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One thing everyone should know about cardiovascular disease

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Goodarz Danaei, Bernard Lown Professor of Cardiovascular Health at Harvard T.H. Chan School of Public Health, discusses one thing everyone should know about cardiovascular disease—that we can easily prevent fatal heart attacks and strokes by reducing how much salt we eat.

There is a direct and linear association between the amount of salt we eat and our blood pressure—and high blood pressure, or hypertension, is the most important risk factor for cardiovascular disease globally. Fortunately, it is also the easiest to treat.

In 2019, I worked with other international scientists to calculate how many lives could be saved around the world if we reduced our average sodium intake by 30 percent. That’s an achievable, and not even particularly ambitious, goal. But it would have a profound impact on public health. In fact, we found that in 25 years, 40 million deaths could be delayed by implementing that intervention alone. That’s almost three deaths every minute.

Goodarz Danaei / Photo: Kent Dayton

Several policies could help us get there, including the reformulation of packaged foods and the introduction of labels that inform consumers of the sodium content of certain foods. The UK, for example, launched a successful salt reduction initiative in 2001 that within a few years managed to reduce the average salt intake by almost one gram per day through awareness campaigns and by encouraging food manufacturers to reduce their products’ salt content.

Researchers are also studying whether replacing some of the sodium chloride in our salt with salt substitutes would help reduce blood pressure. We don’t know yet if this effort would be successful or if people would add more salt to their food to compensate for a less-salty taste.

There’s no doubt, however, that we should eat less salt. Americans eat on average about 8.6 grams of salt per day, which is more than twice the recommended intake by the American Heart Association.

We have become so accustomed to salt that we feel the need to add it to the food we cook at home or order at a restaurant. The truth is that there is no reason to add salt. Natural foods already contain enough sodium themselves and their flavor can be enhanced by adding other ingredients like herbs, spices, garlic, and citrus.

It’s especially important that the food our children eat, including school lunches, contains low levels of salt. Habits are hard to change later in life, so intervening early on children’s diets and palates can have huge long-term consequences for public health.

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Bernard Lown Professor of Cardiovascular Health

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February 23, 2025
What Are the Environmental Impacts of Plant-Based Meats?

Environmental assessments of 50 different plant-based meats show them to be vastly more sustainable than animal-based meats.

“There is increasing consensus that transitioning towards reduced meat consumption and more plant-based diets is a key feature to address important health and sustainability challenges” that humanity is facing, yet the graph below and at 0:25 in my video The Environmental Impacts of Plant-Based Meat Substitutes shows that the trajectory of global meat consumption has increased.

According to the Food and Agriculture Organization of the United Nations, “we will have to double the production of meat and dairy to meet the predicted demand for animal proteins in 2050.” However, we would have to do the exact opposite to contain the ecological damage and “environmental impact of livestock.”

“Nearly every credible forecast shows that if we’re to have any chance of meeting future food in a sustainable fashion, lowering our meat consumption will be absolutely essential.”

More centralized governments may be effective in influencing consumption patterns. For example, the “Chinese government has outlined a plan to reduce its citizens’ meat consumption by 50%,” but since the main drivers of global meat consumption are factors such as rising incomes, urbanization, and Western culture, the “main identified drivers of meat demand are difficult to influence through direct policy intervention.” Thus, we must take our case directly to the consumer. However, information and education may not be enough. We may need the “increased availability of ready-made plant-based products.”

Too often, alone, “ethics and sustainability does not stand much of a chance in a world of consumers…Many consumers seem deaf to ethical arguments…[that] are quickly forgotten when one is buying food.” When it comes to “consumers’ perceived barriers to following a plant-based diet,” the largest barrier may simply be “meat appreciation,” enjoying the taste of meat. So, in practice, if we want people to shift to plant-based options, “the taste, structure and nutritional value of vegetarian meals could be developed to more closely follow the preferences of meat eaters.” Why design a veggie burger primarily for vegetarians? They’re already not eating meat. When Patrick Brown founded Impossible Foods, “his goal was to create something a burger lover would say is better than any burger they’ve ever had.’” Also in the marketplace is “the Beyond Burger, created by Beyond Meat, a company founded to tackle climate change by creating vegan products free from meat and animal by-products” that are “Juicy, Meaty and Delicious.”

But are they better for the climate? If so, how much better? Reputable groups have published environmental lifecycle assessments covering the Impossible Burger and the Beyond Burger, and I did a short piece for the Swiss investment firm UBS summarizing the results, as you can see below and at 2:48 in my video.

Indeed, switching to either plant-based meat option, the Impossible Burger and the Beyond Burger reduce greenhouse gas emissions, land use, and water footprints by about 90 percent, compared to beef.

