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May 11

Eating behavior dimensions and 9-year weight loss maintenance: a … – Nature.com

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May 11

How can supplements stay relevant in an evolving weight … – Nutritional Outlook

When does it pay to be the butt of a joke? When that joke reaches an audience of nearly 20 million American television viewers1, thats when.

And by that reckoning, comedian Jimmy Kimmels sly lampooning of Ozempic and its famous fans at the 95th annual Academy Awards did the once-unassuming diabetes drug a reputational favor.

Not that Ozempic needed the boost: Almost overnight, the prescription injectable went from near-obscurity to viral sensation thanks to the attention of influencers and celebrities who touted its promise as the latest weight-loss wonder drug.

And while that frenzys subsided somewhat, Ozempic as a weight-management tool isnt going awaynor are the questions it raises about how best to do weight loss in an environment as rife with barriers to success as it is with hopes for it.

No wonder Andrea Zangara, head of scientific communications and marketing, Euromed (Mollet del Valls, Spain), sees the saga of Ozempic as a never-ending story.

There will always be demand for easy and effective weight-loss solutions, he says. And that recurring pattern underscores the importance of understanding the factors that contribute to weight management. For supplement brands, that means making R&D the priority when creating products that tick all the boxes: convenient, natural, safe, and effective.

Why Weight?

If occasional dramas in the weight-management space are nothing new, the forces animating the current Ozempic buzz, as well as the urgency of tackling real issues around excess bodyweight, are.

As Zangara says, As we emerge from the pandemic with a renewed awareness of the importance of health, weight management has become a priority as consumers aim to improve their well-beingparticularly after adopting unsatisfactory dietary and lifestyle habits during lockdown.

And consumers are taking that aim not a moment too soon: The World Obesity Federation predicts that by 2035, 51% of the globe will be overweight or obese should current patterns continue, Zangara notes.

Net Effects

But urgent need shouldnt prescribe urgent action that fails to account for the consequenceswhich is where the headlong rush toward Ozempic raises concern.

Its active component, and that of similar drugs, is semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist that upregulates the effects of this naturally occurring hormone.

Those effects include increased insulin production and a subsequent decrease in circulating levels of blood glucose, as well as inhibited production of the hormone glucagonwhich, as yin to insulins yang, increases the breakdown of liver glycogen and the synthesis of new glucose, thereby boosting blood-glucose levels.

Combined, these reciprocal actions help explain why Ozempic and other semaglutide drugs are potent diabetes treatments. But what makes semaglutide relevant for weight management are its actions on the brains hypothalamic hunger centers and its ability to slow stomach emptying and thus extend postprandial feelings of fullness.

The net effects there amount to greater satiety, less hunger, and fewer food cravingsall of which stack the odds in favor of eating less and shifting the bodys energy balance toward caloric deficit. And that, as the laws of thermodynamics predict, shifts the scale downward.

Not So Fast

So far so good, right?

Not necessarily. As Zangara sees it, the drugs sudden popularity demonstrates how quickly information can spread and influence public opinion, especially when it comes to weight loss. And while he acknowledges that medications like Ozempic arent bad starting points for obese individuals, hes hardly alone in noting that it has its limitations.

Shaheen Majeed, CEO of BGG Americas, Algae Health Sciences, and HBNI North America (Irvine, CA), also sees drawbacks. Im not an expert on Ozempic by any means, Majeed says, but historically, most pharmaceutical weight-loss drugs have had serious side effects. One need only visit Ozempics own website, he notes, to review its litany of possible complicationsfrom nausea and abdominal pain to pancreatitis, thyroid tumors, and kidney failure. Plus, Majeed says, the drug is an injectable, so Id certainly not consider it convenient.

Michael Chernyak, president, CK Nutraceuticals (Oakville, ON, Canada), adds that cravings may resume once use of the drug stops. And indeed, he says, Weight gains of around 10%-15% have been observed in obese subjects who discontinued use.

And as far as Gary Troxel, CEO, Gateway Health Alliances (Fairfield, CA), is concerned, the drugs apparent vogue is unfortunate for several reasons.

First, he laments the supply bottlenecks that impeded diabetics access. Besides that, he says, Hollywood and some media are normalizing the use of a powerful medicine thats not intended for healthy individuals. For people who dont have the serious medical issues for which these drugs were intended, taking them as shortcuts to weight management is ill advised and possibly dangerous. And it perpetuates the myth that theres a magic bullet for weight loss.

Quick-Fix Appeal

Of course, Troxel gets that myths allure. Its human nature to seek easy solutions, he concedes. Maintaining healthy body weight and composition requires work and discipline around eating healthily, exercising, and making smart lifestyle choices. And staying on those wagons isnt easy in our distracted, hyper-caloric age.

Chernyak also sees the desire for easy weight loss as human nature at its finest. But, he continues, The fact that obesity and other metabolic indications are still so prevalent means that quick fixes simply dont existat least not in a sustainable fashion. So even though busy, tired consumers will always bite on the next big promise or miracle product, permanent diet and lifestyle changes are the answers long-term.

That makes common sense to Majeed. Anything that seems too good to be true usually is, he concludes. Weight loss isnt rocket science and doesnt have to be risky. The best formula for safe weight management is maintaining caloric intake at normal levels and eating a healthy dietcombined with regular aerobic exercise and a good weight-loss supplement.

And lest anyone worry: Ozempic may have dominated recent news cycles, but health-conscious consumers who prefer natural ways of addressing wellness will continue to gravitate toward clinically validated weight-loss supplements, Majeed predicts.

Multiple Mechanisms

Increasingly, that clinical validation shows that contemporary weight-management supplements achieve their benefits via multiple mechanisms of action.

The word Zangara uses to describe this is pleiotropic, or producing more than one effect, and he sees it as a signature advantage of todays weight-management supplements relative to their predecessors.

These innovations reflect a deeper understanding of the relationship between nutritional supplementation and weight management, Zangara argues, and they offer a more comprehensive approach by targeting multiple mechanisms rather than focusing on a single aspect of weight loss.

Fruit-Based Solutions

For example, Zangara notes that the pomegranate polyphenols punicalagin and urolithin can influence satiety signaling via hormones like leptin and ghrelinwhich affect hunger and fullnesswhile also improving metabolic health by reducing insulin resistance, blood pressure, and stress-hormone levels.

