s came from adding a fish oil capsule providing 700mg of EPA and DHA.
  • Less added sugar.
    • While this study focused on fructose, their high-nutrient-quality diet was lower in all added sugars.

All these changes make great sense if you are trying to lose weight.

ProfessorI would group these changes into 7 recommendation

1) Follow a whole food diet. Avoid sodas, sweets, and highly processed foods.

2) Include all 5 food groups in your weight loss diet. Fruits, vegetables, whole grains, dairy, and lean proteins all play an important role in your long-term health.

3) Eat a primarily plant-based diet. My recommendation is to substitute plant proteins for at least half of your high-fat animal proteins. And this study reminds us that soy protein foods are a convenient and effective way to achieve this goal.

4) Eat a diet high in natural fiber. Including fruits, vegetables, whole grains, beans, nuts, seeds, and soy foods in your diet is the best way to achieve this goal.

5) Substitute healthy fats (monounsaturated and omega-3 fats) for unhealthy fats (saturated and trans fats) in your diet. And this study reminds us that it is hard to get enough omega-3s in your diet without an omega-3 supplement.

6) Reduce the amount of added sugar, especially fructose, from your diet. That is best achieved by eliminating sodas, sweets, and highly processed foods from the diet. I should add that fructose in fruits and some healthy foods is not a problem. For more information on that topic, I refer you to a previous “Health Tips” article.

7) Finally, I would like to remind you of the obvious. No diet, no matter how healthy, will help you lose weight unless you cut back on calories. Fad diets achieve that by restricting the foods you can eat. In the case of a healthy diet, the best way to do it is to cut back on portion sizes and choose foods with low caloric density.

Finally, I should touch briefly on the third major conclusion of this study, namely that the “high-nutrient quality diet” was not more effective than the “low-nutrient-quality” diet for people who were insulin resistant. In one sense, this was not news. Previous studies have suggested that insulin-resistant individuals have more difficulty losing weight. That’s the bad news.

However, there was a silver lining to this finding as well:

  • Only around half of the overweight, abdominally obese adults in this study were highly insulin resistant.
    • That means there is a ~50% chance that you will lose more weight on a healthy diet.
  • More importantly, because both diets restricted calories by 25%, insulin-resistant individuals lost weight on both diets.
    • That means you can lose weight on any diet that successfully reduces your caloric intake even if you are insulin resistant. That’s the good news.
  • However, my recommendation would still be to choose a high-nutrient quality diet that is designed to reduce caloric intake, because that diet is more likely to be healthy long term.

The Bottom Line 

A recent study asked, “Can healthy eating help you lose weight?” This study was a randomized controlled study, the gold standard of clinical studies. The participants were randomly assigned to:

  • A high-nutrient quality diet that restricted calories by 25%.
  • A low-nutrient-quality diet that restricted calories by 25%.
  • Continue with their habitual diet.

These were not healthy and unhealthy diets in the traditional sense.

  • Both were whole food diets.
  • Both included fruits, vegetables, low-fat dairy, and lean meats.
  • Both restricted calories by 25%.

The diets were designed so that the “high-nutrient quality” diet had significantly more plant protein (in the form of soy protein), fiber, healthy fats (monounsaturated and omega-3 fats), and significantly less fructose and other added sugars than the “low-nutrient-quality” diet.

At the end of 12 weeks:

  • Participants on the high-nutrient quality diet lost 33% more weight and had better cardiovascular markers than participants on the low-nutrient-quality diet.

The authors concluded, “Our results demonstrate that the nutrient composition of an energy-restricted diet is of great importance for improvements of metabolic health in an overweight, middle-aged population. A high-nutrient quality energy-restricted diet enriched with soy protein, fiber, monounsaturated fats, omega-3 fats, and reduced in fructose and other added sugars provided additional health benefits over a low-nutrient quality energy-restricted diet, resulting in greater weight loss…and promoting an antiatherogenic blood lipid profile.”

In short, participants in this study lost more weight and had a better improvement in risk factors for heart disease on a high-nutrient-quality diet than on a low-nutrient-quality diet. Put another way, diet does matter for weight loss. Healthy eating helped them lose more weight and gave them greater improvement in their heart health.

For more details on this study, what this study means for you, and my 7 recommendations for a healthy weight loss diet, read the article above.

These statements have not been evaluated by the Food and Drug Administration. This information is not intended to diagnose, treat, cure, or prevent any disease.

 ______________________________________________________________________________

My posts and “Health Tips From the Professor” articles carefully avoid claims about any brand of supplement or manufacturer of supplements. However, I am often asked by representatives of supplement companies if they can share them with their customers.

My answer is, “Yes, as long as you share only the article without any additions or alterations. In particular, you should avoid adding any mention of your company or your company’s products. If you were to do that, you could be making what the FTC and FDA consider a “misleading health claim” that could result in legal action against you and the company you represent.

For more detail about FTC regulations for health claims, see this link.

https://www.ftc.gov/business-guidance/resources/health-products-compliance-guidance

 _______________________________________________________________________

About The Author 

Dr. Chaney has a BS in Chemistry from Duke University and a PhD in Biochemistry from UCLA. He is Professor Emeritus from the University of North Carolina where he taught biochemistry and nutrition to medical and dental students for 40 years.

Dr. Chaney won numerous teaching awards at UNC, including the Academy of Educators “Excellence in Teaching Lifetime Achievement Award”.

Dr Chaney also ran an active cancer research program at UNC and published over 100 scientific articles and reviews in peer-reviewed scientific journals. In addition, he authored two chapters on nutrition in one of the leading biochemistry text books for medical students.

Since retiring from the University of North Carolina, he has been writing a weekly health blog called “Health Tips From the Professor”. He has also written two best-selling books, “Slaying the Food Myths” and “Slaying the Supplement Myths”. And most recently he has created an online lifestyle change course, “Create Your Personal Health Zone”. For more information visit https://chaneyhealth.com.

For the past 45 years Dr. Chaney and his wife Suzanne have been helping people improve their health holistically through a combination of good diet, exercise, weight control and appropriate supplementation.

 

 

Health Tips From The Professor