Latest news with #AmericanCollegeofLifestyleMedicine
Medscape
08-07-2025
- Health
- Medscape
New Advisory Offers First Consensus in Prescribing GLP-1s
Anywhere from 6% to 12% of the US population has taken a GLP-1 agonist. But until now there hasn't been a cohesive message among physicians for how to care for this growing patient population. Last month the American College of Lifestyle Medicine, the American Society for Nutrition, the Obesity Medicine Association, and The Obesity Society released a joint advisory that included a list of nutritional and lifestyle priorities to help physicians guide patients on their weight-loss journey. Published in late May in the journal Obesity, the priorities included a baseline nutritional assessment, an understanding of patient goals, management of the most common medication side effects, reduced dependence on ultra-processed foods, prevention of nutrient deficiencies, strength training to prevent muscle loss, and other lifestyle factors that might influence weight loss. 'GLP-1s are reshaping the landscape of obesity treatment, but it's clear that medication alone is not a complete solution,' John E. Courtney, PhD, CEO of the American Society for Nutrition, said in a statement. While the medications can powerfully reduce hunger in patients who take them, they work best in conjunction with lifestyle changes, the most important of which is proper nutrition. An Emphasis on Diet Primary care physicians need to work with patients to better understand their diet before prescribing these medications, said lead study author and Advisory Chair Dariush Mozaffarian, MD, PhD, director of the Food is Medicine Institute of Tufts University, Boston. 'These medications are approved as an adjunct to nutrition and lifestyle therapy and right now they're being used as a first line in most cases,' said Mozaffarian. Asking a simple set of questions about what patients eat in a day, whether they snack, and whether they eat out at restaurants can provide physicians with a good idea of a patient's diet pitfalls. Dariush Mozaffarian, MD, PhD Other barriers to healthy eating can include cost but also knowledge of how to prepare healthy meals, proper cooking equipment, culture, and food traditions around healthy eating. Additionally, some patients might not live near grocery stores. A study published last year in the journal Obesity Pillars found that physicians and dietitians can help patients maximize long-term weight loss results by providing them with personalized guidance. For example, apps that can help patients track nutrition and daily caloric intake as well as personalized advice that can help highlight their dietary sticking points. Additionally, about half of all patients have significant gastrointestinal issues on these medications and eating a healthy, well-balanced diet can help them to stave off some of the most common side effects, including constipation, nausea, and vomiting, said Mozaffarian. This includes tricks of the trade like drinking ample water, eating small meals, getting enough fiber, and avoiding fatty foods. Ramping up dosages of the medications more slowly can also help patients to avoid these symptoms. Reducing Dependence on Ultra-Processed Foods 'Many patients not only eat less but their preferences for foods change and one of the most common themes is that they no longer crave ultra-processed foods that are very sweet or contain artificial ingredients,' said Mozaffarian. These are the foods that can be high in fat and contain chemicals that make people want to keep eating them. There's also research to show that ultra-processed foods are increasing some of the comorbidities that go along with weight gain like diabetes and nonalcoholic fatty liver disease. Some of the chemicals in these foods might also be driving effects on the gut microbiome and intestinal health, said Carolynn Francavilla, MD, a nationally recognized obesity physician who owns and operates Green Mountain Partners for Health and Colorado Weight Care, both in Denver. Staving Off Nutrient Deficiencies What's more, some research has shown that many patients aren't getting ample nutrition because their appetite is so suppressed. One study released in April in Frontiers in Nutrition found that patients on GLP-1s were not getting sufficient amounts of fiber, calcium, iron, magnesium, potassium, and choline as well as vitamins A, C, D, and E. Carolynn Francavilla, MD Focusing on minimally processed foods can help patients to avoid deficiencies that come with the medications. When a patient's diet is drastically reduced, it can make it difficult to get enough protein as well as essential micronutrients. Carefully planning meals to fit in enough protein as well as fruits, vegetables, and whole grains is a great way to ensure that patients avoid deficiencies. However, some processed foods, for example, meal replacement shakes and bars might help patients get enough nutrients when they don't have the appetite they once did. 'These should be an exception because for some patients they can help fill in the gaps,' said Francavilla. Other Lifestyle Factors That Help Optimize Weight Loss Patents not only lose fat on GLP-1s but also lose bone and muscle if they don't participate in strength training at least twice weekly. And as mentioned above, protein, calcium, and vitamin D are also very important for reducing the bone and muscle loss that can lead to frailty later in life. The advisory also names other lifestyle factors like sleep, mental stress, substance use, and social connections as important priorities that can help patients maximize long-term success on these medications. 'GLP-1s help more than all the prior generations of obesity drugs, but that doesn't obviate the need for good physical activity and managing all the other stressors in one's life,' said Ziyad Al-Aly, MD, an assistant professor in the Division of General Medicine & Geriatrics at Washington University School of Medicine in St. Louis. Ziyad Al-Aly, MD Sleep is especially important and can often be overlooked. A wide breadth of research shows that sleep deprivation plays a role in weight loss. A study published in the April 2022 issue of the journal Nutrients found that individuals who slept for 5.5 hours per night lost less fat than those who slept for 8.5 hours per night. Al-Aly noted that one of the lesser known side effects of these medications is that they can cause sleep disturbance. This means that sleep hygiene, for example, going to bed at the same time nightly, avoiding screen time before bed, and avoiding caffeine later in the day are particularly important for those taking these medications. Substance use can also be problematic because while some research has shown that these medications impact the brain reward center, thereby reducing addictive behavior like alcohol abuse, patients who still drink too much are at a much greater risk for dangerous nutrient deficiencies. Physicians need to ensure that their patients are aware of these risks. This advisory is tremendously helpful for physicians in providing a unified message, said Al-Aly. 'This is exactly what prescribers and doctors in patient communities really need, not only to help patients reach dramatic weight loss but to take into account their long-term risk factors and health.'
