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High seafood diet may increase risk of 'forever chemicals' - USA TODAY

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When Mary Hennigan started as a city reporter in 2022 for the Arkansas Times, she was fresh out of grad school and her young, untrained palate was still maturing. She seemed eager to experience new cuisines outside of her comfort zone, but she was nervous.

In her two years in the newsroom shes flourished as a reporter and become a more curious eater. Shes now wise to the fact that every restaurant she yearns for on a Monday is likely closed; shes endured the crushing experience of having to resort to cheap, sad and often adorable desk meals to accommodate the budget of a working journalist; shes always down to toss you a snack from her desk stash; shes developed some creative modifications at restaurants around town; and if theres an option to add an egg, shell do it every time.

Today is her last day at the Arkansas Times. Shes taken a gig as a reporter for the excellent Arkansas Advocate, so shell be consuming most of her lunch meals down the street. But hopefully shell still send us food selfies of her pitiful desk meals (girl dinner!) and find time to meet us at La Hacienda for cheese dip (she never skips out on cheese dip). Here are some shining moments from Hennigans Eat Arkansas correspondence and her Arkansas Times diet.

Whats your favorite type of egg? Mines hard boiled. Mary Hennigan

There was a week after Thanksgiving when Hennigan was heading home for lunch to eat air fryer sweet potato fries almost daily. But these werent just any sweet potato fries.

Youre looking at sweet potato fries with melted Thanksgiving marshmallows on the side, which she said provided perfect fry dunkability.

Hennigans random food correspondence can be works of subtle genius, like this picture of a piece of fruit she decided to send our way with the caption, This is my plum:

Heres a recent haphazard pairing of delights that fueled her through a day of tedious reporting:

Journalism glamour shot.

One of Hennigans finest Eat Arkansas moments was discovering an off-menu item that inspired her to write a seven-word food jingle. One night at Three Fold last summer, Hennigan opted for the restaurants noodle soup, and her partner chose the dumpling soup. While they were slurping, Hennigan found herself longing for the broth in her partners bowl.

My meal was great, but the comforting noodles with the saltier dumpling broth base was what I craved, she wrote.

A sesame butter is added to the noodle soup, which makes it similar to a miso soup texture. Its softer. The dumpling soup broth has a saltier soy base, she said.

In the days leading up to her next Three Fold visit, she feared that ordering noodle soup in the dumpling soup broth with no cilantro might give her a reputation for being fussy with her orders. To steady herself, she started singing the words noodle soup in the dumpling soup soup around the office.

After a few modifications (and almost surely developing a reputation as the customer with the weird soup order), she sent us a Slack message explaining that shed finally found the words to nail down what she likes:

I perfected my noodle soup in the dumpling soup soup order. Here it is: Noodle soup. No cilantro, shredded chicken, add an egg. No sesame oil. Medium [spice level].

We have to hand it to her, though. Its delicious.

I really dont want to watch it [a 2022 mayoral forum]. I want to eat dinner and carve a pumpkin. Mary Hennigan

Hennigans top five Halloween candy rankings:

Not so sad lunch. Hennigans a sucker for marinated artichokes and Babybel cheese.

Last time I went to a Buc-ees there was a mascot in there, like an actual buc-ee, and he was chasing me around! Mary Hennigan

Happy faces after escaping the editorial office for La Hacienda.

Sad lunch? More like school lunch:

A true sport around the office, Hennigan didnt hesitate to rock some new swag to add some flair to the millionth 7 Brew story of my career:

This sad lunch really does fit the bill, but Hennigan said the burritos were actually pretty good:

Heres some meals Hennigan enjoyed enough to send food selfies our way:

Barbecue nachos from Count Porkula.

Pepperoni calzone from Laylas was one of the best things ever, Hennigan said.

Pretty sure this sad lunch was a winner:

Fittingly, Hennigans last lunch as an Arkansas Times employee hailed from neighboring Irianas. Arkansas Times editor Austin Gelder (one of the biggest Irianas fans in Arkansas Times employee history) and Hennigan have Venmoed each other for Irianas slices no less than 30 times.

