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David Sinclair Profile picture
@davidasinclair
Jan 15, 2025 • 12 tweets • 4 min read • Read on X
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The largest and longest clinical trial comparing the effects of lifestyle changes vs. medicines on glucose control, inflammation, blood pressure & cholesterol over 24 weeks. The lifestyle changes won - hands down

Here's what they found...
tinyurl.com/yjev6dbtImage
The clinical trial was conducted in the Marshall Islands, which has the seventh-highest diabetes prevalence globally. There were 169 participants... Image
Image
The country’s high prevalence has been partially attributed to its increased reliance on imported foods, including white rice, refined four, sugar-sweetened beverages and canned meats... Image
A whole-food, plant-based lifestyle intervention plus moderate exercise (PB+Ex) was much more effective for improving glycaemic control than standard medicines. It also reduced the need for diabetes and cardiovascular medications... Image
Compared with medicines, the lifestyle change decreased HbA1c by an additional 14 mmol/mol (1.3%) at week 12 and 8 mmol/mol (0.7%) at week 24... Image
63% of those who changes their lifestyle and also took medicines reduced the dose or frequency of their glucose-lowering medications... Image
The diet+exercise group also had lower body weight, C-reactive protein and cardiovascular medication use compared with standard medical care.... Image
Here's the summary: Image
We all know a healthy diet + exercise is beneficial but this study clearly shows lifestyle changes can be even better than medicines in treating type 2 diabetes, and they improve cardiovascular health biomarkers as well 🥑🏃🏻‍♀️💪
The prescribed diet was high in fibre (35 g/4184 kJ), low in fat (20–25% of energy; saturated fat <7% of energy), moderate in protein (10–15% of energy) and low sodium...
During weeks 1–2, PB+Ex participants received 12 prepared meals/week and were instructed to consume no animal products & minimal ground grains & refined carbohydrates...
The PB+Ex group was instructed to do moderate intensity aerobic & resistance exercise 60 min/day during wks 1–2 and 30–60 min/day during wks 3–24 & counseled to walk 10–20 min before breakfast & after lunch and dinner (end)

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More from @davidasinclair

David Sinclair Profile picture
May 11
ED drugs like Cialis & Viagra, when taken as a low dose daily, can help maintain vascular function in brain and muscle, and are a promising, though still debated, approach for preventing & treating dementias. The human data for Cialis (tadalafil) is stronger …🧵 Image
Preclinical (🐁) evidence consistently supports the neuroprotective and cognitive-enhancing effects of PDE5-Is. Large-scale clinical datasets also suggest potential benefit
journals.sagepub.com/doi/10.3233/AD…
However, findings remain inconsistent, likely due to methodological limitations such as small sample sizes, insufficient treatment durations & heterogeneous patient populations Image
Read 6 tweets
David Sinclair Profile picture
Mar 21
For 25 years, my team has been told we were wrong, by scientists, big pharma, the media, ethicists, and trolls. It hasn’t been easy

Looking back, it was 100% worth it

Here’s why you should believe in yourself… 🧵
In my 20s and 30s, I didn’t realize that criticism is actually a positive sign. It’s easy to see in retrospect, but those days were incredibly tough for all of us in the Sinclair lab and a lesson for everyone who’s looking to change the world Image
Image
First big discovery:

DNA instability & epigenetic changes are a universal cause of aging (1996-1999). Critics immediately said we were wrong but we pushed on Image
Read 15 tweets
David Sinclair Profile picture
Mar 16
So great to see the OG work that helped spark the longevity revolution taken to the next level:

New paper confirms two main causes of aging:
1. DNA instability -> epigenetic noise
2. Mitochondrial decline
...independently causing failure of the cell

Is this relevant to us? 🧵 Image
Firstly, Dan Gottschling is a legend, having discovered yeast epigenetic gene silencing at the gender genes (a/alpha), telomeres, and painfully scooped me as a postdoc in 1996 by publishing epigenetic silencing at the ribosomal DNA (rDNA) 😆 ... Image
In my postdoc with Leonard Guarente in the 1990s, we predicted (below in my notebook) then confirmed something strange in aging yeast: tiny circles of "extrachomosomal" DNA accumulating inside old cells Image
Read 25 tweets
David Sinclair Profile picture
Mar 8
Osteoarthritis & back pain affects millions of people. Instead of managing symptoms, imagine rebuilding joints by making them young

New study shows the reprogramming gene combo OSK regrows joints in mice & effect depends on TET2 so it's epigenetic...🧵 Image
While limited to mouse models, these findings add to a growing body of evidence that rejuvenation by epigenetic reprogramming may safely reverse aging-related decline in multiple tissues, or whole body one day Image
These experiments used local AAV-OSK delivery directly into the knee joint. Treated animals showed improved cartilage structure and reduced subchondral bone thickening compared with controls Image
Read 16 tweets
David Sinclair Profile picture
Mar 1
According to ITOA, NAD declines with age, causing epigenetic changes & disease susceptibility

In 2010, we showed NAD-dependent enzyme, SIRT3, protects the heart 🐁

New study says NAD precursor NMN protects the heart via SIRT3 in mice fed a Western diet

Why's that important? 🧵 Image
In the United States alone, about 1 in 5 deaths is due to cardiovascular disease. That’s roughly 700K-900K deaths per year. Globally, cardiovascular disease causes nearly 20 million deaths annually
Metabolic dysfunction is a major driver. In the US, ~40 percent of adults are obese and nearly 1 in 3 adults has metabolic syndrome

Globally, more than 500 million people are living with diabetes
Read 15 tweets
David Sinclair Profile picture
Feb 22
Good news: Another study showing that fasting can help cancer patients. A 16 hour fast enhanced the cancer-killing activity of T cells and synergized with immunotherapy to reduce tumor size, ostensibly by causing cancer cells to release the amino isoleucine... 🧵 Image
In the tumor microenvironment (TME), there was increased isoleucine processing and intracellular acetyl-coA, along with increase expression of genes involved in the starvation response, autophagy
There were also alterations in glutamine metabolism, a known source of energy for cancer cells
Read 9 tweets

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