Tag Archive for: weight

Two Questions on Independence

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I spend a lot of time observing people; I can spot someone with a gait problem whether the cause is their lower back, a knee, or an overall core issue. I also watch people move who have weight problems, especially young people in their 20s, 30s, and 40s carrying extra weight. Degenerative diseases aside, what kind of life will they have in their 50s, 60s, and 70s? I’ve watched what that does to people as well. I know from experience what carrying an extra 30 pounds is like. What must 100 or more extra pounds be like?

I’ve discussed the how of weight loss many times: eat less, eat better, and move more. But it really comes down to making the decision: 

            How independent do you want to be?

It’s one thing to become dependent on others due to an accident or other issue; it’s another to voluntarily give up your independence without gaining as much control over your body as you’re able. Think about that as we celebrate Independence Day this week.

Independence Day

I try to keep the Memo free from all other issues other than health and the things that can impact health, but I’m going to make an exception this one time to answer this question:

            Can we rely on U.S. election results?

I’m an election worker in my county in Michigan. I’ve been doing that for about six years. I’ve read what people say about elections, and for the most part, they don’t know what they’re talking about. The system is set so that only registered voters with proper identification can vote (and we’re really good at enforcing that), and those votes are protected throughout the election process, even after they are counted and reported.

Here in Michigan, the Heritage Foundation analyzed 17 years of data, 26 elections in total, and in almost 65 million votes they found 19 cases of reported (not adjudicated) fraud, or 0.0000294%.

Here’s my challenge. If people question an election, they should become a part of the process. Become a poll worker, election worker, or election inspector in their county. Use that one day during primaries and during the national election in November to be a part of the process. Yes, there will be some training beforehand. Yes, it can be a long day or days. But if anyone wants to be sure the process is fair and free, they should be there in person and watch it firsthand. Regardless of anyone’s political persuasion, if they won’t do that, anything they say about the election process is meaningless. Feel free to forward this Memo to anyone who repeats the theories without participating in the process. Time to ante up if we want to keep our elections free and fair.

Enjoy the 250th celebration of our country’s Independence!

What are you prepared to do today?

        Dr. Chet

Does Your Weight Affect Disease?

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Researchers from Finland investigated the relationship between being overweight/obese and infectious diseases. Not any one specific disease—all 925 of the known microbes that cause infectious diseases. They used data from two Finnish studies and the UK Biobank Study. They obtained the height and weight to calculate BMI and examined hospital and death records from the electronic medical records of both countries.

They used data from 2018 through 2020, deemed before COVID, 2021 during COVID, and 2023 after COVID; they looked for hospitalizations and death due to infections. There were about 47,700 Finnish subjects and 479,500 UK subjects. The researchers used the standard definitions of normal, overweight, and the four classes of obesity: normal BMI less than 24.9 kg/m2, overweight as 25.0 – 29.9, grade I obesity as 30.0 – 34.9, grade II obesity as 35.0 – 39.9, and greater than 40.0 as grade III obesity.

Comparing grade III obesity with normal-weight subjects, they found the risk of infections and deaths was three times greater in the obese subjects. Combining all the data, the risk of infectious diseases contributing to hospitalizations and death increased in a stepwise manner. Simply put, as the level of obesity rose, so did the risk of infectious diseases. One more thing? The hazard ratio increased dramatically during the COVID epidemic and returned close to baseline after the pandemic ended.

The Bottom Line

This is just one study and because it’s an observational study, no cause and effect can be determined. But my feeling is that this should give pause to everyone who carries extra body fat. The very nature of being overweight or obese compromises the immune system; that means the person is at risk for an infectious disease from any one of 925 potential microbes and maybe more by now. This is the time to work toward getting to a normal weight for your height. Increase your healthspan: Eat less. Eat better. Move more.

What are you prepared to do today?

        Dr. Chet

Reference: Lancet 2026; 407:951–62

The Bottom Line on Full-Fat Dairy

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If you’re a long-time reader, you know that science by headlines really annoys me because they often distort the findings of the research papers to make them seem more important than they are—gotta get that next click! It doesn’t help that research institutions send out press releases that contribute to the hype of their research findings. Such is the case with the two papers I reviewed this week.

In the first paper, researchers claimed blood values of fatty acids found in high-fat dairy products potentially decreased the risk of developing type 2 diabetes in two large cohorts. Of the 3,333 subjects who were free of diabetes when the study began, 277 developed diabetes after 15 years of follow-up. That seems like a low number compared to the general population, although these were studies on healthcare professionals who might have a better lifestyle than the rest of the population.

The problem is that they tested the blood only for dairy fats at the beginning of the study. While they did administer the food-frequency questionnaire every four years, there’s no way of knowing how the dairy fats changed over the years. At best, this is a large study that shows some form of correlation between dairy intake and type 2 diabetes but tells us nothing to help us decide whether we should change the type of dairy we eat.