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The Mary Hennigan diet: How to eat lunch like an Arkansas Times city reporter - Arkansas Times

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Seafood lovers, beware: A new study suggests that regularly eating certain marine species may increase the risk of exposure to perfluoroalkyl and polyfluoroalkyl substances (PFAS), commonly referred to as forever chemicals.

For the study published April 12 in the journal Exposure and Health, researchers examined the seafood consumption habits of more than 1,800 Portsmouth, New Hampshire residents, as well as the PFAS levels in a variety of seafood items found at a market there. They discovered the presence of PFAS in a range of products, with shrimp and lobster having the highest concentrations.

PFAS are manufactured chemicals used in everything from clothing to electrical wiring insulation. They dont fully break down and therefore end up in the air and bodies of water, contaminating our food and beverages. Scientists have linked the chemicals with several human health effects, including growth and development disruptions, liver injury, and an increased risk of certain cancers.

We hope that this brings attention to the fact that seafood consumption could be an important route of PFAS exposure for high seafood consumers, Celia Y. Chen, PhD, study coauthor and research professor in the Department of Biological Sciences at Dartmouth College, told Health. We do hope that this study will spur others to look more closely at this issue in their states and regions.

Previous research has shown dangerous levels of PFAS in freshwater fish, but Megan Romano, PhD, study coauthor and associate professor of epidemiology at Dartmouths Geisel School of Medicine, told Health that her team was surprised to discover that researchers hadnt investigated PFAS in marine seafood as widely.

This struck us as odd because most of the fish and shellfish that people eat tend to come from the sea rather than freshwater, she said. We recognized that in order to understand how much PFAS people may be exposed to when eating marine seafood, we needed to ask three key questions: How much seafood do people eat? What kinds of seafood do people eat? How much PFAS is present in the types of seafood that people eat?

To answer the questions, the team surveyed the seafood consumption habits of 1,829 Portsmouth adults and children aged two to 11. They also measured levels of 26 types of PFAS found in fresh cod, haddock, lobster, salmon, scallops, shrimp, and tuna. The seafood originated in various regions and ended up in a Portsmouth market.

Researchers found that Portsmouth residents tended to be high consumers of seafood. Of the adults surveyed, 95% reported eating seafood within the last year.

Men in the state reported eating a little over an ounce of seafood daily, while women consumed just below an ounce. These amounts are 1.5 times the national average for both men and women, per the National Health and Nutrition Examination Survey. Children consumed around 0.2 ounces, the highest end of the national range.

Shrimp, haddock, salmon, and canned tuna were the most commonly consumed items.

The scientists also discovered that basket shrimp and lobster had the highest average PFAS concentrationsas high as 1.74 and 3.30 nanograms per gram of flesh, respectively. Concentrations in other products analyzed generally measured less than one nanogram per gram.

Our findings suggest that for very frequent seafood consumers, there may be a risk of excessive PFAS exposure from certain seafood items with shrimp and lobster, Romano said. This study suggests that we should be gathering additional data to establish fish consumption advice more broadly.

The research builds on other studies that have found high PFAS levels in certain seafood species, Tracey Woodruff, PhD, MPH, director of the Program on Reproductive Health and the Environment at the University of California, San Francisco, told Health. Those studies have examined seafood from coastal waters in the United States, Europe, and elsewhere, according to Romano.

The study authors noted, however, that there is still much to learn about the connection between PFAS and seafood, including the interplay of factors that lead to the accumulation of PFAS in the tissues of aquatic animals. Romano said its currently believed that an animals levels depend on how much PFAS is in the water and sediment where it lives, how it feeds, where it lives in the water column, and whether or not it eats smaller marine life.

Experts stress that you dont have to nix seafood altogether to avoid unsafe PFAS exposure. Instead, simply be mindful when choosing which ones to eat.

Seafood is an excellent source of lean protein and omega fatty acids, but it may also contain PFAS or mercury, so it is important to be a conscientious consumer, Romano said. This is especially important for vulnerable populations, such as pregnant people and young children.

Opt for species that researchers found to contain lower amounts of PFAS, such as tilapia, recommends Woodruff. Smaller fish like tilapia or sardines generally tend to be lower in contaminants. Those can be a win-win for consumers, she said.

Its also important not to rely too heavily on one seafood option, Romano said. The key is really to eat a balanced diet that includes a wide variety of healthy foods and protein sources.