Similar lifecycle analyses have been performed on more than 50 different plant-based meats. All such studies found them to be vastly more sustainable than meat and processed meat products, with no real differences in greenhouse gas (GHG) emissions observed between the different sources of protein used in the plant-based meats, whether wheat, soy, or another. Though, obviously, any products containing eggs would be significantly worse with “significantly higher amounts of GHG.”

Now, of course, if we went straight to the unprocessed peas and soybeans from which the Beyond and Impossible Burgers are made, we wouldn’t get just a 90 percent lower environmental impact, but around a 99 percent lower impact. That impact drops to zero, however, if no one is willing to eat it.

A review of consumer research on meat alternatives found that although considerations like “health, environmental and animal welfare aspects can persuade consumers and influence their decision to try a meat substitute, the appearance, and taste of those meat substitutes are crucial factors for their consumption on a regular basis.”

Interestingly, these days, plant-based foods may actually have a leg up. Researchers gave omnivorous college students both animal- and plant-based chocolate milk, macaroni and cheese, chicken tenders, and meatballs, but told them they were actually all made from plants. The researchers “surprisingly and unexpectedly found that when subjects tasted the food and rated how much they liked the taste, those who were told the food was vegan liked the food signiﬁcantly better than did those who were told the food was of animal origin. Thus, thinking a food was vegan actually increased liking for the taste of that food.”

Other demographics may have a different reaction, though, in which case there is always “sustainability-by-stealth,” using blended products that substitute some of the animal protein for plant protein. Recently, such “hybrid products (meat analogs in which part of the meat is replaced by plant-based ingredients) have made a promising entrance,” so much so that Perdue and Tyson, two major meat producers, are bragging about the incorporation of plant protein into their blended products, as you can see here and at 4:41 in my video.

This is from the first of nine videos in a series on plant-based meats, which includes the titles in the related posts below.

For background on food and climate change, see Diet and Climate Change: Cooking Up a Storm.

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February 21, 2025
Navigating behaviour change with confidence
What if the key to lasting behaviour change isn’t just what you teach your clients—but how you connect and communicate with them? In this episode of The Dietitian Connection Podcast, we sit down with Stephanie Notaras, a dietitian and expert in counselling and communication, to explore how clear and confident communication can help overcome barriers to change.

Hosted by Brooke Delfino

Biography

Stephanie Notaras is an APD, a PhD Candidate, the host of the Nutrition Counselling Corner podcast, a published author and the owner of the Dietitian Counselling Skills practice helping dietitians improve their counselling skills for better client retention, outcomes and revenue in their practice. She has a master’s in counselling and has developed and published a counselling framework for dietetic practice. Stephanie was awarded Dietitian of the Year 2024 at the Australian Allied Health Awards.
In this episode, we discuss:

Why communication is just as crucial as nutrition knowledge

The difference between coaching and counselling in dietetic practice

How to use the Stages of Change Model to guide client progress

Strategies to compassionately challenge clients and move them toward action

How strong counselling skills improve client retention and outcomes
Additional resources

Click here to listen to the Nutrition Counselling Corner podcast (on Apple Podcasts and Spotify)

Click here to join the Dietitians: Counselling Skills Community Facebook Group

Connect with Stephanie Notaras at stephanienotaras.com or in Instagram @dietitiancounsellingskills

Click here for Dietitians Unite 2025 tickets in Melbourne on 30 May

The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.
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February 20, 2025
Why Is Sorghum One of My New Favorite Grains?

Learn why sorghum is one of my favorite new grains.

“Despite playing a significant role in Africa and Asia as a staple grain, sorghum has only recently emerged as a potential human food source in the developed world.” And it isn’t just a principal grain in many parts of the world, but it’s “critical in folk medicine” traditions, too. What might its health benefits be? There are some in vitro data from test tubes and petri dishes, as well as in vivo data, meaning “within the living” in laboratory animals, but only in the last decade have we started seeing human trials.

In one study, participants were asked to eat sorghum pancakes or corn pancakes for supper every day for three weeks. Both groups saw significant, 20 to 30 percent drops in their cholesterol, but all participants were also “requested not to consume eggs and other cholesterol-boosting foodstuff,” so that may very well have played a role.

Another study used biscuits. Those eating sorghum biscuits said they felt more satiated than when they ate wheat biscuits, but that “did not translate to differences in intake at the subsequent ad-libitum [all-you-can-eat] meal.” So, does it matter that they subjectively felt more satiated if that did not cause them to eat any less? Unsurprisingly, when put to the test, those eating sorghum versus wheat biscuits didn’t lose any weight, though the data are a bit mixed. A recent study concluded that “sorghum can be an important strategy for weight loss in humans.” However, those in the sorghum group didn’t actually lose more weight. They did eat hundreds more calories a day, though, and they still lost more body fat, as you can see below and at 1:41 in my video The Health Benefits of Sorghum.

