Fork U with Dr. Terry Simpson

In recent years, GLP-1 agonists have gained significant attention as effective treatments for obesity and type 2 diabetes. However, emerging research suggests these medications may also influence brain function and behaviors related to reward and addiction. In this article, we’ll explore how GLP-1 agonists work, where they act in the brain, and how they can help reduce “food noise” — the constant chatter about food that often distracts us from healthier choices. Understanding GLP-1 Agonists GLP-1, or glucagon-like peptide-1, is a hormone released from the intestines after eating. It plays a crucial role in regulating appetite and glucose metabolism. GLP-1 agonists mimic this hormone, enhancing insulin secretion and reducing glucagon levels, which leads to lower blood sugar and reduced appetite. Popular medications in this class include semaglutide (Ozempic, Wegovy) and liraglutide (Saxenda). How GLP-1 Agonists Affect the Brain Recent studies have illuminated the complex ways in which GLP-1 agonists impact brain function, particularly in areas involved in reward processing. Researchers have found GLP-1 receptors in key brain regions such as: Hypothalamus: This area regulates appetite and energy balance. Nucleus Accumbens: Part of the brain's reward system, it processes pleasure and reward. Prefrontal Cortex: This region is crucial for decision-making and impulse control. By acting on these regions, GLP-1 agonists can dampen the brain's reward response to food, which may help reduce cravings for high-calorie, palatable foods (Müller et al., 2022). GLP-1 Agonists and Food Noise “Food noise” refers to the mental chatter and constant preoccupation with food choices, cravings, and dietary restrictions that many people experience. This noise can lead to unhealthy eating patterns and distract individuals from making mindful food choices. GLP-1 agonists appear to quiet this food noise. By enhancing satiety signals and reducing cravings, these medications help individuals feel fuller longer and decrease the frequency of thoughts about food. Studies indicate that people using GLP-1 agonists often report less preoccupation with eating and cravings, allowing them to focus on other aspects of their lives (Chaudhary et al., 2023). Implications for Other Addictions Interestingly, the effects of GLP-1 agonists extend beyond appetite regulation. Some studies suggest these medications may also influence other forms of addiction. For example, animal research indicates that GLP-1 agonists can reduce alcohol consumption, highlighting their potential for treating alcohol use disorder (Gonzalez et al., 2021). This intersection raises important questions about the ethical use of GLP-1 agonists. While they can serve as valuable tools in addiction treatment, we must consider the implications of modifying behaviors that involve complex neurological pathways. It even appears to change one's reaction to stress. Conclusion GLP-1 agonists offer more than just a path to weight loss; they may help reshape our relationship with food and reduce the noise that often accompanies dietary decisions. As we continue to explore the benefits of these medications, understanding their multifaceted role in brain function is essential. Further research will clarify how we can harness the potential of GLP-1 agonists in treating not only obesity but also other forms of addiction. References Chaudhary, N., et al....

Apolipoprotein B (apoB) is the causative agent in atherosclerosis. If your apoB is low, you will not develop atherosclerosis. However, if your apoB is high, you could die young. We know this because of genetic studies of people with different levels of apoB and their health outcomes. What is Atherosclerosis of the heart? Atherosclerosis is a progressive laying down of "plaque" in the wall of the coronary arteries. Since the coronary arteries feed the heart, this can lead to three outcomes: What is in the plaque? In the above artery, you can see the yellow cholesterol in the wall. This is a "soft" plaque, like porridge. The plaque is not inside the vessel. The artery is lined by a layer called the intima. So how does cholesterol get from the inside of the blood vessel to behind the layer? The Process of Atherosclerotic Plaque Formation Lipoprotein Entry into the Arterial Wall: The process begins when ApoB-containing lipoproteins pass through the endothelial layer of arteries. Normally, this layer acts as a barrier, but factors like high blood pressure or inflammation can make it more permeable, allowing these particles to accumulate beneath the endothelial cells. Retention and Modification: Once inside the arterial wall, ApoB lipoproteins are trapped by proteoglycans (components of the extracellular matrix). These retained lipoproteins undergo modifications, such as oxidation, which makes them more likely to trigger inflammatory responses. Inflammatory Response: The modified lipoproteins activate endothelial cells and attract immune cells like monocytes. These monocytes enter the arterial wall and transform into macrophages. Macrophages engulf the modified lipoproteins, turning into foam cells, which are a hallmark of early atherosclerotic plaque. Plaque Development: Over time, foam cells accumulate, leading to the formation of fatty streaks in the arterial wall. Smooth muscle cells migrate into the intimal layer of the artery, contributing to the formation of a fibrous cap that covers the plaque. This cap consists of connective tissue, calcium, and cholesterol deposits. Progression and Complications: As the plaque grows, it narrows the artery and restricts blood flow. If the fibrous cap ruptures, it can lead to the formation of a blood clot (thrombus), which may block the artery entirely, causing a heart attack or stroke. Preventing Plaque Formation Understanding how ApoB-containing lipoproteins contribute to atherosclerosis underscores the importance of managing blood cholesterol levels. Lifestyle changes such as diet, exercise, and medications like statins can reduce LDL levels, lowering the risk of plaque formation and subsequent cardiovascular events. Atherosclerosis is a gradual process that starts with the seemingly harmless entry of ApoB lipoproteins into arterial walls. By addressing the risk factors that promote lipoprotein retention and inflammation, the progression of atherosclerosis can be slowed or prevented. LDL particle size LDL particles can...