Finally, Chen emphasized the importance of examining your unique eating habits. Then you can investigate how they might contribute to PFAS exposure and make potential changes.

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A High Seafood Diet Might Put You at a Higher Risk of Exposure to 'Forever Chemicals' - Health.com

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Jessie Orozco, a 21 year-old resident of Burbank, stands in line at the Ralphs self-checkout line with five items in his hands: hamburger patties, pork sausage links, thin-cut beef sirloin, ground beef and a packet of American cheese singles.

Orozco is about to embark on the latest diet fad, the carnivore diet.

I didnt feel good after eating high-carb foods, Orozco said. I would feel tired and have stomach pains.

Orozco restricts his diet to animal products and stays clear of plants. Advocates of the carnivore diet, such as Shawn Baker, author of The Carnivore Diet, claim this diet aids weight loss, regulates blood sugar and improves mood.

Instagram has over two million posts with the hashtag #carnivore and over 113,000 posts with the same hashtag on TikTok. While this fad soars in popularity, it is not met with the same support from dietitians.

Fad diets dont work, said Amanda Sauceda, a dietitian and a nutrition and dietetics professor at Long Beach State.

Lack of nutrients is a primary concern with this diet. Although meat is a great source of iron and B vitamins, most adults in the U.S. experience a deficiency in potassium, dietary fiber and calcium, according to the U.S. governments 2020-2025 Dietary Guideline for Americans.

Nutrient deficiencies can negatively impact digestion, energy levels and mental health. The easiest way to get these nutrients is through fruits, vegetables and other plant-based foods.

However, almost 90% of the U.S. population is failing to meet their recommended vegetable intake and 80% are failing to meet their recommended fruit intake, according to the government guideline.

Meanwhile, almost 70% of the U.S. population exceeds their recommended meat, poultry and egg intake, which are at the center of the carnivore diet.

The carnivore diet does allow multivitamins to fill in the nutrient gaps, although it is not reliable and lacks FDA regulation.

[About 44% of] multivitamin and mineral supplements analyzed in 2020 by ConsumerLab.com were found to have quality problems, such as having more or less of the vitamins and minerals than their labels claimed, according to a consumer reports article about vitamins. Some may even contain contaminants.

Not everyone is consistent with taking vitamins on their own either.

I feel like I dont need [multivitamins] but I still try to take it a couple times a week, Orozco said.

Primitive eating can be well intended by trying to eliminate processed foods, but Kia Octaviano, a registered dietitian at Long Beach State, said extreme dieting can develop into eating disorders.

According to Octaviano, low-carb diets also amplify negative stigmas about carbs even though they are the preferred source of energy for your brain.

Its definitely hard because you start to crave carbs a lot, Orozco said.

Instead of restricting foods, Sauceda and Octaviano recommend a personalized approach focusing on moderation, affordability and adding more nutrient-dense foods for a healthier diet. This can look like a plate with a juicy steak paired with plant-based foods, such as lentils, plantains or a cucumber salad.

[Diet fads] make you fearful of food or shameful that youre eating them, Sauceda said.

Long Beach State students can schedule an appointment with Octaviano through student health services to speak about their health goals and dietary needs.

A lot of diets are the same variation of a low-carb diet, Octaviano said. So if they truly did work why do we have to keep reinventing them.

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The Carnivore Diet goes against the grain of nutritional science - Daily Forty-Niner - Daily 49er

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GOTHENBURG, Sweden Irritable bowel syndrome is often misunderstood because of its many nuances and complexities. The chronic condition usually causes abdominal cramping, bloating, constipation, and diarrhea. Typically, either diet, medication, or both are used in the treatment. However, new research now shows that dietary treatment is actually more effective than medications when it comes to IBS.

Standard dietary advice for those with IBS includes things like focusing on eating smaller, more frequent meals rather than eating three larger ones. Additionally, greatly limiting common triggers like alcohol and coffee is widely advised. If medications are used, its typically to improve certain symptoms like constipation or bloating. Sometimes, even antidepressants are utilized.