This may be because of their greater fiber consumption or intake of other goodies, like the resistant starch in sorghum. The vehicle the researchers used was an artificially flavored, colored, and sweetened powdered drink mixture of water, milk powder, and either sorghum or wheat flour. That may be good for a study since you can make a blinded control, but it leaves you wondering what would happen if you actually ate the whole food.

The resistant starch is exciting, though. Most of the starch in sorghum is either slow-starch—that is, slowly digestible—or fully resistant to digestion in the small intestine, which offers a banquet bounty of prebiotics for our good gut flora down in our colon. Evidently, it isn’t the sorghum starch itself, but interactions with the proteins and other compounds that effectively act as starch blockers, inhibiting our starch-munching enzymes. Sorghum ends up with “the lowest starch digestibility” among grains, which is why, traditionally, it was considered to be an “inferior” grain—but inferior in the sense of not providing as many calories. (That’s a good thing in the age of epidemic obesity.)

When study participants were given either a whole-wheat muffin (the control) or a sorghum muffin, with both containing the same amount of starch, researchers saw significantly higher blood sugars 45 minutes to two hours after subjects ate the wheat muffin, as shown below and at 2:58 in my video.

They also saw a higher insulin spike, starting almost immediately after consuming the wheat muffin, as seen below, and at 3:03.

Overall, after consumption of the sorghum muffin, researchers found a 25 percent lower blood sugar response, and the participants’ bodies had to release less than half the insulin to deal with it, as seen here and at 3:11 in my video.

The same type of results were found with people with diabetes. Researchers saw a lower blood sugar spike with sorghum porridge compared to grits, and the participants’ bodies could deal with it with a fraction of the insulin.

So, we need to educate people on how healthy sorghum is—and, some suggest, “develop products that are…healthy, convenient to use, and tasty.” No need! Sorghum is already healthy, convenient, and tasty just the way it is. I just press a single button on my electric pressure cooker with two parts water and one part sorghum, and it’s ready in 20 minutes. You can make a big batch and use it all week just like you would rice.

Of course, there isn’t big money for the food industry when people eat the intact, whole grain. Instead, the industry is looking at sorghum for its “enormous potential for exploitation” in creating “functional foods and food additives.” (Did you know that adding sorghum to pork or turkey patties can decrease their “cardboardy ﬂavor”? Why eat sorghum when you can instead use it to make gluten-free beer?)

It’s funny. When I wrote in How Not to Diet about taxpayer subsidies going to the sugar, corn syrup, oil, and livestock industries to subsidize cheap animal feed to help make Dollar Menu meat, I jokingly asked, “When was the last time you sat down to some sorghum?” Now that we know how good it is for us, maybe we should be taking advantage of the quarter billion dollars the United States is spending to prop up the sorghum industry and sit down to some sorghum after all.

If you missed the previous video, check out Is Sorghum a Healthy Grain?

My How Not to Diet Cookbook is full of delicious and healthful grain recipes. Check it out here.

“Resistant starch”? Learn more about Resistant Starch and Colon Cancer and Getting Starch to Take the Path of Most Resistance.

For more on the benefits of different grains, see related posts below.

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February 18, 2025
Gut-loving goodness e-book | Dietitian Connection

What’s included:
✓ 10+ simple gut-loving recipe ideas your clients will enjoy

The patient resources are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The patient resources are for your information only, and we advise that you exercise your own judgment before deciding to use the information provided. Professional medical advice should be obtained before taking action. Please see here for terms and conditions.

Please note that all of our resources must be used in full and are unable to be personalised or customised.

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February 15, 2025
Is Sorghum a Healthy Grain?

How does sorghum compare with other grains in terms of protein, antioxidants, and micronutrients? And the benefits of red sorghum compared to black and white varieties?

Sorghum is “the Forgotten Grain.” The United States is the top producer of sorghum, “but it is typically not used to produce food for American consumers.” Instead, it’s used mainly “to produce livestock feed, pet foods, household building materials…but it is a preferred grain for human diets in other parts of the world, such as Africa and Asia.” There, it’s been a staple and eaten for thousands of years, making it currently the fifth most popular grain grown after wheat, corn, rice, and barley, beating out oats and rye.