The Cyclical Nature of Autoimmune Diseases: A Huckster's Playground Autoimmune diseases are notoriously difficult to manage because they don’t follow a linear progression. Patients often experience periods of remission, where symptoms lessen or disappear, followed by flare-ups, where symptoms return, sometimes worse than before. This cyclical nature gives the illusion that certain "treatments" or lifestyle changes are working when, in reality, the disease is simply following its natural course. Hucksters exploit this ebb and flow, offering unproven solutions and claiming credit for any improvements that coincide with the natural remission phase. When symptoms return during a flare-up, they may shift the blame to the patient, suggesting they didn’t follow the regimen properly or need to try an even more restrictive approach. In many cases, these alternative therapies center around the idea that gut issues cause autoimmune diseases, particularly leaky gut syndrome. The pitch is simple: repair the gut, and the immune system will stop attacking the body. Unfortunately, the science doesn’t back this up. Why the Gut Isn’t the Root Cause of Autoimmune Disease It's true that there is a connection between the gut and the immune system. In fact, about 70% of the immune system resides in the gut, and gut bacteria (the microbiome) play a role in regulating immune responses. However, autoimmune diseases are far more complex than just a gut issue. Genetic predispositions primarily drive Autoimmune diseases, environmental triggers, and immune system dysregulation. While diet and gut health can influence immune responses, there’s no evidence that simply "healing" the gut will reverse the course of autoimmune diseases. The immune system in these conditions has gone awry in ways that are not fully understood, and current medical treatments focus on suppressing overactive immune responses and managing symptoms—not on gut health alone. Myasthenia Gravis (MG) is an autoimmune disease where medical treatment significantly outperforms dietary interventions. MG is characterized by autoantibodies targeting the neuromuscular junction, leading to fluctuating muscle weakness and fatigability. The primary treatment modalities for MG involve immunosuppressive therapies and precision medicine approaches. Current treatment guidelines, as discussed by Cavalcante et al., highlight the use of immunosuppressive therapies such as corticosteroids, azathioprine, and mycophenolate mofetil to control symptoms and improve muscle strength. (reference here) Additionally, novel biological drugs targeting B cell activation, antibody recycling, and complement system-mediated neuromuscular junction damage have shown efficacy and safety in clinical trials. These precision medicine approaches are tailored to the patient's specific immunopathogenic mechanisms, offering a more targeted and effective treatment strategy. In contrast, dietary interventions have not demonstrated significant efficacy in managing MG. While general nutritional support is important for overall health, there is no specific diet that can modulate the autoimmune mechanisms underlying MG to the same extent as pharmacological treatments. In summary, medicine does better than diet in managing Myasthenia Gravis, with immunosuppressive therapies and precision medicine approaches being the cornerstone of treatment.[1] Here’s why relying on gut health as the sole solution is like using a garden hose to fight a forest fire: A. The Complexity of Autoimmune Dysregulation Autoimmune diseases involve dysregulation at multiple levels of the immune system. In...

Should I eat bread? The low carbohydrate movement has demonized bread. But is bread fattening? Does it cause inflammation? And if so, why do we call bread the Staff of Life? The Staff of Life Imagine calling white bread the staff of life. And yet bread is more responsible for humans ending a nomadic existence. The cultivation of wheat and barley, both in the Nile and in the Euphrates/Tigris rivers, led to civilization. Calendars, Art, Religion Not having to forage meant there was time to build a more permanent shelter. It also meant a steady supply of food. This also meant a calendar was needed because when is the optimal time to plant? The calendar helped predict when the rivers would swell and recede. The bottom land, with its rich topsoil, is ideal for growing crops. When you don't need to spend time looking for food, you have time to develop other things: Storage Systems Harvested grain can be stored. Storing grain in Egypt was easier because of the dry climate. Joseph, of the Hebrew Bible, prophesied to the Pharoh of an upcoming famine. As a result, the Pharoh built silos and stored a portion of each harvest. Seven years later, the harvest failed. But The silo system was complex. Filling from the top and arranged in a way that winds would keep the grains cool. Where did Egyptians get the idea for such an invention? From bees. You can see the bees' natural ventilation system here: Bees were the symbol of royalty in ancient Egypt. Their honey was tears from the sun god. Bee architecture was copied for the ventilation system for the silos storing grain. Thus, the storage of grain allowed society to thrive during the time of famine. Bronze Age to Iron Age Bread was portable. Served as currency. Allowed armies to march. Facilitated trade between city states. The grain rich regions of the Nile produced grain traded with Mycennians for olive oil and wine. The Roman emperors gave bread to the poor as welfare. Part of the bread and circus program to keep Romans happy. Bread was imported to Rome, and ultimately, Roman citizens were given "their daily bread." Rome fell, but bread continued to be important. Bread until 1920 Grains, including bread, were the major source of calories for most of Europe. From the fall of Rome through the Middle Ages, bread was the main source of calories, along with other grain products. Bread in the Industrial Age White bread was considered pure, hygienic, the whiter the better. Brown bread could be contaminated. The ability of mills to separate wheat from chaff, and to make bread without a human hand touching it was irresistible. Industrial bread slicing resulted in "best thing since sliced bread." White bread became the preferred style of bread from the 1920s until 2009. Fortification of bread with vitamins in the 1940s made bread a health food. Pellagra (vitamin B 3 deficiency) and beriberi (thiamine deficiency) had sadly become common in the US and were eliminated by fortification. So it was indeed revolutionary, but calling it a health food? Even the Federal Trade Commission had issues with this "12 ways campaign" and sued Wonder Bread. The Feds lost. Age of Aquarius Beats Bread In spite of the world loving white bread,

Seed Oils: Toxic or Not? Today, the low-carb/carnivore community has a new enemy. It is seed oils. Here is their argument: That is the summary of their logic. Now, let's get to the science. What are Seed Oils? See those beautiful seeds, in them are bits of oil. This is the rapeseed plant, which we have covered before. From rapeseed came canola oil. And this has been used as a source of oil starting about 4000 years ago. A much misunderstood oil, please see our previous podcast. Seed Oils Every seed has oil. Nuts are a type of seed, and their caloric density comes from oil. Oddly, low carb/keto types tend to eat nuts, the carnivore crowd avoids them. Seed oils are another name for vegetable oils, and they are used often in cooking because they have a neutral taste and high smoke point. The more common ones include corn, peanuts, sunflowers, grapes, and others. Seed Oils and Ancient Humans Besides the logical fallacy about what ancient humans ate, seed oils have been cultivated and used for the whole of written humanity. Ancient Egyptians used oils for cooking and perfume. Even the Bible talks about the use of oils, including the gifts sent to the birth of Jesus. To summarize, humans have recorded the use of oils from seeds through all recorded history. Components of Seed Oils There is no one "oil" that can chemically be called a "seed oil." Rather, every seed contains different compositions of oils, and it is how the body uses those particular oils that makes us interested in them. Thus, seed oils as a term is silly. I wonder why the carnivore/keto crowd decided to use "seed oils" instead of vegetable oils? After all, they don't call beef tallow "meat oil." Oleic Acid: Olives to Butter Oleic acid is the main fatty acid in olive oil (55-85% of the oil). This is a mono-unsaturated fatty acid, which everyone seems to agree is heart healthy. Hence, the more oleic acid in something, the better. But are Vegetable Oils Inflammatory? The short answer is no. To be inflammatory, they would have to elicit an inflammatory response. This means that inflammatory markers in the blood would be elevated for those who use vegetable oils over meat oils. In contrast, there is no increase in inflammatory markers of those who use vegetable oils. Want to see the data? Take a look at this paper where they look at foods, like vegetable oils, with high ratios of omega-6 fatty acids. What didn't they find? Higher levels of inflammatory markers. Thus, seed oils are not inflammatory. Atherosclerosis and Seed Oils Do vegetable oils increase your risk of atherosclerosis, or do they decrease it? If the carnivore crowd is correct, they have not been yet, then their view of the vegetable oils is that it would increase your risk of atherosclerosis REFERENCES: Courville AB, Majchrzak-Hong S, Yang S, Turner S, Wilhite B, Ness Shipley K, Horneffer Y, Domenichiello AF,