To explore things further, a team of researchers conducted a study including adult patients with severe or moderate IBS symptoms at Sahlgrenska University Hospital in Gothenburg, Sweden. They compared three treatments: two dietary and one based on medication. The first group received conventional IBS dietary advice, like changing certain eating behaviors in combination with eating lower amounts of fermentable carbs commonly referred to as FODMAPs. High FODMAP foods are dairy and beans that can cause more pain and gas in people with IBS.

The second group was advised to eat a lower-carb, higher protein and fat diet. Then, the third group took medication based on the patients most pressing symptoms. Each group had around 100 participants, and the treatment period lasted four weeks. The researchers used an established IBS symptom scoring scale for analysis and found that, among those who received traditional IBS dietary advice and ate low-FODMAP foods, 76 percent had significantly reduced symptoms.

In the second dietary group, 71 percent had significantly reduced symptoms, while only 58 percent did in the medication group. Of note, all groups reported significantly better quality of life and reduced physical and mental symptoms.

At a six-month follow-up, when participants in the dietary groups had partially returned to their typical eating habits, 68 percent still had clinically significant symptom relief in the low FODMAP group, while 60 percent did in the low-carbohydrate diet group.

With this study, we can show that diet plays a central role in the treatment of IBS, but that there are several alternative treatments that are effective, says Sanna Nybacka, a researcher, dietitian, and study leader, in a media release.

We need more knowledge about how to best personalize the treatment of IBS in the future and we will further investigate whether there are certain factors that can predict whether individuals will respond better to different treatment options.

IBS treatment often needs to take many different approaches because of how variable it can present itself. There also isnt one cause of IBS, which inherently makes effective treatment measures more difficult to pinpoint.

Stress is often considered a big trigger, but a bacterial infection could also be behind someones gut trouble. Eating low FODMAP has been a top dietary intervention and definitely helps people find symptom relief as long as they stick to the dietary protocol.

This study showed that a majority of participants who partially returned to their previous eating habits after six months still reported relief. It would be interesting to see how those results hold true after one year or more.

For many with IBS, conventional dietary advice works for the short term, specifically while the guidance is being followed. Typically, once people allow more leniency in their diet, they find themselves back at square one at some point. For these reasons, taking a deeply individualized approach to care for IBS patients is important for providing lasting results. If you think you may be struggling with IBS, be sure to work with an experienced physician and registered dietitian who specializes in gastrointestinal health.

The findings are published in The Lancet Gastroenterology & Hepatology.

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This diet is more effective than medication for treating IBS, study reveals - Study Finds

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LOUISVILLE, Ky. People living with Parkinsons disease can experience difficulties with activities they enjoy. An exercise class allows those with the neurological disease to move their bodies and meet other people with Parkinsons disease.

Edward Heymann heads to the gym Tuesday afternoons to pump his muscles. But he also plays another role in the workout class.

I want them to know that they love when they come in," Heymann said. "That's part of what this is all about: the camaraderie that takes place."

Heymann was diagnosed with Parkinsons disease more than seven years ago. The neurological disease has affected his ability to balance, preventing him from enjoying some of his hobbies such as golf.

Heymann noticed there were programs for people living with cancer and diabetes, but there was nothing like it for those with Parkinsons disease. He worked to change that.

You see people talk to people, communicate with people who (feel) belonging," Heymann said.

The Northeast YMCA in Louisville started the Total Movement fitness programin 2022.

Everybody's on a different journey ... maybe they're not running the marathon, but we're trying to slow down the process and give them a quality of life, instructor Barb Millhollan said.

The free 12-week program aims to provide community for people of all ages living with Parkinsons disease, which Heymann said is a large component of the program.

You're together," he said. "You know that you're now not an island to yourself."

Participants in the program work with a Healthy Living Coach to come up with a plan to stay active. Instructors are certified to work with Parkinson's patients.

The classes are open to all ages of people who have been diagnosed with idiopathic Parkinsons disease. Right now, the class is offered at the Northeast Family YMCA and the Southwest Family YMCA of Greater Louisville.

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Exercise program helps those with Parkinson's - Spectrum News 1

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Obesity is defined as a BMI greater than or equal to 30 by the CDC and is currently among the most prevalent diseases in the world, in addition to being an important risk factor for many other diseases. It has high rates of morbidity and mortality21,22 and, in this context, weight loss can bring countless positive impacts to the individual. Currently, there are several treatments for obesity, and we can divide them into non-surgical or surgical.