They may also increase levels of adiponectin, a hormone produced in fat cells that improves insulin sensitivity while attenuating inflammationall of which Zangara says may affect fat metabolism and positively influence the gut microbiome, potentially affecting the gut/brain axis through modulation of gut peptides involved in satiety signaling.

Thus Euromed standardized its Pomanox pomegranate extract to 30% punicalagins, and a recent study2 on the product found that subjects who supplemented with it daily for three weeks felt less hungry, more satisfied, and fuller relative to those in the placebo group. Another study3 found that supplementation yielded significant increases in urinary total phenolics excretion, antioxidant capacity, and lean body mass while reducing blood pressure, fat mass, body fat, and salivary cortisol levels.

Calling it the stress hormone, Zangara notes that cortisol can promote fat storage and muscle breakdown, hamper metabolism, and disrupt sleep, which itself can affect appetite regulation and metabolism, he says.

Euromed also explored the metabolic effects of abscisic acid (ABA), a phytohormone present in figs, with research4 on its ABAlife fig extract standardized to various ABA concentrations showing that it regulates blood glucose and insulin levels while lowering the glycemic and insulinemic indexes of high-glycemic-index foods.

Interestingly, Zangara says, the compound may bind to LANCL2 receptors to initiate cellular signaling that enhances glucose uptake and increases expression and membrane translocation of a glucose-transport protein, thereby improving glucose homeostasis via a mechanism not unlike semaglutides. Given the similarities in how they work, he concludes, ABAlife may offer weight-management benefits with fewer potential side effects than synthetic weight-management drugs like Ozempic.

Turmeric to the Rescue

Also turning to the plant kingdom, scientists at Sabinsa Corp. (East Windsor, NJ) developed the companys CurCousin supplement based on a minor plant metabolite occurring in Curcuma longa, or turmeric root, explains Kalyanam Nagabhushanam, PhD, Sabinsas president of R&D.

In a recent clinical trial5, twice-daily supplementation with 25 mg over the studys 90-day duration yielded statistically significant drops in bodyweight, body-mass index, and waist circumference in obese participants, with additional benefits appearing in the supplement groups lipid profiles, he says, including a detectable increase in HDL. Increases also emerged in levels of adiponectin, Nagabhushanam adds.

Obesity is always underlined with chronic inflammation, he continues, and a reduction of that was observed in subjects receiving CurCousin.

Finally, an animal study6 published this year associated the supplement with benefits around thermogenesis and modulation of the gut microbiota, leading Nagabhushanam to conclude that, Clearly, CurCousin combines several advantages and acts on various pathways.

Gut Instincts

Approaching wellness via the microbiome is a specialty at OptiBiotix Health Plc (York, UK), and as CEO Stephen OHara says, The challenge with weight management is to steer the conversation in a new direction with alternatives that offer no reported side effects but that deliver the same results as do pharmaceuticals like Ozempic.

For example, the companys SlimBiome, a patented, mineral-enriched prebiotic fiber complex, gently expands in the stomach to help consumers feel fuller longer, OHara claims. The ingredient also attenuates blood-glucose levels and reduces cravingall actions seen with semaglutide.

But the fiber complex actually modifies the microbiome, OHara says, to increase the number of microbes associated with lean body shape.

According to one double-blind, placebo-controlled study carried out by Oxford Brookes University7, SlimBiome reduced hunger by 10%, food cravings by 11%, and food intake by 49%. A second study8 by the University of Roehampton demonstrated a 21% reduction in food cravings and a 26% improvement in mood, OHara adds. It also showed that 90% of volunteers lost weight, reduced their body fat, and exhibited reductions in hip and waist circumferences.

In comparison to injectable drugs, SlimBiome generated no side effects in either study, and it appears to spare muscle even at the expense of body fata hedge against reported cases of muscle loss and wastage associated with semaglutide use, OHara notes. So while theres no simple path to weight loss, he concludes, there are safe, effective, and sustainable alternatives that help consumers help themselves.

Out of Africa

Gateway Health has looked to Africa for clues about how to formulate safe and effective weight-management supplements, and one of the trails it followed led to African mango, or Irvingia gabonensis.

Used traditionally, this botanical is now the subject of research for its apparent ability to modulate hormones linked to appetite, satiety, insulin sensitivity, and energy metabolism, Troxel notes.

And in five peer-reviewed, double-blind, placebo-controlled clinical studies involving more than 400 subjects9-13, supplementation with IGOB131, the companys Irvingia gabonensis product standardized to an aqueous-ethanol-extracted minimum of 10% albumins and 1% ellagic acid, has led to significantly lower bodyweight and body-fat percentage, as well as significantly lower levels of LDL cholesterol and the inflammatory biomarker C-reactive protein.

And while initial observations suggested that the extracts beneficial metabolic effects owed to its high fiber content, Troxel says that subsequent analysis suggests additional and unidentified bioactive components have contributory effects.

Also out of African tradition is Dyglomera, Gateway Healths patented extract of Dichrostachys glomerata standardized to an aqueous ethanolextracted minimum of 10% polyphenols. According to Troxel, the supplement doesnt just restore sensitivity to insulin, leptin, and adiponectin to improve blood sugar, satiety, and appetite; it also favorably modulates various metabolic pathways and reduces oxidative stress linked to cell damage and that contributes to obesity and a high body-mass index.

A randomized, double-blind, placebo-controlled clinical study of 297 subjects14 found that after eight weeks of supplementation, participants in the Dyglomera group lost an average of 24.5 lb compared to 1.16 lb for the control group. The Dyglomera subjects also saw significant improvements in blood glucose and lipid parameters and reduced insulin resistance and circulating markers of inflammation.

Heartened by such results, Troxel has no doubt about weight-management supplements prospects even in the face of blockbuster drugs. In fact, supplements role in weight management routines may actually increase as ingredient science expands through well-designed clinical studies.

Yes, Ozempic and its ilk may exert a short-term impact, he allows. But we think off-label use will fizzle once the public becomes more aware of the potential serious side effects of drugs like these. Healthy consumers will follow their traditional preferences for natural solutions over pharmaceuticals.

References

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May 11

Carnivore Diet: Benefits and Risks – Health.com

The Carnivore Diet is a restrictive diet that eliminates most plant foods, including fruits, vegetables, and beans. When following a Carnivore Diet, a person relies solely on animal products to meet all or most of their nutritional needs.