Ancestral Diets and Logical Fallacies There is an appeal to ancient history: the idea that ancient beings were either "designed"—as from a creator—or "evolved" to eat in a certain way. Both are logical fallacies, but both are meant to be the "ex-cathedra" in a debate. You read these logical fallacies in communities that claim they understand this. Here are some comments you will get: Appealing arguments, but they are as flawed as they are simply incorrect. What Do We Know About Early Humans? Of the early human records, they are based on precious little data. Consider in the fossil record we have about our ancestors? And by the way, where do we start? If we begin with homo sapiens, we have been around as a species somewhere between 70,000 to 250,000 years. Often the "low-carb" community will conflate distant cousins of homo sapiens as direct ancestors. Most of them were not but were a branch on the tree of evolution that are only related to us. Homo Erectus Perhaps the best adapted was the homo erectus, which was around for two million years. It is doubtful that homo sapiens will make it that long, but we can hope. Most fossil finds come from Australia and Asia - where they not only foraged but also established some organized hunting. Fossil Records There are about 6000 fossils of early man. That's it. Just 6,000. When we look for fossils of our particular, such as early homo sapiens, we have enough fossils that we might fill up a school bus. How long did they live? It turns out we know. Many died around the age of 35 years. So why do we want to eat like they did? At this point, someone in the audience will be bound to say - "They lived longer if you take into account infant mortality." When we date a fossil and see when it died, we don't average the infant mortality of the time. Recent Discoveries Bones and teeth from seen people, and isolated teeth, were reported recently. These came from a cave in Morocco. As these teeth are from about 15,000 years ago. Hence, the diet was before the advent of agriculture. Evidence points to plants being a major part of these hunter-gatherer's menu. As plants can be stored by hunter-gatherers all year round to protect against seasonal prey shortages. Thus, there is a regular food supply. Hunter-Gatherers The famous caveman diet- life wasn't so simple. When people of the carnivore tribe try to convince you about their diet, they invoke the mighty hunter. A better term was that our ancestors survived by being fishers, gatherers, and scavengers.

Rice and Fruit or Carnivore The rice diet successfully treated malignant hypertension. Today, we have medications that treat malignant hypertension. Before the 1940s, there were no drugs available to treat this disease, resulting in death from untreated malignant hypertension within six months. Despite the best medical care available, President Franklin Delano Roosevelt died from this disease. History of the Rice Diet Walter Kempner developed the rice diet to treat malignant hypertension. For example, failing kidneys would be given a reprieve with a diet low in sodium and protein. Then removal of saturated fat would allow some recovery of the heart. In a disease that had 100 percent death in six months, Kempner's results were amazing. For example, in Kempner’s original cohort of 192 people, only 25 patients died. In addition, 107 patients showed significant improvement (from 200/112 mm Hg to 149/96 mm Hg) with the diet. Equally important, heart size decreased in 66 of 72 patients. Moreover, cholesterol was reduced in 73 of 82 patients. Finally, retinopathy improved or disappeared completely in 21 of 33 patients. "Therapeutic results are little short of miraculous," noted an editorial in the New England Journal of Medicine. The Rice Diet Patients were first hospitalized. The diet consisted of white rice, sugar, fruit, fruit juices, vitamins and iron. Total calories were 2,000 with 20 grams of protein and 150 mg of sodium. Kempner kept careful records of his patients. Reporting success and failure is a key to academic transparency. Finally, the ability to reproduce the data in other centers provided the final key to Kempner's work. Contrast the Carnivore Diet The carnivore diet is popular among young, buff men whose living is made by promoting and coaching this diet. They sell the diet based on classic marketing techniques used for overweight patients. Marketing phrases used by hucksters for years to trap people unhappy about their weight. No Science in the Carnivore Diet The carnivore diet relies on anecdotes, not evidence. Testimonials rule Facebook and YouTube sites. There are no publications about the diet. Finally, many in the carnivore community push against medicine. Conspiratorial thinking is strong, with phrases like this: Try to raise a concern about how this diet would increase the risk of heart disease, and they double down with misinformation. They will deny the evidence showing that high cholesterol leads to heart attacks and strokes. Or make the claim that if you are "metabolically healthy," you don't need to worry about cholesterol. No Academic Researchers There are no academic research scientists following people trying the carnivore diet. That means there is no transparency about the results. In addition, there is no accountability for any bad results. Those who promote the diet include Paul Saladino, a physician who doesn't see patients and makes his income selling supplements. The Liver King, who doesn't follow the diet, was caught using performance-enhancing drugs. Shawn Baker is an orthopedic-trained surgeon who lost his medical license and makes his money promoting the carnivore diet. The New Mexico Medical Board ordered the "voluntary and permanent...

The Benefits of Whole Grains in Your Diet I want to take you back in time. While we talk about the Mediterranean diet not being a diet of culture but a pattern of eating – it still had its origins in the Mediterranean. The original Mediterranean diet was described as far back as 500 BC in the Ilead. The ancient Greeks ate whole grains, fruits, vegetables, pulses, and a bit of fish. Red meat was rare. While red meat may not have been a dietary staple for the Ancient Greeks, it was consumed during feasts, festivals, and special occasions. Cows were considered sacred gods, like Zeus, and their slaughter was for religious ceremonies and consumed during feasts The majority of the population received protein from fish, poultry, legumes, and whole grains. The First Olympics This was the diet of the first Olympians, as well as the Romans. Ancient Greeks worshiped the body, as you can see from the statues, as well as our language. We get the word gym from the Greek word “gymnasion," which translates to a place to exercise naked. But those gyms not only had a place to train but also schools, where literature, philosophy, math, and music were taught, as well as a social gathering place. We also get Diet from the Greeks, which originates from “diaita,” meaning the “way of life” or a manner of living. The Greeks had a balanced approach to health and well-being, emphasizing diet, exercise, and the mind. Gym bros and bro science were yet to be invented. Ancient Grains Could those Olympians of old who ate diets filled with whole-grain cereals have been wrong? Or could it be that those grains of the past were different from today’s grains? If you’ve ever been on a “low carb” diet, one of the first food groups you eliminate are grains. As you dutifully got rid of the last bit of joy in your life, you feel it was the cost to have your weight drop. You might have thought – "Grains are evil." Low Carb Life Without Grains Eating burgers without the bun, breakfast without toast, no pastries, no bread, no pasta, no rice, and you were losing weight. Lots of confirmation bias. Oh those heady early days of a low carb diet, losing weight, feeling better, maybe even noticing cholesterol improved. Hard to sustain though, and did you ever get tired of steak? Finding Joy in the Mediterranean Diet Now you come here and find the best diet is the Mediterranean diet. Lots of peer reviewed literature to support it. Then you wondered what in grains was evil. The first easy thought was that it all breaks down to glucose, and glucose is evil. Unless you know biochemistry and realize no, that’s not it. Your body runs on glucose. It's the Gluten And maybe you read about celiac disease and gluten as its trigger. Maybe some blogger convinced you that wheat in America is filled with gluten, and this is the problem. Unable to sustain a low-carb diet, you return to the joy of the morning pastry or dessert, all the while thinking grains are what caused the weight to return. Now you come to the Mediterranean Diet, and whole grains, not refined grains, are on the menu. Still, you are suspicious, and you think – maybe it was the gluten. Celiac Disease Or what happens if you come to the Mediterranean diet and have Celiac disease and gluten causes horrific issues? But should we all avoid gluten? And can we have a Mediterranean diet if we must be gluten-free? Should the ancient Greeks become Carnivores instead of those grizzly men who are on a diet now associated with the healthiest people on planet Earth? Clearly not. Eating too much red meat is associated with increasing heart disease and cancer, while the Mediterranean diet is associated with less heart disease and cancer. Carnivore's Take Carnivores like pointing to the ancient...

