Diet

• One day, she explained that she adds apple cider vinegar to improve my health.
• Apple cider vinegar is a natural product made of fermented apple juice that has gone sour.
• I decided to turn medical sleuth and investigate whether apple cider vinegar is as good for health as it sounds.

Claim: disinfectant properties

• But does apple cider vinegar’s decontaminant qualities translate to the human gut?
• Our stomachs produce acid, which acts as a natural barrier to infection, so how can adding more acid help?

Claim: weight loss and management of type 2 diabetes

• There are plenty of anecdotal claims that apple cider vinegar can aid weight loss, supported by limited evidence from several small studies.
• Apple cider vinegar is thought to cause weight loss through its effect on delay of gastric emptying.
• Reduced calorific intake will lead to weight loss – but how are the metabolic effects on blood glucose and lipids mediated?
• In type 2 diabetes there is a reduction in sensitivity to insulin which in turn leads to a reduced uptake of glucose by cells.

Claim: reduces risk of heart disease

• Raised blood lipids are a risk factor for cardiovascular diseases such as myocardial infarction and stroke.
• Well, I’m afraid there’s no scientific evidence that vinegar consumption of any kind reduces cardiovascular morbidity and mortality in those with or without diabetes.

Claim: cancer treatment and prevention

• One of the more outrageous claims of benefits of daily apple cider vinegar consumption is that it may prevent or treat cancer.
• A frequently quoted case-control study from China found that an increased consumption of vinegar was associated with a reduced incidence of oesophageal cancer.

Stephen Hughes does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

• Hundreds of thousands of people worldwide are taking drugs like Ozempic to lose weight.
• As demand for semaglutide increases, so are claims that taking it is “cheating” at weight loss or the “easy way out”.
• We don’t tell people who need statin medication to treat high cholesterol or drugs to manage high blood pressure they’re cheating or taking the easy way out.

How does it work?

• GLP-1 gets secreted by cells in your gut when it detects increased nutrient levels after eating.
• GLP-1 receptor agonist (GLP-1RA) medications like Ozempic help the body’s own GLP-1 work better by mimicking and extending its action.
• Read more:
  The rise of Ozempic: how surprise discoveries and lizard venom led to a new class of weight-loss drugs

What can users expect? What does the research say?

• Higher doses of semaglutide are prescribed to treat obesity compared to type 2 diabetes management (up to 2.4mg versus 2.0mg weekly).
• A large group of randomised controlled trials, called STEP trials, all tested weekly 2.4mg semaglutide injections versus different interventions or placebo drugs.
• Trials lasting 1.3–2 years consistently found weekly 2.4 mg semaglutide injections led to 6–12% greater weight loss compared to placebo or alternative interventions.

• Weight reduction due to semaglutide also leads to a reduction in systolic and diastolic blood pressure of about 4.8 mmHg and 2.5 mmHg respectively, a reduction in triglyceride levels (a type of blood fat) and improved physical function.
• Another recent trial in adults with pre-existing heart disease and obesity, but without type 2 diabetes, found adults receiving weekly 2.4mg semaglutide injections had a 20% lower risk of specific cardiovascular events, including having a non-fatal heart attack, a stroke or dying from cardiovascular disease, after three years follow-up.

Who is eligible for semaglutide?

• Australia’s regulator, the Therapeutic Goods Administration (TGA), has approved semaglutide, sold as Ozempic, for treating type 2 diabetes.
• The TGA has approved Wegovy to treat obesity but it’s not currently available in Australia.

What else do you need to do during Ozempic treatment?

• In addition to taking medication, people had brief lifestyle counselling sessions with dietitians or other health professionals every four weeks as a minimum in most trials.
• The aim of these trials was to show the effect of adding the medication on top of other lifestyle counselling.

A review of obesity medication trials found people reported they needed less cognitive behaviour training to help them stick with the reduced energy intake. This is one aspect where drug treatment may make adherence a little easier. Not feeling as hungry and having environmental food cues “switched off” may mean less support is required for goal-setting, self-monitoring food intake and avoiding things that trigger eating.

But what are the side effects?

• In on study these led to discontinuation of medication in 6% of people, but interestingly also in 3% of people taking placebos.
• More severe side-effects included gallbladder disease, acute pancreatitis, hypoglycaemia, acute kidney disease and injection site reactions.
• Here are some potential risks and benefits

  To reduce risk or severity of side-effects, medication doses are increased very slowly over months.

• Health, Meat and Livestock Australia, and Greater Charitable Foundation.
• She has consulted to SHINE Australia, Novo Nordisk, Quality Bakers, the Sax Institute, Dietitians Australia and the ABC.

• “Bempedoic acid is the only FDA approved non-statin LDL lowering therapy to demonstrate reductions in MACE in both primary prevention and secondary prevention patient populations.
• The Hispanic population is the largest ethnic minority in the U.S., yet is a population historically underrepresented in clinical trials.
• At Esperion, we discover, develop, and commercialize innovative medicines to help improve outcomes for patients with or at risk for cardiovascular and cardiometabolic diseases.
• CLEAR Outcomes is part of the CLEAR clinical research program for NEXLETOL® (bempedoic acid) Tablet and NEXLIZET® (bempedoic acid and ezetimibe) Tablet.

• NEW YORK CITY, April 02, 2024 (GLOBE NEWSWIRE) -- Sesame , the company building a radically new healthcare system for uninsured Americans and those with high-deductible plans,  today unveiled an expansion of its partnership with Costco to offer specialized health care for weight loss with pricing exclusively for Costco Members.
• “We are witnessing important innovations in medically-supervised weight loss,” said David Goldhill, Sesame‘s co-founder and CEO, and a serial author on American healthcare reform.
• “Sesame’s unique model allows us not only to make high-quality specialty care like weight loss much more accessible and affordable, but also to empower clinicians to create care plans that are specific to — and appropriate for — each individual patient.”
  How does Sesame’s weight loss service work?
• This weight loss  program represents an expansion of the partnership, which thus far has garnered a Net Promoter Score of 82 – considered a “world class” score – from Costco Members utilizing Sesame.