This diet is popular amongst people who want to lose weight and improve medical conditions like diabetes. There are numerous health concerns related to this eating pattern, but some argue that the Carnivore Diet is a healthy way to eat.

This article takes a deep dive into the Carnivore Diet and tells you everything you need to know about what it is, how to follow it, and how this unconventional way of eating affects health.

Although the Carnivore Diet has only recently become popular, scientists have been interested in this very low-carb way of eating for hundreds of years.

There are several accounts of researchers mimicking the traditional meat-based dietary intake of Arctic or nomadic societies as far back as the 1700s. For example, in 1797 Dr. John Rollo successfully treated patients with type 2 diabetes using a diet that consisted primarily of meat and fat after studying the very low-carbohydrate diet of indigenous people in St. Lucia. After discovering that a very low-carb diet benefited those with diabetes, it became a widely adopted treatment for managing this condition until the discovery of insulin in 1921.

The Carnivore Diet we know today was popularized by Shawn Baker, M.D.,who authored a book titled The Carnivore Diet in 2018 after finding that a meat-based diet benefited his health. This version of the Carnivore Diet advocated for the complete elimination of plant foods and total reliance on meat and other animal products like eggs, seafood, and full-fat dairy products.

Some Carnivore advocates follow a strict Carnivore Diet that only includes animal-based foods, while others follow less restrictive versions that allow for small amounts of plant-based foods, like low-carb vegetables.

However, most people following Carnivore-type diets get most of their calories from meat and other animal foods.

Although there are different versions of the Carnivore Diet, most people following this eating pattern primarily consume animal foods, such as:

In addition to animal-based foods, people on Carnivore Diets allow for seasonings like salt, pepper, herbs, and spices.

A 2021 study that included data on the dietary intake of 2,029 people following Carnivore-style diets found that red meat products, like beef, lamb, and venison, were the most commonly consumed foods, followed by eggs and nonmilk dairy products. The study also found that over 50% of the participants drank coffee at least once per day.

People following Carnivore Diets get most of their calories from animal-based foods. Although less restrictive versions of the carnivore diet exist, the following foods are usually restricted or completely avoided by those following this eating pattern:

Water is the preferred beverage when following a Carnivore Diet, though many people who follow this diet include tea and coffee in their daily routine.

Additionally, some people allow for a small amount of low-carb vegetables, like greens and zucchini.

Currently, theres limited research investigating the health benefits of following a Carnivore Diet.

However, theres plenty of evidence that very-low carb diets can benefit the health of some people, such as those with type 2 diabetes.

Although there are no strict rules regarding the macronutrient ratio of the Carnivore Diet, it can generally be considered a type of high-protein, very low-carb diet.Studies show that certain very low-carb diets, like the keto diet, could be helpful for certain health conditions. But, keep in mind that very low-carb diets arent the same thing as the Carnivore Diet, and theres currently limited evidence that the Carnivore Diet improves health in any way, specifically.

That said, the Carnivore Diet may offer a few benefits.

Low-carb diets are effective for improving health outcomes in people with diabetes. This is because these diets are low in carbohydrate-rich foods, which have the largest impact on blood sugar and insulin levels.

If a person follows a Carnivore Diet, their carbohydrate intake would be minimal, and their blood sugar levels and reliance on diabetes medications would likely decrease.

In the 2021 study that included data on the dietary intake of 2,029 people followingCarnivore-style diets for nine to 20 months, researchers found that the participants with type 2 diabetes experienced reductions in their levels of hemoglobin A1c (HbA1c)-a long-term marker of blood sugar control- and significant reductions in their diabetes medication use. In fact, among the 262 participants with type 1 or type 2 diabetes (T2DM), 84% discontinued oral diabetes medications and 92% of participants with T2DM discontinued their use of insulin.

Although these results are promising, more research investigating the effectiveness and safety of the Carnivore Diet is needed. Also, its important to note that diabetes can be effectively managed using less restrictive diets, such as plant-based diets and more inclusive low-carb diets, which are far better for overall health and easier to stick to long-term.

The Carnivore Diet eliminates many foods and beverages implicated in weight gain, including ultra-processed foods and added sugar. Since this dietary pattern is low in carb-rich foods and so high in protein, which is the most filling macronutrient, its likely that the Carnivore Diet will promote weight loss, at least in the short term.

In the 2021 study mentioned above, the participants reported substantial reductions in their body mass index (BMI)a measure of body fat based on height and weightafter transitioning to a Carnivore Diet.

While this is encouraging, the Carnivore Diet is highly restrictive and likely unsustainable for most people. Similar diets, like the keto diet, have also been shown to be effective for short-term weight loss. However, diets that cut out a number of healthy foods like keto are notoriously difficult to stick to, and most evidence suggests that, in the long-term, their efficacy is comparable to other, less restrictive weight loss diets.

This means that even though the Carnivore Diet may promote quick weight loss, more inclusive diets that are easier to follow are likely just as effective for long-term weight loss and healthy weight maintenance.

Participants included in the 2021 study reported that following a Carnivore Diet led to improvements in their overall health, physical and mental well-being, and some chronic medical conditions.

This may be because the Carnivore Diet cuts out foods and drinks associated with poor physical and mental health, including ultra-processed foods and added sugars.

But keep in mind that the participants included in this study had only been following the Carnivore Diet for nine to 20 months. Its unknown how the Carnivore Diet impacts long-term health, including disease risk.

Overall, more research is needed to fully understand how the Carnivore Diet impacts overall health.

Though proponents of the Carnivore Diet suggest that this way of eating can help boost weight loss and improve chronic diseases, there are several significant downsides to this way of eating.

First, this diet is extremely restrictive and cuts out foods that are known to improve health and deliver essential nutrients, like fruits and vegetables. Diets low in produce have been consistently linked with an increased risk of several diseases, including cancer and heart disease, as well as overall mortality risk.

A high intake of red and processed meat has also been associated with an increased risk of several health conditions, including colorectal cancer, breast cancer, colon cancer, and heart disease.

Another concern with the Carnivore Diet is the environmental impact of a dietary pattern high in red meat and other animal products. Research shows that red meat production significantly contributes to greenhouse gas emissions and has a considerable impact on global warming and climate change.

Whats more, a diet low in plant foods can lead to unpleasant side effects like constipation, fatigue, low mood, nutrient deficiencies, and more.

Heres an idea of what someone following a Carnivore Diet might eat on a daily basis:

Keep in mind that some people following a less restrictive Carnivore Diet may include some produce in their diet, like low-carb vegetables.