Learn to Cook Fish Fish is not only a healthy option but also a versatile ingredient that can be transformed into a myriad of mouthwatering dishes. Whether you're a seafood aficionado or looking to expand your culinary repertoire, mastering the art of cooking fish can elevate your cooking skills to new heights. In this article, we'll explore the techniques and recipes to create delicious fish dishes that will impress even the most discerning palates. Cooking Methods: Delicious Fish Recipes: Now that you're familiar with the basics of preparing and cooking fish let's explore some mouthwatering recipes to try at home: For more great recipes, see terrysimpson.com.

Health Benefits of Fish Consumption Fish consumption has been linked to various health benefits due to its rich nutritional profile. The health benefits of fish consumption include cardiovascular health, brain function, and well-being. Because fish are a rich source of omega-3 fatty acids, vitamins, minerals, and other nutrients, they are an important part of a balanced diet. Fish, the Most Ancestral Food Fish has long been recognized as a valuable source of essential nutrients beneficial for human health. Seafood is a staple part of the diet across different cultures and regions. Since most of the first human communities were coastal, fish were a common source of food. Cardiovascular Health Exceeds Risk Regular fish intake reduces the risk of cardiovascular diseases, such as coronary heart disease and stroke (Mozaffarian & Rimm, 2006). That study showed that the benefits of fish intake exceed the potential risks. Even for women of childbearing age, the benefits of modest fish intake, excepting a few selected species, also outweigh the risks. The heart health effect comes from the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) found abundantly in fatty fish species (Kris-Etherton et al., 2002). These fatty acids exert anti-inflammatory, antiarrhythmic, and vasodilatory effects, lowering blood pressure and triglyceride levels and reducing the formation of blood clots (Calder, 2015). Brain Function Fish consumption has also been associated with improved cognitive (brain) function and a reduced risk of brain disorders such as Alzheimer's disease. The omega-3 fatty acids EPA and DHA play a crucial role in brain health (Gómez-Pinilla, 2008). Epidemiological studies have consistently shown a positive correlation between higher fish consumption and better memory (ref). Moreover, research suggests early-life exposure to seafood has long-term brain benefits and decreases age-related cognitive decline (Wurtman et al., 2009). Nutrient Profile, Such as Vitamin D But omega-3 fatty acids are not the only benefit of eating fish. Fish are also a rich source of various essential nutrients vital for human health. Vitamin D, in particular, is naturally abundant in fatty fish and plays a crucial role in bone health, immune function, and mood regulation (Holick, 2007). These include high-quality protein, vitamins (such as vitamin D and B-complex vitamins), and minerals (such as selenium, iodine, and zinc) (Kris-Etherton et al., 2002). Furthermore, the bioavailability of these nutrients from fish is superior to other dietary sources, including supplements. Thus, fish consumption is an efficient means of meeting nutritional requirements (Rosell & Appleby, 2006). Fish Farms Aquaculture, the farming of fish and aquatic organisms, has undergone significant advancements in recent years, leading to improvements in sustainability, efficiency, and product quality. Fish Farms have had significant problems in the past. In the last fifteen years, there has been an improvement in environmental management strategies and sustainable farming practices. Those practices have changed my mind about seafood. Consequently, you can now buy quality farm-raised seafood, which adheres to the high standards of any food. Hence, I now recommend some...

Three Great Diets The Mediterranean diet, the DASH diet (Dietary Approaches to Stop Hypertension), and the MIND diet (Mediterranean-DASH Intervention for Neurodegenerative Delay) are all great eating patterns. Each diet focuses on different aspects of health. Mediterranean Diet The Mediterranean diet comes from the traditional dietary patterns of countries bordering the Mediterranean Sea, such as Greece, Italy, and Spain. High in the consumption of fruits, vegetables, whole grains, nuts, seeds, legumes, olive oil, fish, and moderate amounts of poultry, dairy, and red wine. Shown to decrease the risk of heart disease and cancer and to improve longevity. DASH Diet Discussed in last week's podcast (ref). DASH (Dietary approach to stop hypertension) was developed to prevent and manage hypertension (high blood pressure). Focuses on increasing intake of fruits, vegetables, whole grains, lean proteins, and low-fat dairy products while limiting sodium, saturated fats, and cholesterol. MIND Diet Developed by researchers at Rush University Medical Center as a hybrid of the Mediterranean and DASH diets, with a focus on brain health and reducing the risk of neurodegenerative diseases like Alzheimer's disease. It also emphasizes the consumption of fruits, vegetables, whole grains, nuts, olive oil, fish, poultry, and beans while limiting the intake of red meat, butter/margarine, cheese, pastries/sweets, and fried/fast foods. Three Diets are Branches of the Same Tree The Mediterranean, DASH, and MIND diets share some common elements. All focus on whole foods and plant-based sources of nutrients. The Mediterranean diet emphasizes health and longevity. While the DASH diet targets hypertension and cardiovascular health. Finally, the MIND diet specifically supports brain health to reduce the risk of neurodegenerative diseases. 1. Rush Memory and Aging Project: A study conducted by researchers at Rush University Medical Center followed over 900 older adults for an average of 4.5 years. Findings showed that individuals who closely adhered to the MIND diet had a substantially lower risk of developing Alzheimer's disease, with a reduction in risk ranging from 21% to 53%, depending on the level of adherence. (ref ) 2. Columbia University Medical Center Study: Researchers at Columbia University Medical Center examined the dietary habits of over 1,000 participants. Individuals who closely followed the MIND diet had a 53% lower risk of developing Alzheimer's disease than those with low adherence to the diet. 3. Alzheimer's Disease Neuroimaging Initiative (ADNI): The ADNI study found that adherence to the MIND diet was associated with better cognitive performance and a reduced rate of cognitive decline over time. 4. Systematic Reviews and Meta-Analyses: Several systematic reviews and meta-analyses have summarized the findings of multiple studies investigating the association between the MIND diet and dementia risk. Overall, these reviews reveal that adherence to the MIND diet is associated with a significant reduction in Alzheimer's disease and dementia. 5. Mechanisms of Action: Components of the MIND diet, such as leafy greens, berries, nuts, whole grains, fish, olive oil, and poultry, have been linked to improved cognitive function and a lower risk of dementia. More research is needed to elucidate the mechanisms underlying the protective effects of the MIND diet. Current evidence suggests that...