Because sorghum is gluten-free and “can be deﬁnitively considered safe for consumption by people with celiac disease,” we’re starting to see it “increasingly used” as actual human food in the United States, so I decided to look into just how healthy it might be. As you can see below and at 0:59 in my video Is Sorghum a Healthy Grain?, it is comparable to other grains when it comes to protein.

Since when do we have to worry about getting enough protein, though? Fiber is what Americans are desperately deficient in, and sorghum does pull towards the front of the pack, as seen here and at 1:06 in my video.

The micronutrient composition is relatively “unremarkable, relative to other cereal grains.” As shown below and at 1:15 in my video, you can see how it rates on minerals, for example.

Where sorghum shines is its polyphenol content. Polyphenols are plant compounds and “their regular consumption has been associated with a reduced risk of a number of chronic diseases, including cancer, cardiovascular disease (CVD), and neurodegenerative disorders.” It’s also been shown to have “a protective effect…on all-cause mortality.” If you compare different grains, sorghum really does pull ahead, helping to explain why its antioxidant power is so much higher, as seen here and at 1:40 in my video.

Now, sorghum gets its grainy butt kicked by fruits and vegetables, but when compared to other grains, a sorghum-based breakfast cereal, for example, might have about eight times the antioxidants than a whole wheat-based one. What we care about, though, isn’t antioxidant activity in a test tube, but antioxidant activity within our body.

If you measure the antioxidant capacity of your blood after eating regular pasta, it goes up a little. If you replace 30 percent of the wheat flour with sorghum flour, it doesn’t go up much higher. But, if you eat 30 percent red sorghum flour pasta, the antioxidant capacity in your bloodstream shoots up about 15-fold, as seen below and at 2:22 in my video.

Red sorghum? Yes. In fact, there are multiple types of sorghum—such as black sorghum, white sorghum, and red sorghum. Below and at 2:31 in my video is how they look in grain form (including yellow sorghum).

Red sorghum and especially black sorghum have extremely high antioxidant activity, comparable to fruits and vegetables, as seen here and at 2:41.

The problem is I can’t find any of the colored sorghum varieties. I can go online and buy red or black rice, purple, blue, or red popping corn, and purple or black barley, but red or black sorghum can be harder to find. White sorghum is widely available for about four dollars a pound, though. Does it have any “unique nutritional and health-promoting attributes”? It’s promoted as “An Underutilized Cereal Whole Grain with the Potential to Assist in the Prevention of Chronic Disease,” according to a study title, but what is the “effect of sorghum consumption on health outcomes”?

As you can see below and at 3:20 in my video, an epidemiological study in China found lower esophageal cancer mortality rates in areas where more millet and sorghum were eaten, compared to corn and wheat, but that may have been due more to avoiding fungal contamination of corn than from any benefit of sorghum itself. Though, it’s possible. “Oats are the only source of avenanthramides,” which give oats some unique health benefits. Similarly, sorghum, even white sorghum, contains unique pigments known as 3-deoxyanthocyanins, which are strong inducers of some of the detoxifying enzymes in our liver and can inhibit the growth of human cancer cells growing in a petri dish, compared to red cabbage, for instance, which just has regular anthocyanin pigments. White sorghum didn’t do much worse than red or black varieties, which have way more of the unique 3-deoxyanthocyanins, so it may just be a general sorghum effect. You don’t know until you put it to the test.

Researchers found that sorghum suppresses tumor growth and metastasis in human breast cancer xenografts. What does that mean? They concluded that sorghum could be used as “an inexpensive natural cancer therapy, without any side effects. We strongly recommend the use of [sorghum] as an edible therapeutic agent as it possesses tumor suppression, migration inhibition, and anti-metastatic effects on breast cancer” for humans. However, xenograft means human breast cancer implanted in a mouse. Yes, the human tumors grew more slowly in the mice-fed sorghum extracts and blocked metastasis to the lung. Yes, sorghum did the same for human colon cancer that, again, was in mice, but that can’t necessarily be translated to how human cancers would grow in humans, since not only do these mice not have a human immune system, they hardly have any immune system at all. They’re bred without a thymus gland, which is where cancer-fighting immunity largely originates. I mean, how else could you keep the mouse’s immune system from rejecting the human tissue outright? But this immunosuppression makes these kinds of mouse models that much more artificial—and that much more difficult to extrapolate to humans.

And that’s a lot of what we see in the sorghum literature—in vitro data from test tubes and petri dishes, and data from rats and mice. There has been “a critical missing piece of the puzzle” needed to link laboratory data to actual beneﬁts in humans. Missing, that is, until now. Thankfully, we now have human interventional studies, which we’ll explore next.

Stay tuned for The Health Benefits of Sorghum.