News18
01-07-2025
- Health
- News18
How to Manage Type 2 Diabetes Without Medication: What Experts Recommend
Last Updated: With consistency, many people can manage and even reverse type 2 diabetes naturally Reversing or managing type 2 diabetes without medication may sound ambitious—but for many, it's entirely achievable through committed lifestyle changes. With the right mix of diet, exercise, stress management, and support, individuals can not only bring their blood sugar under control but even reach remission. 1. Rethink your plate Nutrition plays a central role in natural diabetes management. Focus on a low glycemic index (GI) diet—foods that release sugar slowly into the bloodstream. This includes vegetables, whole grains, legumes, nuts, lean proteins, and healthy fats. Reducing refined carbs and processed sugar is key. Dr. Anoop Misra, a leading Indian endocrinologist, highlights the importance of cultural relevance in diet. 'In Indians, swapping white rice and refined carbs for millets, whole grains and legumes significantly improves insulin sensitivity and glycaemic control." Plant-based diets, now strongly endorsed by the American College of Lifestyle Medicine, have shown promising results in improving metabolic health and reducing insulin resistance. 2. Move more, sit less Aim for at least 150 minutes of moderate aerobic activity per week—like brisk walking, cycling, or swimming—along with strength training two to three times weekly. Even a short walk after meals can make a noticeable difference in controlling post-meal blood sugar spikes. 3. Watch your weight Even a modest weight loss of 5–10% can significantly improve blood sugar levels. Focus on portion control, avoid crash diets, and make long-term, sustainable changes. 4. Don't overlook sleep, stress and hydration Stress triggers cortisol, a hormone that can spike blood sugar levels. Yoga, meditation, or deep breathing exercises can help. Poor sleep also worsens insulin resistance, so aim for 7–9 hours of quality rest. And staying hydrated helps your body regulate glucose more effectively. 5. Monitor and stay supported Track your blood sugar regularly and maintain open communication with your healthcare provider. Joining diabetes support groups or involving family members can also improve motivation and adherence. With consistency, many people can manage and even reverse type 2 diabetes naturally. But always consult your doctor before making major changes to your health routine.
Yahoo
13-06-2025
- Health
- Yahoo
Prediabetes interventions at forefront of treatment: What to know
The conversation around prediabetes has entered a new day for Americans. Earlier this week, the American College of Lifestyle Medicine published the first clinical practice guideline to prioritize lifestyle interventions in treating Type 2 diabetes and prediabetes. The guideline offers a comprehensive roadmap for clinicians to effectively incorporate therapeutic lifestyle behavior interventions as a mainstay of treatment, while also complementing existing guidelines for diabetes, many of which mention lifestyle as part of care but often do not provide specifics. So, what is prediabetes? What are the symptoms? What could be the short-term and long-term complications of having prediabetes? Prediabetes is a warning of Type 2 diabetes. It develops when a person's blood sugar levels are elevated but not enough to be fully diagnosed. Type 2 diabetes. According to the American Diabetes Association, people who are 45 years old with prediabetes have a 10-year risk of developing Type 2 diabetes ranging from 9-14 percent. Researchers estimate that 84 million adults in the U.S. have prediabetes. More than 80 percent of people with prediabetes don't know they have it. Most people with prediabetes don't have any symptoms, but darkened skin, skin tags, and changes in the eyes could be indicators of a person being prediabetic. The main cause of prediabetes results from a person being insulin resistant. Insulin resistance happens when cells in your muscles, fat and liver don't respond regularly to insulin. Insulin is a hormone your pancreas makes that regulates blood sugar levels. Genetics, excess body fat, visceral fat, physical inactivity and persistently eating highly processed, high-carbohydrate foods and saturated fats can all contribute to a person becoming insulin resistant. Becoming prediabetic can be problematic for a person, with the main complication of it developing into Type 2 diabetes. Other issues can arise, such as heart attacks, strokes, eye problems, kidney issues and nerve damage. Reversing prediabetes can be done, but it's typically not possible to reverse diabetes complications. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
The Hill
13-06-2025
- Health
- The Hill
Prediabetes interventions at forefront of treatment: What to know
