Have You Heard of Ozempic Face?

Semaglutide is an injectable drug for diabetes in the class called GLP-1 analogues. Click for my overview of the class. Semaglutide is sold in the U.S. as brand name Ozempic.

Folks with diabetes taking Ozempic found that it promoted fat weight loss. Facial fat tends to fill in wrinkles, hence, younger-looking skin. Loss of fat on the face can make your skin sag and older-looking, more wrinkled, gaunt. That’s so-called Ozempic face.

Semaglutide and others in it’s class are increasingly being used by non-diabetics for weight loss, either as an injection or a pill.

From the esteemed medical journal, People:

To restore volume in a patient’s face, doctors will often perform noninvasive, but expensive, procedures such as injecting Radiesse and hyaluronic acid-based fillers or Sculptra injections, which stimulates collagen production. Doctors can also restore volume with a face lift or by transferring fat from other body parts to the face.


Steve Parker, M.D.

h/t DiabetesDaily

Paleo Diet Might Improve Hashimoto’s Thyroiditis and Grave’s Disease

But the evidence is weak. From the Journal of the American Nutrition Association:

Abstract

The aim of this systematic review was to examine the characteristics of Paleolithic diet (PD) interventions designed for adult patients with autoimmune thyroid disease (AITD) in order to determine if diet elements have the potential to successfully reduce thyroid antibodies (Ab) such as thyroglobulin (Tg), thyroid peroxidase (TPO), and thyroid stimulating hormone receptor (TSHR), and improve thyroid hormones (thyroxine (T4), triiodothyronine (T3) and thyroid stimulating hormone (TSH)) or resolve AITD pathogenesis. Randomized controlled trials (RCTs) with an adult population of 18 years and older, diagnosed with Hashimoto’s thyroiditis (HT) or Graves’ disease (GD) (Basedow’s), who were placed on a diet of Paleolithic or ancestral nature, and achieved reduction of AITD Abs, improvement of thyroid hormones, and, or resolution of AITD were searched. Various electronic databases were used. Bias was assessed using critical appraisal tools from the Scottish Intercollegiate Guidelines Network (SIGN) and Joanna Briggs Institute (JBI). Studies were excluded according to exclusion criteria and results analyzed. One randomized controlled trial (RCT), a pilot study, and six case studies were found. In total, eight AITD studies focusing on Paleolithic or ancestral interventions were located. In highlight, females were the predominant gender. Case studies solely focused on AITD with protocols ranging from 8-60 weeks. All studies showed clinical improvements, one had significant improvement, two showed AITD resolution. After structured evaluation of nutritional interventions utilizing the PD on the effects of AITD, it was concluded foods of ancestral nature along with the addition of specific supplements, food components, exercise and mindfulness meditation, and exclusion of modern day foods have a considerable impact on thyroid Ab and hormones. The relevant studies suggest while this dietary protocol can be useful in clinical practice, larger-scale studies need to be conducted. Key teaching points: There are currently no dietary interventions recommended for the treatment of autoimmune thyroid disease. The Paleo diet has been documented to improve AITD antibodies and thyroid hormones in both Hashimoto’s thyroiditis and Graves’ disease.The Paleo diet can provide a natural source of nutrients similar to supplemental nutrients that have shown positive results on AITD.The paleo diet provides specific macronutrient percentages that may be beneficial in reducing AITD antibodies, while improving thyroid hormones.Methylation supplementation may be useful in AITD cases.


Steve Parker, M.D.

U.S. Longevity Falling, Not Keeping Up With the Jones’s

From NPR:

The average life expectancy for Americans shortened by over seven months [in 2021], according to new data from the Centers for Disease Control and Prevention.

That decrease follows an already big decline of 1.8 years in 2020. As a result, the expected life span of someone born in the U.S. is now 76.4 years — the shortest it has been in nearly two decades.

But we still have the best healthcare system in the world, right? Not if you judge it by life expectancy. From Health System Tracker:

Life expectancy in the U.S. and peer countries generally increased from 1980-2019, but decreased in most countries in 2020 due to COVID-19. From 2020 to 2021, life expectancy at birth began to rebound in most comparable countries while it continued to decline in the U.S. The CDC estimates life expectancy at birth in the U.S. decreased to 76.1 years in 2021, down 2.7 years from 78.8 years in 2019 and down 0.9 years from 2020. The average life expectancy at birth among comparable countries was 82.4 years in 2021, down 0.2 years from 2019 and up 0.4 years from 2020. 

Click the article links for potential explanations.

Steve Parker, M.D.

PS: Healthy diet, exercise, and weight management improve longevity. Let me help.

Hiccups: What’s Your Favorite Cure?

I’ve written previously about how Paul Ingraham helped cure my patello-femoral pain syndrome.

More recently, Paul looked into hiccup cures because his father had an intractable case. What finally worked for dad? Breathing into a plastic bag.

Boosting blood CO2 (hypercapnia) by breathing in a PLASTIC bag. This one is quite plausible and is easy and safe to try. Hypercapnia definitely affects some kinds of hiccups. The story (from a smart source, a good “friend of PainSci”): “There’s an even easier way out of hiccups — at zero cost. Learned it from my uncle, who studied medicine in Brazil in the 50s. Anesthetized patients with hiccups were a pain, so they needed to get rid of it ASAP. Method: breathing in a PLASTIC bag, small enough for you to get to hypercapnia (get higher blood levels of CO2). You have to hold the bag REALLY tight around nose and mouth to prevent air from escaping, and if you have troubles with dizziness, it’s advisable to sit down for it. As soon as it gets uncomfortable, mostly after 4-6 breaths, you can stop, the hiccup will be gone. I don’t know what this does to the phrenic nerve, but it works 100%.”