Non-surgical treatments include non-drug and drug treatments. Among the non-medicated, we can highlight the change in eating habits, regular physical exercise, and cognitive behavioral therapy8. Ideally, these measures should be implemented for all patients living with obesity, even for those who will undergo drug or surgical treatment. Recently, in addition to lifestyle change, neuromodulation with deep transcranial stimulation has also been studied and has shown effectiveness in weight loss reduction23.

A systematic review carried out in 2021, which analyzed 64 articles concluded that among the most effective non-surgical interventions are low-carbohydrate or low-fat diets and combined therapies. This study also showed that non-drug interventions, such as physical exercise, when used alone, are not very effective in reducing the weight of these patients Therefore, a combination of two or more therapies should be chosen24.

Pharmacological treatment must be chosen together with the patient. One or more drugs can be used, the main ones used being: Liraglutide, Semaglutide, Tirzepatide, Orlistat, Phentermine and Sibutramine25.

Liraglutide was recently approved for the treatment of obesity and is now one of the most widely used drugs. It acts as a GLP-1 receptor agonist26,27,28, enhancing its effects. This group of drugs is already known in the treatment of Type 2 Diabetes Mellitus, a condition that can often be associated with obesity29,30, since its pathophysiology involves increased insulin resistance. The main actions of this drug are: increased satiety due to a reduction in the speed of gastric emptying, increased insulin release and decreased glucagon release. Semaglutide is a drug with a similar mechanism of action who demonstrated not only a substantial weight loss31, but was also associated with a lower 10-year T2D risk in people with overweight or obesity after 2years of follow up32. More recently, a new drug that combines GLP-1 and GIP receptor agonist, Tirzepatide, has shown even better results in the short term33.

Orlistat, in turn, reversibly inhibits the lipase enzyme34, which has the function of breaking down fat from food for its absorption, as well as inhibiting the absorption of ingested triglycerides. Thus, there is elimination of fat in the feces35. The main adverse effects are gastrointestinal symptoms, however this can be beneficial as it leads to a change in behavior, for example causing a lower consumption of foods rich in fat36.

Phentermine, an amphetamine analogue, can be used in conjunction with topiramate for the treatment of obesity. The mechanism of action of the drugs is not yet known, however, significant weight loss has already been observed, in addition to a reduction in the consumption of hypercaloric foods and a decrease in the speed of gastric emptying with the use of this combination of drugs37,38.

Sibutramine, widely used in the 1990s, acts to inhibit the reuptake of serotonin, norepinephrine, and dopamine34. Serotonin, in turn, activates POMC system neurons and inhibits NPY neurons, thereby promoting reduced appetite and increased satiety. Despite generating weight reduction39, some data show increased cardiovascular risk40, and therefore, it is no longer used as a first-line drug.

Among the possible surgeries, the most performed today are: Roux-en-Y Gastric Bypass (RYGB), Biliopancreatic diversion (BPD), Laparoscopic Sleeve Gastrectomy (LSG) and Laparoscopic Adjustable Gastric Band (LAGB). According to the NIH and the American Bariatric Society41,42, some indications for performing bariatric surgery are adults with BMI greater than or equal to 40 and adults with BMI greater than 35 accompanied by some comorbidity such as type 2 diabetes mellitus, obstructive sleep apnea or hypertension.

RYGB is one of the best-known procedures and its complications vary according to the surgical technique used. Some complications include gastric distention, ulcers, cholelithiasis, hernias, dumping syndrome, and hyperammonaemia encephalopathy.

BPD presents long-term nutritional complications, such as anemia, bone diseases and fat-soluble vitamin deficiency. This technique has high mortality rates, mainly due to the complexity of the technique.

Among the procedures described, LSG is the one with the fewest complications, being described in the literature bleeding or stenosis of the stoma. An alternative technique using endoscopy for sleeve gastroplasty has shown to be safe and efficient for weight loss after 104weeks, with important improvements in metabolic comorbidities43.