In the second paper, they also used a similar food-frequency questionnaire to identify what types of dairy products the subjects used. As I’ve said many times, these are fraught with potential errors. On top of that, the difference in body weight gain between those who used the most low- and no-fat dairy products and those who used the most high-fat dairy products was about a tenth of a pound. If you account for the initial BMI and body weight, the results are about two tenths of a pound. That’s not exactly exciting over 11 years, is it?

The Bottom Line

They didn’t state the obvious, but I will. It could be that full-fat dairy keeps women (and probably men) feeling satisfied longer so they don’t eat as much. That’s what fat can do. But we can’t really know because researchers didn’t measure diet carefully enough in either study to be able to analyze it. In these cases, they didn’t collect the right type of data that could really answer the questions; thus results were not very significant.

It always comes down to six words: Eat less. Eat better. Move more. If you choose to eat dairy, you can’t overeat any type because while it may take more of the low-fat foods to reach the number of calories in high-fat dairy, eating too much is just what it says: eat too much and you’ll gain weight.

What are you prepared to do today?

Reminder: Taking Back Your Muscle, Part 2: Protein is tomorrow at 1 p.m. Eastern Time. If you want clarity on creatine, amino acid, peptides, and protein and how to use them for your health, buy the webinar by 11 a.m. ET to watch live, or you can watch the replay at your convenience.

        Dr. Chet

References:
1. circ.ahajournals.org/content/early/2016/03/22/CIRCULATIONAHA.115.018410
2. Am J Clin Nutr 2016;103:979–88.

Does Whole Milk Reduce Obesity?

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The second research paper that was included in many news articles that talked about the potential benefits of full-fat dairy products was a study from the Women’s Health Study (1); researchers collected dietary data and self-reported weight and height from over 39,000 women. The analysis included only about 18,000 middle-aged and older women who had a normal BMI when the study began. They analyzed the change in body weight over 11 years of follow-up.

All women gained weight over time. Contrary to expectations, those who consumed the highest number of high-fat dairy products gained less weight than those who used low- or no-fat dairy products. Of the 18,000 women with normal BMI in the beginning of the study, just over 8,000 became overweight or obese over the duration of the study.

Is it time to switch back to whole milk and cheese? I’ll give you the bottom line on Saturday.

The next webinar, Taking Back Your Muscle, Part 2: Protein, is on Sunday at 1 p.m. ET. If you’ve ever had any questions about protein, amino acids, or creatine, this webinar is for you. I added one more topic that fits with protein and that’s the role of peptides, short chains of amino acids that are a hot topic today. Find out what they are, what do they do, and how much need by joining me Sunday at 1.p.m. Purchase your access to the webinar and/or replay today for $17.95; Insiders and Members get their usual discounts.

What are you prepared to do today?

        Dr. Chet

Reference: Am J Clin Nutr 2016;103:979–88.

It’s Going to Be a While

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In the last Memo, When Will We Get Something Better?, we looked at research on a new drug to counter obesity. But don’t hold your breath.

The researchers developed a sophisticated algorithm and used AI to find the process and the potential obesity-protein hormone to help combat obesity. What’s next? Several years or longer of clinical trials to test its effectiveness and safety in human beings. If it works, it will be another pharmaceutical solution to obesity and a step better than the GLP-1 agonists currently available. Two of the researchers hold the patent for the process and the protein itself, but there are no shortcuts on the science.

In my opinion, the problem is this: that’s not really the solution. They’re looking for a pharmaceutical solution. This protein, called BRG for short, will still have to be regulated like a pharmaceutical, made like a pharmaceutical, and prescribed as such even though it’s a natural hormone made in the body.

Where the research should focus is on a natural way to stimulate the body to upregulate (turn on) the gene or genes with diet, exercise, or some other natural means. Turning specific genes on and off is where we want to be, not creating companies and chemicals that will create a single molecule. It’s just the wrong approach to me. It may very well work, but it’s not natural in any way. I’m not suggesting that people with massive obesity won’t benefit from it, but it’s treating the symptoms of the problem, not the problem itself.

The problem is that because we overeat the wrong foods while not moving enough, genes have become upregulated and stay that way. We need solutions that help us get to downregulating those genes so that weight loss can become permanent.  Eat less. Eat better. Move more. For life.

What are you prepared to do today?

        Dr. Chet

References:
1. https://med.stanford.edu/news/all-news/2025/03/ozempic-rival.html
2. Nature (2025). https://doi.org/10.1038/s41586-025-08683-y

When Will We Get Something Better?