The conversation around prediabetes has entered a new day for Americans. Earlier this week, the American College of Lifestyle Medicine published the first clinical practice guideline to prioritize lifestyle interventions in treating Type 2 diabetes and prediabetes. The guideline offers a comprehensive roadmap for clinicians to effectively incorporate therapeutic lifestyle behavior interventions as a mainstay of treatment, while also complementing existing guidelines for diabetes, many of which mention lifestyle as part of care but often do not provide specifics. So, what is prediabetes? What are the symptoms? What could be the short-term and long-term complications of having prediabetes? Prediabetes is a warning of Type 2 diabetes. It develops when a person's blood sugar levels are elevated but not enough to be fully diagnosed. Type 2 diabetes. According to the American Diabetes Association, people who are 45 years old with prediabetes have a 10-year risk of developing Type 2 diabetes ranging from 9-14 percent. Researchers estimate that 84 million adults in the U.S. have prediabetes. More than 80 percent of people with prediabetes don't know they have it. Most people with prediabetes don't have any symptoms, but darkened skin, skin tags, and changes in the eyes could be indicators of a person being prediabetic. The main cause of prediabetes results from a person being insulin resistant. Insulin resistance happens when cells in your muscles, fat and liver don't respond regularly to insulin. Insulin is a hormone your pancreas makes that regulates blood sugar levels. Genetics, excess body fat, visceral fat, physical inactivity and persistently eating highly processed, high-carbohydrate foods and saturated fats can all contribute to a person becoming insulin resistant. Becoming prediabetic can be problematic for a person, with the main complication of it developing into Type 2 diabetes. Other issues can arise, such as heart attacks, strokes, eye problems, kidney issues and nerve damage. Reversing prediabetes can be done, but it's typically not possible to reverse diabetes complications.
Medscape
04-06-2025
- Health
- Medscape
Advisory: Nutrition Priorities for GLP-1 Use in Obesity
Four clinical organizations jointly released a clinical advisory with evidence-based nutrition and lifestyle interventions to enhance glucagon-like peptide 1 (GLP-1) treatment outcomes for obesity. METHODOLOGY: An expert group comprised of multiple clinical and research disciplines assessed the literature to identify pragmatic priorities for nutrition and other lifestyle interventions relevant to GLP-1 treatment for obesity. Based on the group's findings, The Obesity Society, American College of Lifestyle Medicine, American Society for Nutrition, and the Obesity Medicine Association simultaneously published 'Nutritional Priorities to Support GLP-1 Therapy for Obesity' in their own peer-reviewed journals. The consensus-based clinical advisory reflects an interdisciplinary collaboration to help clinicians support patients receiving GLP-1 treatment with evidence-based nutritional and behavioral strategies. TAKEAWAY: The expert group found that GLP-1s reduced body weight by 5%-18% in trials, with modestly lower effects in real-world analyses, and multiple clinical benefits. Challenges included side effects, especially gastrointestinal (GI); nutritional deficiencies due to calorie reduction; muscle and bone loss; low long-term adherence and subsequent weight regain; as well as high costs resulting in low cost-effectiveness. The group recommended eight priorities to address the challenges: (1) Patient-centered initiation of therapy; (2) careful baseline nutritional assessment; (3) management of GI side effects, (4) personalized, nutrient-dense, minimally processed diets; (5) prevention of micronutrient deficiencies; (6) adequate protein intake and strength training to preserve lean mass; (7) leveraging a good diet to maximize weight reduction; and (8) promoting other lifestyle changes around activity, sleep, mental stress, substance use, and social connections to maximize long-term success. IN PRACTICE: 'Medical therapy for obesity and lifestyle changes go and-in-hand,' Marc-Andre Cornier, MD, The Obesity Society president, said in an accompanying press release. 'This guidance lays a nutrition roadmap to help providers support their patients on sustainable and lasting weight reduction journeys. It underscores the importance of nutrition on quality of life and is an important contribution to the literature about incorporating lifestyle interventions into obesity care.' SOURCE: The clinical advisory, led by Advisory Chair Dariush Mozaffarian, MD, DrPH, of Tufts University, Boston, was published simultaneously in Obesity , American Journal of Lifestyle Medicine , The American Journal of Clinical Nutrition , and Obesity Pillars . LIMITATIONS: Recommendations are based on a literature review and a consensus among expert group members. DISCLOSURES: Mozaffarian reported research funding from the National Institutes of Health, Kaiser Permanente Fund at the East Bay Community Foundation, National Association of Chain Drug Stores Foundation, Google Health, and The Rockefeller Foundation; scientific advisory board, Beren Therapeutics, Brightseed, Calibrate, Elysium Health, Filtricine, HumanCo, Instacart Health, January Inc., WndrHLTH; scientific consulting, Amazon Health; equity in Calibrate and HumanCo; and chapter royalties from UpToDate.