The procedure with the lowest mortality rate is the LAGB44. Despite this, it can present complications such as obstruction, band erosion, band slippage and gastric prolapse, esophagitis, hernia, in addition to having a high rate of reoperation, reaching 50% of patients who underwent this surgery45.

In this article, we compare data on weight loss through intensive drug treatment, which includes changes in eating habits, physical exercise, and medications, and through surgical treatment. Both treatments showed that weight loss caused an improvement in the lipid panel, with a reduction in total cholesterol, triglycerides and LDL, an increase in HDL, improvement in systolic and diastolic blood pressure, decrease in glycated hemoglobin and insulin resistance (accessed through HOMA), in addition to reducing the risk for cardiovascular diseases.

Our systematic review confirmed the findings of individual studies that bariatric surgery has a greater potential for weight reduction, BMI and waist circumference, as already described in individual articles and widely in the literature. It should be noted that even in the long term, this difference remained. Similarly, a 2014 Cochrane systematic review46 comparing RCT with more than 1year of follow-up showed that all 7 articles included demonstrated an advantage of the surgical group. An article47 on the use of pharmacological treatment for obesity showed that even recent drugs approved, including GLP 1 agonists, are not able to reduce weight to levels similar to those of bariatric surgery to date, despite the emergence of new drugs still in initial phase48. It is worth mentioning that in these studies the comparison time is relatively short (12months) and that we do not have data on the long-term impact. Thus, in relation to long term weight loss, bariatric surgery is still the best option.

Most articles were not able to individually demonstrate that surgical treatment is superior to non-surgical in terms of pressure reduction. However, the result of the meta-analysis showed a superiority of the surgical group in relation to both systolic and diastolic pressure, more pronounced in the BPD group. Wang49 performed a systematic review focused on the impact on pressure and demonstrated that there was a reduction in systolic and diastolic values, but the subgroup analysis showed that this occurs only in the RYGB groups for systolic pressure. Similarly, Schiavon also demonstrated a significant reduction in the need of blood pressure medication after 3years in the RYGB group when compared intensive medical treatment for obesity50. This difference found in only one subtype of surgery seems to be just a reflection of the sample size, which can be interpreted that surgical treatment in general tends to reduce pressure to a greater extent than non-surgical treatment. The fact that different types of surgery are significant may reflect the studies selected in our meta-analysis, which have longer follow-ups.

In relation to both HOMA-IR and glycated Hb, there was a more significant improvement in the group that underwent surgery. The way in which the data on diabetes remission was reported in the articles did not allow a meta-analysis to be carried out with these data and, therefore, it was not included. However, individual data from the Mingrone 2015, Mingrone 2021 and Schauer articles showed that the surgery group had better results. A network meta-analysis from 202151 comparing the different types of metabolic surgery for the treatment of obesity and diabetes showed that RYGB was 20% more likely to result in remission of type 2 diabetes compared to SG. There was no significant difference between the other groups. Moreover, the effects of bariatric surgery on diabetes is not exclusive for patients with obesity, as shown by a study with patients with a BMI of 2732kg/m2 that had a better glycemic control when treated with RYGB20. Regarding the lipid profile, Schauer's study was not able to demonstrate superiority in relation to LDL and HDL parameters. However, by combining the data from Mingrone's articles, it is possible to demonstrate that surgical treatment is superior. Regarding cholesterol reduction, Mingrone's studies showed that although RYGB and BDP were better in relation to non-surgical treatment, the BDP technique had a statistically greater reduction in relation to RYGB. This can be explained by the greater intestinal exclusion in BDP and, therefore, having a greater impact on lipid absorption. Despite Sayeed's study52 et al. was not included in this meta-analysis due to the inadequate way of separating the groups for analysis, the results regarding the lipid profile showed that the group that received both interventions was superior to the exclusive non-surgical treatment. It is important to point out that despite a statistically significant difference between the groups, the effect size of this difference is probably not clinically significant.

The choice of treatment for obesity can also have an impact on several other patient comorbidities. Hossain et al.53 performed a systematic review with 26 studies that showed that bariatric surgery appears to be more effective in the treatment of asthma. Similarly, a study by Crawford et al.15 showed that there is a greater increase in bone turnover in groups undergoing bariatric surgery in relation to pharmacological treatment. Other than that, bariatric surgery is also demonstrated to be superior in the treatment of other obesity related pathologies, such as Non-Alcoholic Steatohepatitis (NASH), and in the treatment of obesity in adolescents54,55.