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The quest for a pharmacological solution to obesity continues—the magic pill to make us thin. While Ozempic and Wegovy, discovered and developed to treat type 2 diabetes, have been successful in helping reduce HbA1c, it has also helped people lose weight; the problem is the side effects. As you might guess, there are receptors for GLP-1 agonists in numerous locations in addition to the brain, and other organs are impacted.

That’s why a press release from Stanford seemed promising: “Naturally occurring molecule rivals Ozempic in weight loss, sidesteps side effects.” This research used a unique approach: they designed a specific algorithm that used artificial intelligence to identify the hormone segments made by an enzyme prohormone convertase 1/3 (PC1/3); basically, it cuts prohormones into smaller segments. Some may have metabolic activity, most would not.

Based on the analysis of 2,600 protein segments, the researchers identified 373 potentials and tested the top 100 most likely to succeed. They identified a hormone segment with 12 amino acids that appears to impact hunger 10 times better than the GLP-1 agonists, which are cleaved from the same prohormone. When they tested it in mice and minipigs by injecting it into the muscles of the animals before eating, it reduced food intake by 50%.

The volume of work done by the specific algorithm using AI probably saved years compared to testing each prohormone by trial and error, but what’s next? When will it be available? I’ll cover that on Saturday.

What are you prepared to do today?

        Dr. Chet

References:
1. https://med.stanford.edu/news/all-news/2025/03/ozempic-rival.html
2. Nature (2025). https://doi.org/10.1038/s41586-025-08683-y

HIIT: Specific Fat Loss

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What were the results of HIIT training? The researchers found that there were reductions in overall weight as well as subcutaneous and visceral fat. What’s the difference? The fat just under the skin is subcutaneous fat; visceral fat is behind the abdominal muscles and around the internal organs and is more related to the development of cardiovascular disease and type 2 diabetes. There were no differences in the outcome variables with two exceptions:

  • Those who were in the running group lost a greater percentage of subcutaneous fat than the cycling group at 16.1% vs. 8.3%. The other difference was that positive changes in the microbiome were correlated with the loss of subcutaneous fat. Before you get too excited, the actual loss of subcutaneous fat was close to two pounds in the running group and about one pound in the cycling group. Still, ask your butcher for one pound of fat and see what it looks like. It’s a lot and probably worth the effort doing the HIIT program.
  • The other benefit was an improvement in some positive bacteria in the microbiome. It wasn’t associated with running or cycling; it was correlated with the loss of subcutaneous fat. It seems that visceral fat would show more benefit, but that wasn’t the case. Maybe someday we’ll find out why.

The obvious problem with doing a running HIIT program is that you have to be able to run—at least for 45 seconds. While my running is progressing slowly, I do intervals only while walking or riding the exercise bike. But running for 45 seconds? I can handle that.

Finally, while I was puzzled about the microbiome benefits, I also questioned why there was a difference between cycling and running when it came to the loss of subcutaneous fat. The researchers didn’t have a reason to explain it. I’ll give you my informed opinion: running integrates more of the core during the actual interval than cycling does. My hunch could be tested with sensors that detect the electrical activity of muscles, but that’s fine tuning that might not be necessary. As a scientist, I always want to know why, but that’s not important; it’s just important that it is.

We’ve seen that 30 minutes of moderate walking can prevent the loss of muscle and a HIIT running program can help lose subcutaneous fat in those who are overweight. How about getting fitter faster? Is that possible? Find out next week when we look at SIT training—and sitting does have something to do with it!

What are you prepared to do today?

        Dr. Chet

Reference: Med Sci Sports Exerc 2024 May 1;56(5):839-850.



HIIT and Fat Loss

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One of the “facts” exercise professionals will tell you is that there is no such thing as spot reduction; by that I mean you cannot target a specific area of your body, let’s say your abdominal area, and lose fat by doing a targeted exercise such as sit-ups or leg lifts. You can make the muscles underneath the skin stronger for sure, but there doesn’t seem to be any evidence that you can reduce the amount of fat in that area.

With 35 years of experience in the field, I would say that requires a qualified answer—it needs to be qualified with the word yet. There hasn’t been a study that proves that you can reduce fat in a specific area yet. Is it theoretically possible? Yes, I think it is. The problem is this: who would do the high quantity of exercise focused on one area long enough per workout session to do themselves any good? It may be that we’ve approached it all wrong by focusing on resistance exercise. Let’s take a look at another study that compared high-intensity interval training (HIIT) on a cycle ergometer versus a treadmill.

Researchers began with two questions. Is there any difference in the fat mass in specific areas of the body after training using a cycle ergometer (an exercise bike that measures the energy output of the cyclist) or a treadmill? In addition to that, is there any change in beneficial microbes in the microbiome after training?