The Carnivore Diet is a highly restrictive diet thats recently become popular amongst those looking to lose weight and improve health conditions like type 2 diabetes.

Although limited evidence suggests that following this eating pattern could result in weight loss and improvements in blood sugar levels, there are significant concerns with the long-term health implications of this diet.

Following the Carnivore diet long-term could increase your risk for a number of serious health conditions, such as colorectal cancer and heart disease.

If youre looking for a safer, more evidence-based way to better your health, consider trying a less restrictive diet high in foods known to improve overall health, such as the Mediterranean diet or a less restrictive low-carb diet.

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May 11

Innovent Announces Phase 2 Clinical Study of Higher dose 9 mg … – PR Newswire

ROCKVILLIE, Md. and SUZHOU, China, May 10, 2023 /PRNewswire/ -- Innovent Biologics, Inc. (Innovent) (HKEX: 01801), a world-class biopharmaceutical company that develops, manufactures and commercializes high-quality medicines for the treatment of oncology, metabolic, autoimmune, ophthalmology and other major diseases, today announced that the phase 2 clinical study of higher dose (9 mg) mazdutide (Innovent R&D Code: IBI362) in Chinese adults with obesity achieved the 24-week primary endpoint.

This is a randomized, double-blind, placebo-controlled phase 2 clinical study to evaluate the efficacy and safety of mazdutide 9 mg in Chinese subjects with obesity [body mass index (BMI) 30.0 kg/m2]. A total of 80 subjects were enrolled (mean baseline weight 96.9 kg, mean height 168.0 cm, mean BMI 34.3 kg/m2) and randomized in a 3:1 ratio to mazdutide 9 mg group or placebo group to receive treatment once a week for 24 weeks. The primary endpoint is the percent change in body weight from baseline versus placebo after 24 weeks of treatment. The study will also extend treatment to 48 weeks.

The results showed that mazdutide 9 mg demonstrated superior body weight loss versus placebo in Chinese subjects with obesity. After 24 weeks of treatment, the treatment difference of the mean percent change in body weight from baseline versus placebo was -15.4%95%CI: -18.8%, -11.9%, P<0.0001; The treatment difference of the mean change in body weight from baseline versus placebo was -14.7 kg95%CI-17.9 kg, -11.5 kgP<0.0001. Meanwhile, 81.7%65.0%31.7% and 21.7% of the subjects in the mazdutide 9 mg group achieved 5% or more,10% or more, 15% or more and 20% or more weight loss from baseline, respectively, while no subject in the placebo group lost 5% or more of body weight from baseline.

In terms of safety, the overall tolerability and safety of the mazdutide 9 mg was favorable. The drop-out rate of the mazdutide group was lower than that of the placebo group. No subject in the mazdutide group discontinued treatment due to adverse events. No serious adverse events occurred. Except for COVID-19 infection, the most commonly-reported adverse events were gastrointestinal-related adverse events, most of which were mild or moderate and transient.

The study is still in progress, and the data of other secondary and exploratory endpoints of the study will be analyzed and disclosed after the end of the study.

Professor Linong Ji, the leading principal investigator of the study, Peking University People's Hospital, stated,"The overweight and obese population in China has continued to increase in recent years. There are about 160 million obese people across China (BMI 28.0 kg/m2), of which approximately 10 million are with moderate and severe obesity (BMI 32.5 kg/m2). The risk of cardiovascular and cerebrovascular diseases for these patients is extremely high, and the quality of daily life and mental health of these patients are significantly affected. Compared with the general obese population, moderately- to severely- obese patients urgently need effective and safe weight loss options. At present, metabolic surgery is the main treatment for people with a BMI 32.5 kg/m2, other treatment options are limited. Despite the obvious efficacy of surgical weight loss, it is only used in a small number of patients for many reasons. In recent years, the development of GLP-1 receptor agonists, especially a new generation of dual-target agonists, has brought prospects for weight loss drugs. However, there are few clinical studies on GLP-1 receptor agonists in patients with moderate to severe obesity in the world, especially in the Chinese population.

I am pleased to see the weight loss efficacy of mazdutide 9 mg has been further improved versus mazdutide 6 mg while showing good tolerability and safety. The observed efficacy of mazdutide 9 mg after 24 weeks of treatment is approaching that of metabolic surgery, which suggests the potential of mazdutide to become a more ideal therapeutic drug for patients with moderate to severe obesity. This study also fills the gap in the clinical research of drug treatment of patients with severe obesity in Chinese and even East Asian populations. I am hopeful that mazdutide 9 mg will also show satisfactory results in future phase 3 studies."

Dr. Lei Qian, Vice President of Clinical Development at Innovent,stated, " Mazdutide 9 mg achieved the primary endpoint in the phase 2 study of subjects with moderate to severe obesity in China, demonstrated a superior weight loss efficacy to placebo after 24 weeks of treatment while showing good tolerability and safety, which is an important step in the overall indication development strategy and lifecycle management of mazdutide. From a global perspective, weight loss treatments for patients with moderate to severe obesity are extremely limited. Single-target GLP-1 drugs have limited efficacy in this population and can hardly achieve 15% placebo-adjusted weight loss even with one year's treatment. However, the mazdutide 9mg regimen gave encouraging efficacy of 15.4% (14.7kg) placebo-adjusted weigh loss only after 24 weeks, in a population with baseline average BMI of 34.3 kg/m2, suggesting it will be effective in the population with greater unmet need for effective therapy. These results are comparable to the most effective multi-target GLP-1 receptor agonist drugs and even bariatric surgery, and a trend of continuous decline of body weight was observed at Week 24 in the study. The study is still in progress and will continue to evaluate the efficacy and safety after 48 weeks of treatment. I am confident that that longer treatment will bring more weight loss efficacy. In addition, we will advance the phase 3 clinical study of mazdutide 9 mg in due course, and strive to provide a drug treatment option that can potentially offer a treatment option where today the only highly effective option is bariatric surgery."

About Obesity

China has the largest overweight and obese population in the world, with the obesity rate likely to increase. Obesity can lead to a range of complications or related diseases that impact life expectancy and deteriorate the quality of life. In more severely obese patients, the incidence and mortality of cardiovascular disease, diabetes, and certain tumors increase significantly. Obesity is a chronic disease that requires long-term management, and there is a lack of long-term effective and safe treatments. Lifestyle intervention is the first choice and basic treatment for patients with overweight or obesity. However, a considerable percentage of patients fail to achieve the desired weight loss goal upon lifestyle intervention and may require pharmacological intervention. Traditional pharmacological therapies have been of limited efficacy and safety issues, highlighting the unmet need for more effective and safe therapies.