The effect of major cardiovascular adverse events (MACE) and mortality56 have also been promising for bariatric surgery. A recent cohort comparing bariatric surgery in patients with obesity and use of GLP1-agonists inpatients with diabetes showed a lower risk of MACE in the surgical group57. The surgical treatment has also shown superiority when compared to medical treatment regarding the prevention of diabetic kidney disease in 5years for patients with diabetes and obesity58. Boyers et al. evaluated the cost-effectiveness of surgical and pharmacological treatment in the treatment of obesity and found that RYGB should be the treatment of choice only if the optimization of health system costs is considered59.

Another important consideration is the fact that pharmacological and surgical treatment for obesity are not mutually exclusive. Most clinicians choose to combine both treatment modalities in practice to improve results. Weight gain after bariatric surgery is a known possibility, and for those patients, two-thirds of the weight regain can be safely lost with GLP1 agonist, providing clinicians with a therapeutic option for this clinical challenge.

Despite the large number of articles in the literature on the treatment of obesity, there are few RCTs comparing non-surgical and surgical treatment, and most of them only follow up in the short term. In addition, many articles do not adequately describe the strategy used in non-surgical treatment. This lack of data and standardization in this type of treatment can lead to bias and possibly the formation of extremely heterogeneous groups for analysis.

Most of the studies included in our systematic review have diabetes as an inclusion criteria. In this circumstance, our findings may not be generalized to patients with obesity without diabetes.

Another important limitation of our systematic review refers to pharmacological treatment in the non-surgical group. The use of GLP 1 agonists has great potential in the treatment of obesity, but they have only started to be used recently. As the purpose of our article is to assess the long-term impact, there are still few articles available that used this drug. The use of the most recent medications, such as Tirzepatide, could not be evaluated in our study, once there are no RCTs in the literature presenting its long-term effects. Those drugs proved to be very efficient and might have similar effect in the long term. Future systematic reviews may reveal a different results when including the new generation of weight loss medication.

Finally, choosing the most appropriate treatment often involves individual characteristics of each patient, and the impact on quality of life can be extremely subjective and difficult to assess.

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Surgery is associated with better long-term outcomes than pharmacological treatment for obesity: a systematic review ... - Nature.com

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When the financial analyst Emily Field was commissioned by Barclays to predict the likely economic implications of the new generation of weight-loss drugs, she came back with a startling answer: this will be comparable to the invention of the smartphone. For 40 years, people have been gaining weight, with a trebling in global obesity rates since 1975 but that trend now looks likely to be slammed into reverse. These new drugs, working in a very different way to previous weight-loss drugs, cause remarkable levels of physical shrinking: for Ozempic and Wegovy, people lose on average 15 per cent of their body weight in a year, while for the newer drugs coming down the line, its a staggering 24 per cent. As these drugs become

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I've lost three stone taking Ozempic. But am I at risk? - The Times

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If you put a lab mouse on a diet, cutting the animals caloric intake by 30 to 40 percent, it will live, on average, about 30 percent longer. The calorie restriction, as the intervention is technically called, cant be so extreme that the animal is malnourished, but it should be aggressive enough to trigger some key biological changes.

Scientists first discovered this phenomenon in the 1930s, and over the past 90 years it has been replicated in species ranging from worms to monkeys. The subsequent studies also found that many of the calorie-restricted animals were less likely to develop cancer and other chronic diseases related to aging.

But despite all the research on animals, there remain a lot of unknowns. Experts are still debating how it works, and whether its the number of calories consumed or the window of time in which they are eaten (also known as intermittent fasting) that matters more.

And its still frustratingly uncertain whether eating less can help people live longer, as well. Aging experts are notorious for experimenting on themselves with different diet regimens, but actual longevity studies are scant and difficult to pull off because they take, well, a long time.

Heres a look at what scientists have learned so far, mostly through seminal animal studies, and what they think it might mean for humans.

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Could a Calorie-Restricted Diet or Fasting Help You Live Longer? - The New York Times

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