Safety Note: Obviously there could be some danger with this method. If he’d had low O2 or was struggling for breath, we likely wouldn’t have dared. (On the other hand, if he’d been in that state, he would’ve been at the hospital.) But he was supervised, with no possibility of getting stuck, and a matter of only just a few breaths. Perhaps there was still some risk… but I think not treating those hiccups was also a risk.

I’ve never tried that method for my hiccups. My personal favorite home remedy is “drinking from the far side of the glass.” AKA, drinking water upside down. Watch this video of a good ol’ boy demonstrating the technique although I would aim for drinking at least 6-8 fl oz of water before quitting. Don’t ask me how it works; it may have something to do with the soft palate or diaphragm.

Steve Parker, M.D.

Leanne Morgan: The Problem With the Paleo Diet

I just spent an hour laughing at Leanne Morgan videos at YouTube. Her humor is not for young people, but instead for women over 40 who have children. I love her accent.

Steve Parker, M.D.

Did Grok Have Eating Utensils? No!

“Me Grok”

DailyMail has an interesting article that promotes eating with your hands instead of forks, knives, and spoons.

Those who are sticklers for etiquette should look away now.

That’s because we’ve all been dining the wrong way and should be eating with our hands, according to a psychologist.

Professor Charles Spence, from the University of Oxford, said giving up cutlery is the secret to enjoying food.

He says eating with our hands can ‘heighten the dining experience’ – even for meals like pasta and messy curries.

The professor also claims that hand-feeding improves food flavor and texture while having myriad health benefits.

Steve Parker, M.D.

h/t Splendid Isolation

Alcohol: Sometimes Less is More

Jameson’s in a hotel bar near Chicago

A few months ago I ran across a thoughtful article by Morris van de Camp titled Love Drinking Less. It’s well worth a read if your alcohol consumption is out of control or heading that way.

Alcohol is a two-edged sword. On the one hand it makes life fun and turns strangers into intimate friends in the course of an evening; on the other, it makes a person dysfunctional. Very dysfunctional. Productive time is lost, relationships are damaged, and health is harmed.

I cannot say that I’ve “struggled” with alcohol in the truest sense. I’ve never been arrested for drunk driving, and I’ve had no serious relationship trouble from drinking. All of my drinking has been in an appropriate time and place — but one drink inevitably would lead to another. I’d wind up accidently drunk when I really wanted a light buzz. I also found that when the time came up when I’d be free to drink, I looked a bit too much forward to it.

If you’re a tippler, this is the time of year to consider a “Dry January.” You may learn something about yourself. Be kind to your liver — you only have one.

Steve Parker, M.D.

PS: It’s also time to decide on your weight loss program for the new year.

Nearsightedness Isn’t as Benign as You Think

Steve Parker MD, paleobetic diet,
Should have spent more time outdoors

Myopia, aka nearsightedness, is extremely common and can start in childhood or young adults. I myself have had to wear glasses since ~age 9, when I was astonished to see individual blades of grass and leaves on trees. Myopia over time it can lead to early-onset cataract, retinal detachment, and glaucoma. MedPageToday has an eye-opening article on treatments that can prevent myopia progression and complications. For example:

Common evidence-based treatments that offer both statistically significant and clinically meaningful efficacies include daytime multifocal soft contact lenses (MFSCL), overnight orthokeratology (ortho-k), and topical low dose atropine (LDA). Novel spectacle lenses also showed a promising myopia-inhibiting effect, albeit with limited availability in U.S. at the current moment. On average, these options slow myopia progression by 30-70%compared to conventional single vision glasses or contacts. With properly selected early interventions, not only the development of myopia stabilizes at younger ages, the endpoint of the progression is also much lower, resulting in significantly lower risk of complications. Furthermore, with lower level of myopia at stabilization, many myopic patients could be good candidates for refractive surgery with given corneal thickness.

I get the impression from the article than treatments need to be started in childhood.

Steve Parker, M.D.

Black Tea Consumption Reduces Risk of Death by 10%

according to an article at Annals of Internal Medicine. The study was done in a U.K. population over decade of observation. The 10% or more reduction in all-cause mortality was seen at a habitual consumption level of two or more cups of black tea daily. Most prior similar studies I’ve seen focus on green tea.

Photo by Lisa Fotios on Pexels.com

Steve Parker, M.D.

Time-Restricted Eating: Better to Restrict Earlier or Later in the Feeding Window?

Chinese researchers reviewed the literature on time-restricted eating and metabolic effects on humans. I’m not paying $31.50 USD for the full text article, but here’s the abstract:

Time-restricted feeding (TRF), a feasible form of intermittent fasting, has been proven to benefit metabolic health in animal models and humans. TRF restricts the daily feeding window to 3 to 12 h for eating ad libitum, with fasting for the rest of the day. To our knowledge, specific guidance on the appropriate time period for eating during TRF has not yet been promoted. Therefore, the aim of the present review was to summarize the current literature on the effects of TRF with different eating windows in humans and compare their effects on metabolic health–related markers. Early TRF (which restricts food intake during the early period of the day) and delayed TRF (which restricts food intake during the later period of the day) studies have shown that both TRF regimens improve metabolic health in terms of reducing energy intake, decreasing body weight, improving insulin sensitivity, reducing blood pressure, and reducing oxidative stress. Differences between the consequences of early and delayed TRF were found, including differences in changes in blood lipid factors. These preliminary findings may help to provide guidance for choosing suitable eating windows during TRF. Future studies with rigorous designs and direct comparisons between the effects of TRF regimens with different eating windows on metabolic health markers are still needed.


Steve Parker, M.D.