Ozempic-like drugs are the weight loss regimen du jour. Most doctors and patients are raving about it, with reason—losing weight has many health benefits. Let’s hope the sure-to-come backlash is not too severe. If you have lived long enough, you have seen weight loss fads come and go, leaving in their wake a significant number of morbidity and mortality. With Ozempic, we are already seeing cases of stomach dysmotility, which may lead to fatal aspiration pneumonia while asleep. Think of a drunk person vomiting while passed out. Lost in the middle of the discussion on metabolism, or managing of calories, is the role of the microbiome. See below.

Hugo Rodier, MD

Weight loss through intermittent fasting or calorie-restricted diet may improve gut microbiome diversity

“According to HealthDay (8/22/2003, Mozes), “initial results of a small, ongoing study suggests that weight loss through either intermittent fasting or a calorie-restricted diet can improve” gut microbiome diversity. Included in the study were “47 healthy adults ranging in age from 18 to 55” with either overweight or obesity. “After tracking calorie-control dieters and intermittent fasters for three months,” the study revealed that “both had significantly improved microbiome diversity.” The findings were published online in the journal Nutrients.”

Microbiome impacted by inflammatory conditions

“MedPage Today (8/8/2023, Bankhead) reports, “An alteration in gut microbiome diversity occurred in patients with three different inflammatory conditions, suggesting a common pathology,” researchers concluded in a study that conducted “prospective rRNA sequencing of patients’ stool samples.” The study revealed that “patients with axial spondyloarthritis…acute anterior uveitis,” and “Crohn’s disease had a low concentration of Lachnospiraceae compared with a control group of patients with back pain and no inflammatory disorders,” with “the most striking difference” being “a low abundance of Fusicatenibacter among nonsteroidal anti-inflammatory drug…users in the control group versus the patients with the inflammatory conditions.” The findings of the 277-patient study were published online in the journal Arthritis & Rheumatology.”

Comment: there have been many other studies proving that practically ALL inflammatory conditions begin in the gut. This is true of run-of-the-mill arthritis and severe diseases as Lupus and Ankylosing Spondylitis.

Kombucha improves blood glucose levels in people with T2D

“MedPage Today (8/1/2023, Monaco) reports, “Drinking kombucha helped improve blood glucose levels in people with type 2 diabetes” (T2D), investigators concluded in a “randomized, controlled pilot trial” involving 12 participants with T2D. After they drank “the fermented tea for a month, participants saw a significant reduction in average fasting blood glucose levels…not seen in those in the placebo group,” the study found. What’s more, “despite the significant reduction seen for kombucha drinkers, glucose levels weren’t significantly different between the two groups at the end of the four-week period,” according to findings published online in the journal Frontiers in Nutrition.”

Comment: kombucha is an excellent prebiotic; it feeds our microbiome, which then will metabolize better. Diabetes and obesity have been shown to be associated with the health of our gut bacteria. See below.

Lower Is Better for Blood Glucose to Reduce Heart Disease

Marlene Busko. Medscape Medical News, August 18, 2023

“Men and women with prediabetes, undiagnosed diabetes, and, notably, diagnosed diabetes were at higher risk of incident cardiovascular disease (CVD), whereas those with low-normal A1c were at lower risk of this in a large, 12-year observational study of UK Biobank data.

The results highlight “the need for strategies to reduce risk of CVD across the [glycemic] spectrum,” urge Christopher T. Rentsch, MPH, PhD, and colleagues in their study, which was published August 11 in the The Lancet Regional Health  Europe.”

Comment: sugar affects how the liver processes cholesterol. So, worrying about cholesterol while scarfing down a lot of sweets doesn’t make sense.

Glucosamine Supplementation and Incidence of Heart Failure

J. Mayo Clinic Procedures  VOLUME 98, ISSUE 8, P1118-1120, AUGUST 2023

“The National Health and Nutrition Examination Survey (NHANES), which included a sample of approximately 16,700 participants; 658 (4%) of them who consumed glucosamine/chondroitin for at least a year had a 27% lower overall mortality and a 58% lower cardiovascular mortality. Prospective data from the UK Biobank (sample of ∼470,000) also found a 15% lower rate of total cardiovascular events with regular use of glucosamine during a median follow-up of 7 years. The glucosamine group was 25% less likely to have HF after adjustment for age and sex.”

Comment: Why would a supplement long associated with joint health have salutary effects on the heart? Don’t read further without reflecting on the articles above!

If you concluded that Glucosamine sulfate and Chondroitin sulfate are helping our microbiome you are correct. Both work as prebiotics. Bonus: their sulfation is critical for the health of the microbiome, especially for people who do not consume eggs, garlic, cruciferous or onions.

Can This Common Herb Help Grow Hair?

Jay Croft. WebMD Health News, August 18, 2023

“If you’re looking to grow hair, you might just have a solution in your kitchen cabinet — if TikTok and some dermatologists are correct.

Rosemary oil is good at regrowing hair in people with androgenetic alopecia, which is a common form of hair loss. The herb might also protect hair from the sun, pollution, and other environmental elements, according to an article in Insider. A 2015 study published by NIH’s PubMed found that rosemary oil was similar to the effectiveness of minoxidil, also known as Rogaine, for regrowing hair in men with androgenetic alopecia. The scalp was also less itchy after three to six months of use. The study included only men.

Still, dermatologist Shilpi Khetarpal, MD, told the Cleveland Clinic that it seems to work. “The study really prompted people to look at rosemary oil for hair growth,” she said. “It became much more common in over-the-counter products after that, too.” The Cleveland Clinic also reports that rosemary oil might also help against dandruff and premature graying. Khetarpal suggests massaging rosemary oil into the scalp, letting it soak overnight, and then washing it out. Try to do these two or three times a week. She also notes that only a few drops of rosemary oil are needed, and that the focus should be on the scalp rather than the hair, which rosemary oil makes look greasy. It may take six months for “meaningful improvement,” Khetarpal said.”

Comment: minoxidil can have side effects. None with rosemary. Advantage Mother Nature.

Vitamin D: cancer incidence, and mortality risk

Healio Minute, July 03, 2023

“Higher levels of serum 25(OH)D and vitamin D were both strongly linked to reduced cancer incidence and mortality. However, serum 25(OH)D levels seem to be a better indicator for cancer-related mortality.”

Comment: one of the main roles of vitamin D is to optimize our immune-detox system, which is 2/3 in the microbiome.

B-Vitamin May Help Boost Antidepressant Efficacy

Batya Swift Yasgur, MA, LSW. Medscape Medical News, June 02, 2023

“The B vitamin, L-methylfolate (LMT) can be an effective adjunctive treatment for patients with major depressive disorder (MDD) with an inadequate response to antidepressants, new research suggests. Investigators analyzed six studies and found support for adjunctive use of LMF with patients with MDD not responding to antidepressant monotherapy. Treatment response was highest in those with obesity and inflammatory biomarkers.

“If clinicians try LMF on their patients with treatment-resistant depression, the treatment is very robust in patients who have high BMI or inflammatory biomarkers, and it’s worth a try even in patients who don’t have these indicators, since it’s safe and well-tolerated, with no downside,” study investigator Vladimir Maletic, MD, MS, clinical professor of psychiatry and behavioral science, University of South Carolina School of Medicine, Greenville, told Medscape Medical News. The study was published online May 9 in the J. of Clinical Psychiatry.”

Comment: we have known about this for decades. We need B vitamins to synthesize our own neurotransmitters from amino acids.