Let’s take a look at what they did. Researchers recruited 16 men with a mean age of 54 and initial BMI of 29.9. After assessing initial fitness level, body fat, and body-fat distribution using the DEXA scan, and taking an initial stool sample for analysis of the microbiome, the subjects were randomly assigned to the bike or the treadmill. To make sure that there were no significant changes in diet, the subjects were required to maintain their typical diet and do seven-day diet records periodically during the study.

Think of this as intervals for the everyday exerciser. The HIIT bike program required them to do ten intervals for 45 seconds each at 80–85% of the maximal heart rate (MHR), and then a 90-second active recovery, or a HIIT running program which were nine intervals for 45 seconds at 80–85% of MHR and again with 90 seconds of recovery between intervals. They were to do this exercise under supervision three times per week for 12 weeks. The goal was to have all exercisers use the same number of calories during the workouts, whether cycling or running. The subjects were then retested to examine the differences if there were any. What did they find? I’ll tell you on Saturday.

What are you prepared to do today?

        Dr. Chet

Med Sci Sports Exerc 2024 May 1;56(5):839-850.

Spot Reduction? Maybe

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Researchers collected data from four prior studies that put a group of sedentary overweight and obese men and women on a walking program. To determine the distribution of muscle, fat, and bone, they took MRIs of their entire body. That gave the researchers not only the amount of muscle and fat mass, but exactly where that muscle and fat were located.

Once researchers assessed the fitness level of these subjects, they developed an exercise prescription for them that had them exercise at 60% to 75% of their maximal aerobic capacity for 30 minutes a session, five days a week, for six months. Their heart rates were monitored throughout the exercise session to make sure that they did not exercise above those levels; that also allowed subjects to increase the speed or grade of the treadmill as they got fitter. The subjects used a food log to track all the food they ate.

Results

Did the subjects lose some weight? Yes. Even though they were trying to maintain what they ate, they were using more calories in exercise than they had been, so they did lose some weight—in this case, just a little over two pounds in the exercising group. The controls actually gained about half a pound in the six-month study.

Now to the good stuff. The results of the MRI showed that there were definitely regional differences in skeletal mass and fat mass. As was expected, the exercising muscles, primarily the hips, thighs, and legs, saw maintenance of the skeletal muscle mass but a decrease in the fat mass. In the upper part of the body, there was a slight decrease in muscle mass in the arms and upper torso with a very slight decrease in fat mass compared to controls.

The Bottom Line

So what does this all mean? First, because the mean age was around 55, maintaining muscle mass is critical—this is the time of life when age-related muscle loss starts to occur.

Second, if this were confirmed in several clinical trials, it would mean that there should be a focus on weight training or aerobic training that utilizes the entire body. Elliptical trainers and recumbent cross trainers come to mind as something that would use both the arms and the legs, so that may be part of the solution. And from personal experience, I can say that dance classes can have a similar effect.

In order to preserve muscle mass, exercising all your muscles is important; 60 to 75% of maximal fitness would be classified as moderate exercise. That means you don’t have to kill yourself in order to obtain the benefits of regular exercise to your cardiovascular system. Add to that some weight training a few days a week, and you have your own prescription for sustaining muscle mass and maybe losing just a little bit of fat mass along the way. But what if I told you that you could increase the loss of fat mass, especially in your abdominal region, by changing up the intensity of your workouts for a few weeks? Next week’s Memos will look at that research.

What are you prepared to do today?

        Dr. Chet

Reference: MSSE. 2024. 56(5):776-782.

Is Spot Reduction Possible?

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One of the questions that I’ve thought about over the years is what happens to the skeletal muscle and fat mass in non-exercising parts of the body. If you’re a runner or a walker, what happens to your upper body? What happens to your lower body? Do you retain or even increase the muscles in your thighs and calves? Do you lose fat from your legs? How about your upper body? Do you maintain the muscle mass that you had, or do you lose some? What about the fat mass? Lose or gain?

When I was a graduate student, I ran the body composition laboratory. Over my years in the lab, I underwater weighed probably 5,000 people, from five-year-olds to 90-year-olds, from those who were underweight to morbidly obese, from tiny little gymnasts to a Big 10 hockey team. While underwater weighing was the gold standard at the time, it used some assumptions about the distribution of skeletal muscle, bones, and fat mass that weren’t as precise as they should be. These days, state-of-the-art is dual X-ray absorptiometry, which is called DEXA for short. But that doesn’t give us a precise analysis of body composition to answer those questions either.

We now have that technology in magnetic resonance imaging. Using MRI can begin to give us the answer to those questions about muscle and fat mass. Can you get rid of that stubborn belly fat? We finally may have some answers, and I’ll tell you about the latest research on Saturday.

Don’t forget to send me your list of vegetables and fruits you ate over the weekend—and remember the ketchup!

What are you prepared to do today?

        Dr. Chet