Should we all be seeking gluten-free grains? See related posts below.

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February 14, 2025
What does a gut-friendly diet look like?
Struggling to keep up with the fast-moving science of gut health – and make it digestible for your clients? This Gut Health Month, we’re joined by leading gut health dietitian, Nicole Dynan, to break down the latest research on gut-friendly diets. Nicole shares evidence-based recommendations and practical strategies to help dietitians translate gut health science into actionable advice.

Hosted by Brooke Delfino

Biography

Nicole Dynan is the founder of The Gut Health Dietitian (est. 2013) and one of Australia’s leading gut health experts. After a decade in corporate chronic disease management, Nicole saw first-hand how gut health impacts energy, stress, mood, and overall well-being. Since then, and together with her team, she’s helped over 35,000 people improve their gut health, feel more comfortable, and regain control of their overall health through science-backed nutrition.
In this episode, we discuss:

Why dietary diversity is essential for gut health

The latest research on fibre, dairy and fermented foods

Ways to simplify the role of prebiotics, probiotics and supplements for clients

How to translate complex gut health science into practical advice
Additional resources

Gut Health Month 2025 is supported by Activia Probiotic Yoghurt, Farmers Union, Life-Space Probiotics, Nerva, The Probiotics Institute, Swisse Nutra+, Coeliac Australia, Crohn’s & Colitis Australia and The Gut Foundation

Click here to download ‘Your Complete Guide to Gut Health Month 2025’ to learn how you can get involved.

Click here for free gut health resources to use in your practice.

Watch our free half-day Gut Health Symposium here.

Connect with Nicole Dynan at guthealthdietitian.com or in Instagram @the.guthealthdietitian

Click here for Dietitians Unite 2025 tickets in Melbourne on 30 May

Additional reading & research papers:

What defines a healthy microbiome – https://gut.bmj.com/content/73/11/1893

Fibre and cancer – https://www.nature.com/articles/s42255-024-01191-9

Legumes and life expectancy – https://www.nature.com/articles/s43016-023-00868-w

Dairy and inflammation – https://www.tandfonline.com/doi/full/10.1080/10408398.2014.967385

Prebiotics, probiotics and fermented foods – https://isappscience.org/

Fermented foods and gut health – https://www.mdpi.com/2072-6643/14/7/1527

The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.
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February 13, 2025
Uses and Side Effects of Ozempic and Other GLP-1 Weight Loss Drugs

Ozempic and others in a new class of weight-loss drugs have been called “the medical sensation of the decade.” Are they worthy of all the hype?

For a deep dive, please see my primer on this topic. OZEMPIC: Risks, Benefits, and Natural Alternatives to GLP-1 Weight-Loss Drugs is available as an ebook, audiobook, and paperback. You can also view my video series for free on the Ozempic topic page or our YouTube channel. Here are some of the key takeaways.

What Is GLP-1?

A naturally occurring hormone in our body, glucagon-like peptide-1 (GLP-1) plays a role in regulating our blood sugar, appetite, and digestion. Our gastrointestinal tract releases more than 20 different peptide hormones, including GLP-1. The primary stimuli for secreting GLP-1 are meals rich in fats and carbohydrates, and GLP-1’s main action is to signal satiety to the brain. It also slows our digestion. Delaying the rate at which food leaves our stomach not only helps us feel fuller for longer, but also helps with our blood sugar control. When GLP-1 or an agonist (mimic) is dripped into people’s veins, appetite is reduced, leading to markedly reduced food consumption—a decrease in caloric intake by as much as 25 to 50 percent.

About GLP-1 Drugs

Our GLP-1 hormone acts as an appetite suppressant by targeting parts of the brain responsible for hunger and cravings. GLP-1-secreting cells don’t only line our intestines; they’re also in our brains. These new anti-obesity drugs are GLP-1 agonists, mimicking the hormone’s action by binding to GLP-1 receptors.

Our body breaks down GLP-1 so quickly that it hardly makes it even one time around our circulatory system, which is why we can’t just take the hormone directly. A compound was discovered—in the venomous saliva of a lizard called the Gila monster—that mimics GLP-1 but is resistant to breakdown. Using that compound as a template, the first GLP-1 agonist was created and approved for the treatment of diabetes about 20 years ago. Instead of most of it being cleared from the body within two and a half minutes, like native, natural GLP-1, much of the drug remains in the body for two and a half hours. That still means twice-daily injections, though, so then came liraglutide, which lasts all day.

What Is Ozempic?

Eventually, semaglutide was developed and branded as Ozempic, which could be injected just once a week. Ozempic was approved in 2017 to treat diabetes. