Ready for an #obesity#research disruptor? @bcorkey 's studies on hyperinsulinemia and inflammation are a perennial favorite
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We often focus on slow or fast metabolism but there isn't enough talk on *energy efficiency*. See how much additional Δkcal is required (beyond that calculated) to effect 10% weight Δ: nejm.org/doi/full/10.10…
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"We ignore this important variable: involuntary control of energy metabolism" - @bcorkey
- "ROS burns extra fuel" - data not shown (not yet published)
- ROS ↑ insulin secretion
- ROS ↑ in response to excess fuel and causes a leak to ↓ energy efficiency
- drugs can cause false negative screens but not false positive screens
- you can probably just treat with mineralocorticoid antagonist instead of going through the diagnostic steps
- "Tirzepatide is a dual agonist"
👉It ↑GIP activity but GLP-1R agonism is less than that of endogenous GLP-1
- "Hypoglycemia is not a concern if you're not on insulin"
👉Risk of hypoglycemia ~1.4% vs. 0.2% in placebo in SURMOUNT-1
@alpanashuklamd et al examined the effect of macronutrient sequencing (carbs first vs carbs last) in ppl with diabetes, prediabetes, or gestational diabetes
Among those with prediabetes, we saw significant differences in glucose, insulin, ghrelin, and GLP-1 -- all favoring the "carbohydrates-last" food order
Always a pleasure to listen to @KevinH_PhD discuss his testing of hypotheses in contributors to #obesity 1/
Many people remember his 14-day study of ultra processed foods (UPF) vs unprocessed foods (n=20) that found energy intake was ~500 kcal/d LESS with unprocessed meals
Details you might not know:
- Groups were not matched for type of sugar
- No hint of a difference in insulin sensitivity between groups based on OGTT results
- Groups were not matched for beverage amount (and implication for speed of food intake)
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Tony Ferrante MD PhD of @ColumbiaMed providing an excellent systems based overview of the "metabolic" complications of #obesity and potential mechanisms: lipotoxicity, inflammation, adipokines
Some highlights:
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Neurology:
Check out this relationship where higher BMI is associated with ↑ risk of #dementia EXCEPT in age >70 when it's better to be in "overweight" category
👉Aiming for a "normal BMI" is not the best goal for everyone 2/
Unsurprising relationships between #CVD and #obesity 3/