Abstract: The Dietary Approaches to Stop Hypertension (DASH) diet is a widely recognized dietary pattern designed to lower blood pressure and promote cardiovascular health. I will attempt to provide an in-depth review of the DASH diet, its origins, key principles, health benefits, and potential limitations. It also explores the scientific evidence supporting its efficacy and applicability in various populations. Furthermore, this paper discusses practical considerations for adopting the DASH diet and its potential future developments in the field of nutrition and health. 1. Introduction The DASH diet, or Dietary Approaches to Stop Hypertension, is a dietary plan primarily developed to combat hypertension (high blood pressure). DASH has since gained recognition for its broader health benefits. Hypertension is a major risk factor for cardiovascular diseases, including heart disease and stroke. Therefore, the DASH diet is essential to reducing these health risks. 2. Origins and Development The National Heart Lung and Blood Institute (NHLBI) developed the DASH diet in a study known as the DASH-Sodium Study. The primary objective of the DASH-Sodium study was to investigate the effect of dietary patterns on blood pressure, in particular, the effects of sodium intake. Researchers aimed to design a diet that could effectively lower blood pressure without medication. The DASH diet emerged from this study as a dietary pattern rich in nutrients and low in sodium, saturated fat, and cholesterol. 3. Key Principles of the DASH Diet The DASH diet emphasizes the consumption of nutrient-rich foods while limiting the intake of sodium, saturated fats, and cholesterol. Key principles of the DASH diet include: 4. Health Benefits of the DASH Diet The DASH diet offers a range of health benefits beyond blood pressure reduction: 5. Scientific...

Did You Try the Carnivore Diet? Did you try the carnivore in January? A month of red meat, eggs, and butter? If you did, you probably lost weight. If you lost weight, you felt better. The Carnivore crowd will point to weight loss as proof of superiority. But did you worry that this might not be the healthiest diet for you long-term? Is it healthy? In short, the answer is no. Perhaps you remember on a previous podcast, we talked about the beer and sausage diet. On that diet, Evo, the pod god who distributes this podcast, lost weight every month he was on the diet. In addition, his weekly lab work -sorry for all the jabs Evo - improved every week he was on the diet. Could you argue that drinking beer and eating sausage is a good diet? You could, and that same logic is what the carnivore crowd uses to convince people the carnivore diet has merit. Simplicity, is Thy Name Carnivore? What could be simpler than eating a diet of just red meat? Who doesn't like a good steak? If you just eat steak or red meat, you will lose weight. When you lose weight, you will feel better. And your labs might improve. You might think it is paradoxical that your cholesterol level went down - it isn't; that is just a result of giving up junk food and weight loss. Every diet has a honeymoon phase, where people think they can do the diet "forever." Then reality comes home: FORK U Today, on Fork U, we will discuss the latest low-carb fad: the Carnivore diet, the denial that goes into those who make up the diet, and the risks of an all-meat diet. I'm Dr. Terry Simpson, and this is Fork U. Fork University Where we make sense of the madness, bust a few myths, and teach you a little about food as medicine. Carnivore Diet The carnivore diet, which primarily consists of animal products like meat, fish, and eggs, has become the latest low-carb fad. It is a controversial and extreme dietary approach. Proponents of the carnivore diet claim numerous health benefits. To be clear, the scientific evidence supporting these benefits is limited, and that long-term studies on the effects of the carnivore diet are lacking. Paul Saladino, Ken Berry, and Shawn Baker are a few doctors who advocate for this diet. And oddly, none of them see private patients, although Saladino and Baker love showing their abs, and spend a lot of time in the gym. The Biotruth of Evolution Some claim the natural diet of humans is meat. This is a biotruth. When someone tells you that “man was meant to eat” this or that – it is part of a logical fallacy known as a biotruth. A biotruth is an argument presented by someone with misunderstood notions of human biology and/or evolution but uses those false arguments to justify their views. In this case, how they eat. You can extend that logical fallacy out: man was not meant to fly, so we shouldn’t be in airplanes. Primitive man did not have laboratories, so we should not have antibiotics. You will see biotruth arguments from people who practice carnivore diets, as well as those who practice vegetarian (and vegan) diets. Often with photographs of our jaws and those of our ancestors – or they will say how we have a long or short intestine, and on that basis, we “were meant” to eat in whatever their view is. As we evolved, were we better...

Sorry It Didn't Work This is the time of year when everyone is excited about some change in their life. My neighbors are doing a "dry January" because they want to cut down on their alcohol. Other neighbors committed to more physical activity before a hip replacement. And there is the inevitable "what diet will I do this time?" Now, before I go to that, long-time readers of my newsletter will realize that I am drinking my cup of Peet's coffee. Peet's is a story of disappointment, which I will use to illustrate a point: Diet Disappointment Diets are like that person who disappoints you again and again. The person you invite to events, but they never reciprocate. The diet starts out great. You lose a bit of weight, decide you can eat this way forever, and this is your new lifestyle. Then something happens. If you are smart, you realize you cannot live that way. Most, though, internalize and think, "It is my fault." Well, it isn't your fault. Low Carb Disappointment Low-carb diets can be disappointing for various reasons. Some people may find it difficult to stick to a low-carb eating plan because they miss certain high-carb foods that they enjoy. This can lead to feelings of deprivation and dissatisfaction with the diet. Additionally, some people may not experience the weight loss or health benefits they were hoping for with a low-carb diet. It's important to remember that everyone's body is different, and what works for one person may not work for another. Furthermore, it is important to focus on overall health and well-being rather than just weight loss or specific dietary restrictions. Every year, someone starts a new version of low carb. I've done a few myself. This year's version is carnivore. Some are doing a carnivore January. The results will be the same as the previous low-carb diets - and let me go back to Peet's coffee. Coffee and Diets I have been a member of Peet's Coffee Club since 1995. I get it faithfully every couple of weeks. Whole beans. It costs about $36 for two bags. Then I discovered I could get it at Costco for $25, with no shipping charge, the same date of roasting. I wrote Peet's, of course. They told me my coffee is always fresh, unlike the bulk sold to Costco. Except the roasting date is on the package. Diets are like that. You get some results, then disappointment. You don't get the return for the money. But someone in the low-carb community will tell you that you didn't do it correctly: Now What? So, some consider weight loss surgery or new drugs. Both of these are reasonable (yes, I have done a lot of weight loss surgery in my time). But what I've advocated is that people have to take responsibility for what they eat even after weight loss surgery. Well, you don't have to - but your body is a perfect calorie counter. Does that mean a "diet?" No, the goal of weight loss drugs or surgery isn't to put someone on a diet for weight loss. The goal is to give them good food so they can nourish themselves. It also means I have to get rid of silly ideas they learned from things like the low-carb diet. The low-carb diet, that friend you always invite into your home, always disappoints. My Journey to Culinary Medicine About ten years ago, I received certification in Culinary Medicine. Part of that training was long hours reviewing the literature...

The Scams and Quacks of the Year The New Year, the point we all look for a second chance. To get healthy, lose weight, adopt a new habit. And waiting for you are the hucksters who want to sell you hydrogen in your water, expensive supplements of dubious value, and some choices that might actually harm you. If it sounds too good to be true, you might just be hearing the sound of the duck - or a quack, at least. TOP SCAMS OF THE YEAR FORK U Today, on Fork U, we will reveal the top scams of 2023 and make sense of the madness that surrounds them. I'm Dr. Terry Simpson, and this is FORK U. Fork University. Where we teach you a little bit about food as medicine Busting myths and making sense of the madness. The Liver King and Paul Saladino Chief among the shirtless salesmen of supplements and scams, 2023 saw the self-described liver king (Brian Johnson) fall from grace, and his partner, Paul Saladino, tried to say he didn't know. Liver King's five-foot-two-inch frame was filled with more steroids and growth hormones than found in a pharmacy. Purchasing somewhere between $12,000 and $20,000 of injectables a month and eating a diet far from the liver he recommended. Ultimately, Johnson admitted this, albeit the evidence was overwhelming. Finally, let us not forget that his business partner, Paul Saladino, loves to yell at spinach and kale while pushing his Heart and Soil supplements. Liver King and Saladino jointly own a supplement business, Heart and Soil. They sell supplements and pretend to tell you about health through the carnivore diet. Moreover, the company "Heart and Soil" is registered in Texas, and Brian Johnson, his wife, and Saladino are all board members. The Shirtless Salesmen of Supplements and Scams Being shirtless is oddly effective, especially among some men. Whether this comes from "we like alpha males with abs" or homo-erotic fantasy, shirtless sells. Countless times showing studies refuting their claims don't move these supporters. In fact, the response from some males was some version of "Show me your abdominals." My retort, "I'd love their abs, but in time they'd love my arteries," just didn't move them. I still find it odd that a grocery store would allow a shirtless person to yell at spinach. Yes, Saladino did train in psychiatry, although he does not see patients. While Saladino said, he had "an inkling" his partner was doing steroids. Johnson (Liver King) used to inject insulin and balance it with maple syrup. Isn't it odd that Saladino's refrigerator is filled with the same maple syrup that Liver King used to balance his insulin to increase glycogen in his muscles? The Carnivore Diet - or - Doctors Don't Learn Nutrition in Medical School Saladino received a medical degree from The University of Arizona, and I was a faculty member (assistant professor) at the time. Saladino loves to pander to the anti-medicine crowd with the trope that doctors don't learn the root cause of disease. I pointed out that we taught him pathophysiology, and he must have forgotten that our Western medicine discovered the root cause of many diseases. In front of one audience, Saladino claims he learned nutrition in medical school. Then, a few years later, he claims he didn't learn nutrition in medical school. Do we learn nutrition in medical school? Do Doctors Learn Nutrition in Medical School? As someone who is certified in Culinary Medicine and taught nutrition, I can say yes and no. The basics of nutrition are anatomy, physiology, and biochemistry. While you can get these courses in college, in...

Canola Oil is Healthy and Inexpensive Did you ever notice there are those people who will tell you how everything is bad for you? Don't eat this and don't eat that? They make grand assertions about the modern food system. Often claiming we should return to the age of the caveman. Assuming that health will return when we eat what our ancestors ate. The Logical Fallacy of Ancestral Diets / and Humans Proponents of ancestral diets are confused by the logical fallacy called a biotruth. What is a biotruth? An argument based upon a misunderstanding of natural selection or the evolutionary process. Usually combined with the conclusion that if it was good enough for primitive man, it should be true for now. Ultimately, we forget that primitive man did not have an easy life. Canola Oil Podcast Transcript Canola oil is today's topic because not everyone wants to buy expensive olive oil. When I mention canola oil on TikTok, the comments go like this: Are those claims valid? Should we avoid Canola oil? Must we avoid Canadians in general? Today on Fork U We will make sense of the madness that is Canola oil. Is it an evil plant that is only good to make oil for your car, truck, or tank? Or is it a reasonable oil for your body? I'm Dr. Terry Simpson, and this is Fork U Fork University Where we make sense of the madness Bust a few myths And teach you a little bit about food as medicine. What is Canola Oil? Canola oil was invented in the 1970s in Canada and is an acronym that stands for Canadian oil's low acid. Canola comes from the pressed seeds of rapeseed plants. Granted, that is an unfortunate name. However, not if you know its epistemology. Rapeseed comes from the Latin rapa, which translates to "turnip." Thus this flowering plant is a member of the turnip, cabbage, and mustard family. Latin just isn't taught anymore. But if you think of Rome often, as we men do, Latin might be the new language for you. Speaking of Mustard, did you ever wonder why we don't have mustard oil in the United States? Primarily Erucic acid. Erucic Acid Erucic acid is a monounsaturated fatty acid that is associated with heart disease. In some poorly done experiments in rats, they seemed to have higher levels of heart disease. Rats, not politicians. But the healthy kind of rats you find in sewers, not the vermin found in Washington, DC. Erucic acid is why you don't find mustard seed oil in the United States. Those who travel to India will experience delicious foods cooked in mustard oil. But don't fear. It will be just fine (ref). In fact, erucic acid decreases the rate of some progressive brain diseases and is being examined to treat cancer and other diseases. Rapeseed Oil as a lubricant Because of the high erucic acid content, rapeseed oil was originally used as an industrial lubricant. Some rapeseed was cold pressed, seeds gathered, pressed, and not heated, and the oil extracted. This has been used as a cooking oil for years, but there was concern regarding the erucic acid content. Canadians Hybrids Canadian scientists began to crossbreed the rapeseed with wild cabbage to lower erucic acid. The seeds of this new hybrid plant became the Canola oil. Later, this plant was genetically modified to withstand Round Up. Hence, it is a genetically modified plant (

Nuts and Seeds, or Supplements People who count calories notice nuts contain about 200 calories per ounce. Nuts are calorie-dense. However, nuts are also nutrient-dense. Moreover, nuts provide fiber, healthy oils, and essential minerals. Nuts have been shown to decrease sudden cardiac death, decrease cholesterol, and provide satiety that helps people who wish to control their weight. Two Brazil nuts contain enough magnesium to meet the adult daily requirement. Food Works, Supplements May Not The advantage of a healthy diet is that you do not need supplements in your diet. While Magnesium is an essential mineral needed in hundreds of reactions in your body, you can get all the magnesium you need by following a Mediterranean Diet. Take Pumpkin Seeds - also known as Pepitas in the US. Kernels: 1 oz, 168 mg or pumpkin seeds in shell: 1 oz, 74 mg Other Foods That Work: Almonds, dry roasted: 1 oz, 80 mg Spinach, boiled: ½ cup, 78 mg Cashews, dry roasted: 1 oz, 74 mg Peanuts, oil roasted: ¼ cup, 63 mg Soymilk, plain or vanilla: 1 cup, 61 mg Black beans, cooked: 1⁄2 cup, 60 mg Peanut butter, smooth: 2 tablespoons, 49 mg Bread, whole wheat: 2 slices, 46 mg Avocado: 1 whole one is 44 mg Potato, baked with skin: 3.5 oz, 43 mg Rice, brown, cooked: 1⁄2 cup, 42 mg Yogurt, plain, low fat: 8 oz, 42 mg Oatmeal, instant: 1 packet, 36 mg Banana: 1 medium, 32 mg Salmon, Atlantic, farmed: 3 oz, 26 mg Halibut, cooked: 3 oz, 24 mg Raisins½ cup, 23 mg Chicken breast, roasted: 3 oz, 22 mg Beef, ground, 90% lean: 3 oz, 20 mg Broccoli, chopped & cooked: ½ cup, 12 mg Apple:1 medium, 9 mg Carrot, raw: 1 medium, 7 mg All of those are foods you get in your diet, and all of them are a part of a healthy Mediterranean Diet. TEXT FROM PODCAST: Which is better? Magnesium glycinate three eight citrate or oxide? This is one of the most common questions I'm asked during my doc talk live sections on TikTok. Magnesium supplementation is a popular subject probably ever since the disgraced Naturopath published her book The Magnesium Miracle, claiming that magnesium could cure over 60 diseases. It was popular because so many people wanted one thing that they could grab hold of to explain all of their problems. And because symptoms of magnesium deficiency are common, fatigue, weakness, insomnia, and heart palpitations, it became a natural reservoir for all of the nonsense that people want to present. Barbara O'Neill, the naturopath banned from Australia for dangerous practices, frequently lectures that taking Celtic salt will cure hypertension, but it isn't Celtic sea salt you need. If you need magnesium today, I will introduce you to Mediterranean magnesium. It will not only help regulate blood pressure but also improve your life and increase longevity. Today on Fork U, we will make sense of the madness of magnesium, and we'll tell you which magnesium supplement you should buy and which you should avoid. And how to take the Mediterranean magnesium miracle and avoid the supplemental magnesium misery of Montezuma. I'm Dr. Terry Simpson, and this is Fork Fork University. where we make sense of the madness. Bust a few myths and teach you a little bit about food as medicine. The Mediterranean magnesium miracle. Where do you get this? Well, first try nuts and seeds, which we include in the fruit section of the Mediterranean diet. Did you know that two Brazil nuts contain enough magnesium for a person for a day? An ounce of pumpkin

We Love Legumes The legume is a powerhouse plant protein. The beautiful bean. Often the source of protein for vegetarians and vegans, and forgotten about in most modern diets today. Thus, we will campaign to bring back the legume. In today's gym, you will find people selling protein powders, advocating all meat diets, and flexing their muscles. But in ancient times, the original Greek Gymnasiums, the source of protein for these fellows, were legumes. Their diet was cereals from whole grains, fruits, legumes, vegetables, and occasionally fish. No meat, no protein powder, no pre-workout. What is a Legume or Pulse? When most think about legumes, they think about the common green bean (Phaseolus vulgaris). Yet there is an entire family of Leguminosae. The precise definition of a legume is any plant from the Fabaceae family that would include its leaves, stems, and pods. A pulse is an edible seed from a legume plant. Pulses include beans, lentils, and peas. For example, a pea pod is a legume, but the pea inside the pod is the pulse. Rediscovering the Bean When Ancel Keys was told there were few cardiac events in Southern Italy, he went to investigate. Legumes have less fat, and thus, a diet rich in legumes should have less fat and, thus, less heart disease. In Naples, only 20-25 percent of the calories were from fat. In contrast, Keys noted in England that 35% of the calories were from fat, while in Minnesota, 40 percent of the calories were from fat. Legumes meant plenty of protein, less fat. The blood cholesterol reflected some of this. Naples had cholesterol values of 165 milligrams per 100 milliliters of blood, while England had over 200 and Minnesota had over 230. Total blood cholesterol was the only measurement at the time. What Keys also showed was the wealthy Neapolitans ate a richer diet: "Still, a small sample of bankers and professional men in Naples, who lived on a much richer diet than the working class, had cholesterol values of about 200 in their blood serum, and some of them had coronary heart disease." (reference 1) Beans and Lower Cholesterol Keys then took 24 healthy men and controlled their diet for fat and protein. Keeping calories constant with equal amounts of protein but changing the fat, the cholesterol fell from 225 to 195 on the lower-fat diet. But the Neapolitan diet was not what he followed. The fat in Naples was mainly olive oil, and the fat in the low-fat metabolic ward was from fat in meat and milk. At the time, Keys concluded it would be difficult to convince people to eat a diet rich in legumes. Americans love their meat. Today, we have better methods to decrease heart disease risk by using statins often with other drugs. While a diet of legumes replacing meat might reduce blood cholesterol by 10-20%, that is often not enough to decrease the risk of heart disease. A combination of modern medications (such as Crestor, Zetia, Repatha) can lower LDL (apo-B levels) to where heart disease can become an "orphan" disease. You can have your steak and eat it too! Legumes and the Mediterranean Diet Legumes are part of the Mediterranean Diet (ref). The recommended amount includes 3-4 ounces of legumes per day. Or using legumes as a major source of protein for a meal several times a week. Legumes: lentils, beans, peas, and peanuts. The more common ones that humans consume. Ancient Peoples and Legumes Until about 12,000 years ago, homo sapiens were hunter-gatherers. For almost two million years before that, our evolutionary ancestors subsisted on hunting and gathering. What was the most common protein source? Legumes. Not meat, as much as your carnivore-crazy friends would have you believe. Remains of lentils, the tombs of the Twelfth...

Turmeric: It can kill you Turmeric is from the root of a flowering plant (Curcuma longa of the ginger family Zingiberaceae), known for being anti-inflammatory. Because of its anti-inflammatory nature, turmeric is one of the most common supplements I am asked about during my TikTok live sessions. This is because people like a "natural" anti-inflammatory supplement rather than over-the-counter medications. Supplements Supplements are excluded from "black box warnings." Those warnings you see in the package inserts in pharmaceuticals. This article is meant to provide references for those interested in doing more research about Tumeric to realize it is not benign. Turmeric has many potential applications for cancer, brain injury, and many other diseases. The key is knowing what dose of turmeric is toxic, what dose is effective, and what dose is ineffective. We also need to know how to mitigate potential dangers. Contrast with Aspirin Aspirin is a known anti-inflammatory agent with many uses. Since aspirin is regulated, we know the dose effect of aspirin. If you have a headache, the 81 mg dose of aspirin will not relieve your headache. But the 325 mg dose will decrease headache. And you know that taking two hundred tablets of aspirin is a toxic dose. A single aspirin can cause a bleeding ulcer, which may lead to death. Some people are allergic to aspirin, and an allergic reaction can lead to death. What we don't know is the effective dose of Turmeric or the lethal dose of it in that supplement bottle. But we know that turmeric, curcumin can lead to liver injury and death. Turmeric and Liver Injury Toxicity is always in the dose. High curcumin levels, the active ingredient in turmeric, have caused liver damage (Ref 1-13). To quote from one of the references: Liver injury due to turmeric appears to be increasing in the United States, perhaps reflecting usage patterns or increased combination with black pepper. (2) Turmeric and Cooking There is no danger in using turmeric as a spice in cooking. First, because your intestines do not absorb turmeric well. Unlike a supplement, which has high doses of curcumin. In addition, supplements also have black pepper, which increases absorption. Since turmeric has a mild anti-inflammatory component, this might have limited benefits as part of a healthy diet. Tumeric belongs in the cabinet, not in a capsule. TEXT FROM THE PODCAST You probably have some turmeric in your herb and spice drawer. You’ve probably heard that Turmeric’s active ingredient Curcumin has anti-inflammatory properties and has been used for centuries as an “ancient” medicine. That yellow powder comes from the root of the Curcuma longa plant, a member of the ginger family. Turmeric has a warm, bitter taste, and I use it in Paella, curry, and add it to salads, rice, or other starches like pearl barley. But what you haven’t heard is that too much Turmeric can kill you. Today we will make sense of the madness surrounding Turmeric. From its promise as an anti-cancer agent to its toxicity, and who should avoid it for daily use. FORK U I’m Dr. Terry Simpson, and THIS is FORK U Fork University Where we make sense of the madness Bust a few myths! And teach you a little bit about food as medicine. Inflammation Inflammation is a complex biochemical, physiological, and even pathological process. Inflammation is the basis of our immune system, and acute inflammation allows us to rid our bodies of cancer, viruses, bacteria, yeasts, mold, and parasites. Without the inflammatory process, we would end up being a pile of goo in twenty-four hours – dead as dead can be. Inflammation allows us

Ozempic, Wegovy, Monjaro, and a host of other drugs – the GLP-1 agonists and near miracles weight loss drugs, and soon a more potent pill form coming. These drugs have known side effects, and there have been increased visits to the emergency rooms. Often because people were not told foods to avoid. As with any new drug, there are the grifters. After all, since it is a prescription, you will have supplement salesmen that promise a natural solution. What about those who claim they can "compound" the drug for you in their compound pharmacy? Weight Watchers and Sequence Was it a coincidence that Weight Watchers (WW) bought Sequence? Sequence is a company that prescribes these drugs through a network of physicians that you contact via telemedicine. Sequence, as it turns out, is one of the more legitimate telemedicine companies, not only trying to get you a prescription but providing a diet plan with it. Weight Watchers purchased Sequence for over 100 million dollars. One thing missing from the frequent prescription of the new drugs is a diet plan. Weight Watchers does this. And Weight Watchers is partially owned by Oprah Winfrey, who has been open about her weight loss struggles. Now, Oprah reports she has been on semaglutide and lost over 45 pounds. Thus Oprah proved that the drugs, with a good diet, are a powerful tool against obesity. It is More Than Willpower - Ask Oprah As a weight loss surgeon, I am constantly asked about willpower and obesity. For example, Oprah Winfrey a person with more willpower than probably anyone you know. Given her resources to have people cook for her, provide her with a workout plan, and any assistance. She even bought a major portion of Weight Watchers. What made the difference? The injectable drug, semaglutide (Wegovy). Obesity Management is more than a diet - ask Weight Watchers The Weight Watchers diet plan has evolved over the years. Even with the Weight Watchers diet plan ranking among the best diets in the world, they purchased Sequence. Thus repositioning themselves to use their diet with the drugs to provide optimal health. Keeping you out of the Emergency Room - Side Effects of the New Drugs Emergency room physicians have noted an increase in patients coming to the ER after using these drugs. I was recently interviewed about this, and you can find it here. Common side effects include nausea, vomiting, bloating, constipation, and diarrhea. Up to eighty percent of people who take these drugs have symptoms. Many of those problems can be avoided by following a few simple rules: Compound Pharmacies and "generic Ozempic" Many compound pharmacies have offered these drugs for sale. They are often at a greatly reduced price. But they are not the same drugs approved and tested by the FDA. There is no "generic" form of Ozempic, Wegovy, or Mounjaro. Compound pharmacies are telling their customers that, since there is a shortage of these drugs, they can compound the drug and sell it to the public. Many of these compound pharmacies import semaglutide from overseas. It is illegal to import a drug from overseas without FDA approval. Furthermore, the drugs they import are not the same formula...