About Mazdutide

Innovent entered into a licensing agreement with Eli Lilly and Company (Lilly) for the development and potential commercialization of OXM3 (also known as mazdutide), a GLP-1R and GCGR dual agonist, in China. As a mammalian oxyntomodulin (OXM) analogue, in addition to the effects of GLP-1 receptor agonists on promoting insulin secretion, lowering blood glucose and reducing body weight, mazdutide may also increase energy expenditure and improve hepatic fat metabolism through the activation of glucagon receptor. Mazdutide has demonstrated excellent weight loss and glucose-lowering effects in clinical studies, as well as reducing waist circumference, blood lipids, blood pressure, blood uric acid, liver enzymes and liver fat content, as well as improving insulin sensitivity, bringing multiple metabolic benefits. Currently, three key phase 3 studies of mazdutide 4 mg and 6 mg in Chinese patients with overweight or obesity (GLORY-1) and type 2 diabetic (DREAM-1 and DREAM-2) subjects are underway. The Phase 2 clinical study of mazdutide 9 mg in Chinese patients with obesity is in progress.

About Innovent

Inspired by the spirit of "Start with Integrity, Succeed through Action," Innovent's mission is to develop, manufacture and commercialize high-quality biopharmaceutical products that are affordable to ordinary people. Established in 2011, Innovent is committed to developing, manufacturing and commercializing high-quality innovative medicines for the treatment of cancer, autoimmune disease, metabolic disorder and other major diseases. On October 31, 2018, Innovent was listed on the Main Board of the Stock Exchange of Hong Kong Limited with the stock code: 01801.HK.

Since its inception, Innovent has developed a fully integrated multi-functional platform which includes R&D, CMC (Chemistry, Manufacturing, and Controls), clinical development and commercialization capabilities. Leveraging the platform, the company has built a robust pipeline of 35 valuable assets in the fields of cancer, metabolic disorder, autoimmune disease and other major therapeutic areas, with 8 approved products on the market. These include: TYVYT (sintilimab injection), BYVASDA (bevacizumab injection), SULINNO (adalimumab injection), HALPRYZA (rituximab injection), Pemazyre (pemigatinib oral inhibitor), olverembatinibBCR ABL TKI,Cyramza (ramucirumab) and Retsevmo (selpercatinib). An additional 3 assets are under NMPA NDA review, 6 assets are in Phase III or pivotal clinical trials, and 18 more molecules are in clinical studies.

Innovent has built an international team with advanced talent in high-end biological drug development and commercialization, including many global experts. The company has also entered into 28 strategic collaborations with Eli Lilly, Roche, Sanofi, Adimab, Incyte, MD Anderson Cancer Center and other international partners. Innovent strives to work with many collaborators to help advance China's biopharmaceutical industry, improve drug availability and enhance the quality of the patients' lives.

Note:

TYVYT (sintilimab injection) is not an approved product in the United States.

BYVASDA (bevacizumab biosimilar injection), SULINNO, and HALPRYZA (rituximab biosimilar injection) are not approved products in the United States.

TYVYT (sintilimab injection, Innovent)

BYVASDA (bevacizumab biosimilar injection, Innovent)

HALPRYZA (rituximab biosimilar injection, Innovent)

SULINNO (adalimumab biosimilar injection, Innovent)

Pemazyre (pemigatinib oral inhibitor, Incyte Corporation). Pemazyre was discovered by Incyte Corporation and licensed to Innovent for development and commercialization in Mainland China, Hong Kong, Macau and Taiwan.

CYRAMZA (ramucirumab, Eli Lilly). Cyramza was discovered by Eli Lilly and licensed to Innovent for commercialization in Mainland China.

Retsevmo (selpercatinib, Eli Lilly). Retsevmo was discovered by Eli Lilly and licensed to Innovent for commercialization in Mainland China.

Disclaimer:

1. This indication is still under clinical study, which hasn't been approved in China.

2. Innovent does not recommend any off-label usage.

Forward-looking statement

This news release may contain certain forward-looking statements that are, by their nature, subject to significant risks and uncertainties. The words "anticipate", "believe", "estimate", "expect", "intend" and similar expressions, as they relate to Innovent, are intended to identify certain of such forward-looking statements. The Company does not intend to update these forward-looking statements regularly.

These forward-looking statements are based on the existing beliefs, assumptions, expectations, estimates, projections and understandings of the management of the Company with respect to future events at the time these statements are made. These statements are not a guarantee of future developments and are subject to risks, uncertainties and other factors, some of which are beyond the Company's control and are difficult to predict. Consequently, actual results may differ materially from information contained in the forward-looking statements as a result of future changes or developments in our business, the Company's competitive environment and political, economic, legal and social conditions.

The Company, the Directors and the employees of the Company assume (a) no obligation to correct or update the forward-looking statements contained in this site; and (b) no liability in the event that any of the forward-looking statements does not materialise or turn out to be incorrect.

SOURCE Innovent Biologics

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May 11

BI 456906 Shows Promise, Reducing Body Weight Up to 14.9%, in … – MD Magazine

A new face may soon introduce itself to treatment algorithms for chronic weight management, as topline data from a phase 2 trial suggests use of a dual glucagon/GLP-1 receptor agonist, called BI 456906, could help patients lose up to 14.9% of their body weight after 46 weeks in people with obesity or overweight without type 2 diabetes.

The excitement surrounding development in the world of obesity management has been at a fever pitch since the presentation of SURMOUNT-1 results at the American Diabetes Association (ADA) 2022 Scientific Sessions.2 Now, fast-forward to May 10, 2023, and Boehringer Ingelheim and Zealand Pharma are hopeful to drum up the same fervor as they announced plans to present the results of their phase 2 dose-finding trial for BI 456906 at the upcoming ADA 2023 Scientific Sessions in less than 2 months.1

Obesity is one of many cardio-renal-metabolic diseases, which together represent one of the fastest growing health challenges worldwide. The distinct mode of action of BI 456906 targets multiple pathways pivotal to metabolic regulation, including those associated with obesity and liver diseases, said Carinne Brouillon, Head of Human Pharma, Boehringer Ingelheim.1 With our longstanding heritage in cardio-renal-metabolic diseases, we are excited by the findings and potential implications for millions of people who urgently need healthcare solutions.

Launched in March 2021, the phase 2 dose-finding study of BI45906 enrolled adult patients aged 18-75 years with overweight or obesity and randomized them to 1 of 4 doses of once-weekly BI 456906 delivered subcutaneously or placebo therapy. Per trial protocol, patients received escalating doses of BI 456906 for the first 20 weeks and the final 26 weeks of the 46-week treatment period was considered a maintenance phase.1

According to ClinicalTrials.gov, the trial enrolled a total of 387 participants. The primary outcome of interest for the trial was the percentage change in body weight from baseline to week 46. Secondary outcomes of interest included the proportion of patients achieving weight loss equal to or exceeding 5, 10, and 15% of baseline body weight as well as absolute change in body weight, waist circumference, and other metrics. For inclusion in the trial, patients need to be between 18-75 years of age, have a BMI of 27 k/m2 or greater at baseline, and must have undergone at least 1 previous unsuccessful nonsurgical weight-loss attempt.3

In their announcement, Boehringer Ingelheim noted, in addition to the main study results, plans to present an additional analysis of the actual maintenance dose indicating even greater weight loss at ADA 2023. The company also pointed out this agent is also being evaluated in a phase 2 study for adults with nonalcoholic steatohepatitis and liver fibrosis, with this trial expected to be completed in Q4 of 2023.1

We are both enthusiastic about these data and encouraged by the clinical outcomes announced today, said David Kendall, MD, Chief Medical Officer, Zealand Pharma.1 At Zealand Pharma we continue our long-term commitment to the discovery and development of novel differentiated peptide therapeutics that target critical metabolic pathways to achieve substantial weight loss while addressing the complex pathophysiology of overweight and obesity.

References:

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May 11

Local Med Spa Helps Residents Defy The Aging Process – Osprey Observer

Have you ever wanted to defy the aging process? Who hasnt? While no one can stop the clock and the passing of time, ageRejuvenation, a local medical spa clinic, can put a plan in place to bring your body back to an optimal level comparable to when your body was the healthiest in your 20s. ageRejuvenation also offers weight loss plans that can help you reach short-term weight loss goals.

Under the medical direction of Dr. Dawn Ericsson, ageRejuvenation is committed to treating symptoms of aging and promoting longer and healthier living regardless of age. Core to its full-scale program is an individualized whole-body approach that helps patients restore their health through hormonal balance, decreased inflammation, improved sexual function and weight loss.

Brett Markowitz, visionary and founder of ageRejuvenation, said it is devoted to customized treatment plans that use advanced diagnostic testing to provide insight into the root causes of symptoms.

We understand that no two individuals are alike, Markowitz said. We also believe that treating the whole body is important. Looking at the thyroid, looking at the hormones, looking at the gut health is essential.

Clients are given a full-body assessment, which includes a lifestyle assessment with regards to stress, blood tests for hormone analysis and an analysis of food sensitivities and intolerances to support gut health.

The average person going through traditional doctors and referrals would go through a whole year and a half to get the assessment and labs we do. We do that, day one. You get answers day one, Markowitz said.

With regards to weight loss goals, ageRejuvenations holistic approach to healthy living ensures clients will have long-term success.

Once you come see us, if you follow what we tell you to do, you are not going to put the weight back on, said Markowitz.

ageRejuvenation has locations throughout Tampa Bay and will be opening additional locations in Atlanta, Georgia and Charlotte, North Carolina. The Brandon office is located at 1155 Nikki View Dr. For more information about the services ageRejuvenation offers, visit http://www.agerejuvenation.com. Call 813-681-8624 for a free consultation.

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May 11

Get in the right frame of mind – Daily Leader – Dailyleader

Published 1:00 pm Wednesday, May 10, 2023

It was the summer of 1991 and I hadnt seen my girlfriend in more than two months.

She was on a summer mission trip to South Dakota, and I had been in Mississippi, trying (not successfully) to get a part-time job that wouldnt require me to cut off my hair and failing to get one (rather successfully).

I was 20 years old and in pretty good shape physically, but about 15 to 20 pounds overweight. I was determined I was going to lose it before my sweetheart returned so I waited until just more than a week from her anticipated return date. Its called planning.

For one week, I would go out into the driveway and stretch, then set off at a jog along the gradual incline toward the interstate bridge from our house in Chunky. It was just at a mile away. Id jog it three times back and forth, a total of three miles, then I would do 100 jumping jacks in the driveway. If I felt like it, Id do as many pushups as I could a few dozen and that would be it. This was my job for the week.

I ate only fruits and vegetables the entire week, and I repeated my odd workout routine daily. It worked. I dropped 15-16 pounds in that week, and looked and felt better.

Though I reincorporated other foods into my diet, I maintained exercise daily and was excited to pick up my girlfriend from the airport. I knew shed be happy for me and glad to see Id noticeably dropped some pounds.

To cut the story short, she didnt notice. In fact, I think when I told her that her response was something like, Oh. OK.

She wasnt impressed, but that was alright with me. I knew Id put in the work and was happy with the results.

It has always been easy for me to gain weight, and for years it was not too difficult to work it off. It just took consistent effort and a proper mental focus. In the last several years, however, the consistent effort has been harder to put in partly due to the long-term degenerative effects of injuries and arthritis, and partly due to the inability to get into a proper mental focus long enough.

But mental focus is where the work really is. I complimented a friend recently on her phenomenal weight loss efforts. She had lost more than 70 pounds and was obviously healthier. She said the only hard thing about it was getting into the proper frame of mind. I knew exactly what she was talking about.

To be successful at anything, we need a proper frame of mind. And I do mean anything. We have to start with it and keep going with it.

The Apostle Paul, in encouraging believers at Philippi, urged them to concentrate their thinking on whatever is true, whatever is noble, whatever is right, whatever is pure, whatever is lovely, whatever is admirable, saying, If anything is excellent or praiseworthy, think about such things (4:8).

A proper frame of mind will get us so much closer to where we need and want to be than anything else we do. Its one reason mental health is so important. May is Mental Health Awareness Month. Take care of yourself. If you need help with your mental health, talk to someone. If your mental health is good right now, take steps to maintain it. Youll be glad you put in the work, and youll be happy with the results.

Brett Campbell can be reached at brett.campbell@dailyleader.com.

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May 11

Ozempic and Other GLP-1 Drugs May Help Reduce Heart Attack Risk – Healthline

If you have type 2 diabetes youre probably aware that the condition puts you at an increased risk of developing heart disease.

Now, a new study has shown that a class of diabetes medications is associated with fewer major adverse cardiovascular events.

The study, conducted at Vanderbilt University Medical Center, found that GLP-1 drugs like Ozempic (semaglutide) resulted in lower instances of Major cardiovascular events (MACE) than DPP4 inhibitors (another type of diabetes drug) in older veterans with no prior heart disease.

The use of a GLP-1 receptor agonist was associated with a 20% reduced risk of MACE and heart failure hospitalization when compared to treatment with DPP4 inhibitors, which were regarded as neutral in respect to cardiac events.

In other words, these results translate to approximately three fewer heart failure, heart attack, or stroke events per 1,000 people using a GLP-1 medication for a year.

The studys researchers say these findings will help clinicians in choosing a diabetes drug regimen for older patients.

Christianne Roumie, MD, MPH, professor of Medicine in the Division of General Internal Medicine and Public Health and senior author of the study, describes it as an important contribution to patient care and says it adds to what we as clinicians know about treating diabetes and heart disease prevention.

GLP-1 inhibitors have emerged as a promising treatment option for individuals with type 2 diabetes, demonstrating not only effective blood sugar control but also additional benefits like weight loss and reduced risk of cardiovascular disease, says Bari Stricoff, a registered dietitian at Well Easy.

According to Stricoff, the reason someone with type 2 diabetes might experience a reduced risk of cardiovascular disease when taking a GLP-1 drug compared to a DPP4 inhibitor hinges on the effects these drugs have on cardiovascular risk factors.

GLP-1 receptor agonists not only lower blood sugar levels but also have additional cardiovascular benefits, she points out.

Firstly, obesity is a major risk factor for cardiovascular disease, and GLP-1 receptor agonists can promote weight loss by reducing appetite and increasing satiety, Stricoff explains. Secondly, some GLP-1 drugs have been shown to reduce blood pressure, which is an important cardiovascular risk factor.

Additionally, Stricoff says some studies suggest GLP-1s have anti-inflammatory and anti-atherosclerotic effects, both of which can reduce the risk of cardiovascular disease.

GLP-1 medications can also have a positive effect on lipid profiles, such as reducing triglyceride levels, which may contribute to a reduced risk of cardiovascular events, Stricoff adds.

Similarly, Crystal Scott, a registered dietitian at Top Nutrition Coaching, says the results of this study are consistent with previous evidence on the links between GLP-1 drugs and cardiovascular health in people with type 2 diabetes.

Like Stricoff, she points to the cardioprotective effects of GLP-1s, noting how these drugs can improve endothelial function, reduce arterial stiffness, and decrease inflammation, all of which can contribute to the development and progression of cardiovascular disease.

Its important to note that the study was retrospective and observational, so it cannot establish causality or rule out potential confounding factors, she points out.

Future randomized controlled trials are needed to confirm these findings and to determine how these medications can be used optimally to prevent cardiovascular disease in people with type 2 diabetes, she surmises.

Additionally, Scott notes that the study population consisted of U.S. veterans, so the results may not be generalizable to other populations.

Furthermore, the study did not examine the long-term safety and efficacy of these medications, she points out.

While the links between GLP-1 drugs and reduced risk of adverse heart health are promising, Stricoff says, it is crucial to recognize that these medications primarily address the symptoms and consequences of type 2 diabetes rather than the root causes of the disease.

While GLP-1 inhibitors can be life-changing for some patients, they should be considered as part of a comprehensive treatment plan that includes nutrition education and behavioral interventions to promote long-term health and wellness, she surmises.

So, GLP-1s aside, what else can you do to improve your heart health?

Stricoff says lifestyle factors play an important role.

Unhealthy lifestyle choices, such as a poor diet, physical inactivity, and smoking, are common risk factors for both type 2 diabetes and heart disease, and these factors can exacerbate the risk of developing heart disease in people with diabetes, she explains.

Whats more, she says its crucial to pair GLP-1 inhibitor therapy with interventions that target the root causes of type 2 diabetes and promote long-term behavior change.

Nutrition education is a vital component of this approach, as it empowers patients to make informed decisions about their food choices, understand the impact of diet on their health, and adopt healthier eating habits that can be sustained even in the absence of medication, she surmises.

Specifically, Scott advises following a diet that is low in saturated and trans fats, sodium, and added sugars, and high in fiber, whole grains, fruits, and vegetables.

She also recommends engaging in regular physical activity, such as brisk walking, cycling, swimming, or dancing, for at least 150 minutes per week.

Medications often come with a long list of scary side effects, so its certainly promising that GLP-1 drugs are linked with a lower risk of adverse cardiac events. The results of this study may help your clinician choose an appropriate treatment for you.

However, effective as these drugs may be, both experts agree, you shouldnt neglect the basics: eat well, move more, and quit smoking.

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May 11

Alzheimer’s: Ozempic and Similar Drugs May Help Decrease … – Healthline

In addition to promoting weight loss and treating diabetes, semaglutide drugs like Ozempic and Wegovy may also prevent cognitive decline.

The drugs, which belong to a class of medications called glucagon-like peptide 1 (GLP-1) agonists, work by altering the metabolic system and lowering inflammation throughout the body.

Scientists suspect this could help slow the progression of neurodegenerative diseases like Alzheimers disease and Parkinsons disease.

Trials evaluating these drugs ability to combat cognitive decline are already underway, however, results arent expected until 2025.

But given their ability to fight inflammation, a risk factor for cognitive decline, some health experts suspect they may prove useful in protecting cognition.

These drugs show great promise in slowing or preventing onset of cognitive decline in those at risk for Alzheimers disease, Dr. David Merrill, MD, PhD, an adult and geriatric psychiatrist and director of the Pacific Neuroscience Institutes Pacific Brain Health Center in Santa Monica, CA, told Healthline.

With brain diseases like Alzheimers, a protein called amyloid accumulates and forms plaques.

Over time, these plaques can affect cognitive function.

Some scientists think that diabetes drugs may prevent amyloid buildup.

Alzheimers disease has also been called diabetes type-III, so it is hopeful that in mild cognitive impairment or early-stage Alzheimers disease patients with metabolic syndrome including insulin resistance or frank diabetes will benefit from treatments for diabetes like the GLP-1 agonists, Merrill said.

Recent evidence has shown that anti-amyloid drugs, another type of medication being investigated for Alzheimers disease, may be effective at combating cognitive decline, however, those drugs come with potential serious side effects, like brain bleeding and swelling.

The hope is that semaglutide could lower the risk of cognitive decline without causing serious health complications.

Research is in the early phases and it will take years to determine if the drugs effectively prevent cognitive decline.

Novo Nordisk launched two trials in 2021 that are evaluating semaglutide in people with early Alzheimers. Those results are expected in 2025.

Other pharmaceutical companies, including Neuraly, are testing GLP-1 drugs against Parkinsons disease.

Dr. Irina Skylar-Scott, a cognitive and behavioral neurologist at Stanford Health Care, believes its important to explore novel mechanisms and identify new treatments for Alzheimers disease.

Given the complexity of the disease and prior unsuccessful clinical trials, we need to think outside the box to make strides for our patients, says Skylar-Scott.

Merrill says theres a known link between mid-life obesity and the development of later-life dementia.

Evidence shows that people who are overweight or have obesity face a greater risk of getting dementia down the road.

When obesity is treated earlier in life, the risk for dementia can drop, too.

Skylar-Scott says the role semaglutide may play in Alzheimers disease and vascular dementia is likely independent of its role in weight loss.

GLP-1 can stimulate the release of insulin, thereby improving insulin signaling, reducing inflammation and promoting survival of brain cells, says Percy Griffin, PhD, Alzheimers Association director of scientific engagement.

Some studies have shown that GLP-1 may reduce amyloid and tau accumulation in the brain.

Other reports have found that GLP-1 has anti-inflammatory effects, specifically on the pancreas, liver, vascular system, kidney, lungs, testis, and skin, says Merrill.

Given the mechanisms of action of these kinds of drugs and the biological changes associated with Alzheimers, it makes sense to examine if these drugs can slow down the progression of the disease, Griffin said.

Whether treatment late in life with a drug like Wegovy or Ozempic can benefit those who already have signs of dementia or Alzheimers disease has yet to be seen, according to Merrill.

At this time, there is not enough clinical data to support the use of these drugs in Alzheimers disease, Griffin said.

Because Alzheimers is a complex disease linked to several changes in brain biology, its unlikely that any one treatment would put a full stop to the cognitive decline, says Griffin.

Theres a strong need for an arsenal of medications and modifications that target all aspects of the biological changes to defeat this devastating disease, Griffin said.

This emphasizes the need for an arsenal of medications which target all aspects of the biological changes to defeat this devastating disease, Griffin said.

Researchers are exploring whether semaglutide drugs like Ozempic and Wegovy could help prevent cognitive decline. The drugs work by altering the metabolic system and lowering inflammation throughout the body, which may help protect brain health. Trials exploring the semaglutides impact on cognition are underway and results are expected in 2025.

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May 11

Dietitians Agree: Cutting Out These 3 Processed Ingredients Will Help Transform Your Body, Once And For All – SheFinds

1. Refined Sugars

Added refined sugars are sweeteners that are added to foods and drinks to improve taste. Some popular types of refined sugar include cane sugar, fructose, corn syrup, and agave. Consuming a diet high in added sugars, such as those found in sweetened beverages, sugary cereals, and baked goods, can lead to weight gain and chronic health conditions, including obesity-related diseases like diabetes and heart disease. Excess refined sugar can cause weight gain because it's high in calories while offering little nutrients.

"Refined sugars provide empty calories which can lead to weight gain due to excess calorie intake. They also cause a spike in blood sugar levels followed by a crash, leading to cravings and energy slumps throughout the day," Novak explains. "This makes it difficult to maintain healthy eating habits as well as adhere to a consistent exercise routine. Furthermore, research has linked high-sugar diets with many chronic diseases such as diabetes, heart disease, and obesity." Yikes, nobody wants that!

Instead of refined sugars, Novak recommends exchanging them for natural sweeteners like molasses which, she says, "can provide some health benefits such as increased iron levels and improved heart health."

Another processed ingredient that can lead to weight gain and other health issues is trans fats. Trans fat, also called trans fatty acids, is a type of unsaturated fat that is found in foods like frozen pizza. While small traces of trans fats occur naturally in foods, large amounts are often found in processed foods. And, consuming a lot of trans fat can lead to unwanted weight gain and increases the risk of diabetes, heart disease, and other health problems.

"Trans fats have been linked to a variety of health issues such as high cholesterol, weight gain, and an increased risk of developing heart disease," Novak warns. "Studies have also found that trans fats increase inflammation in the body which can lead to a host of other health problems." Foods high in trans fats also slow your metabolism.

Instead of processed foods high in trans fats, she recommends looking for foods made with whole grains and healthy oils. "Whole grains such as quinoa or oats are packed with vitamins, minerals, fiber, protein, and antioxidants which can help to support weight loss efforts by keeping you fuller for longer periods of time," Novak says. And, she notes, whole grains have been linked to reduced risk of certain cancers and improved heart health.

Healthy oils, like olive oil or coconut oil, Novak says, "contain essential fatty acids and a variety of beneficial antioxidants which can help to reduce inflammation, promote healthy brain function, and boost energy levels." These oils are often better (and healthier) for cooking than other types of oils.

Similar to refined sugars, artificial sweeteners are used as a substitute for sugar to reduce calorie intake and promote weight loss. Although you may have added this sweetener to your coffee, Novak warns though that artificial sweeteners may also be detrimental to weight loss, because of "their ability to change how our bodies regulate appetite hormones." She also adds that artificial sweeteners can contribute to insulin resistance and a slower metabolic rate, which can cause chronic health risks.

Novak also recommends swapping artificial sweeteners with natural sweeteners like honey. "Honey," she says, "is a natural sweetener that can provide some nutritional benefits while still satisfying cravings for sweetness. It contains vitamins, minerals, antioxidants, enzymes, amino acids, and polyphenols which can help to improve digestive health as well as reduce inflammation in the body." Yum!

So, experts like Novak say to avoid processed ingredients like refined sugars, trans fats, and artificial sweeteners. She also recommends eating more fruits and vegetables, drinking enough water, reducing stress levels, getting enough sleep, and exercising regularly. Additionally, she says to consult with a professional to ensure you're meeting your weight loss and long-term health goals.

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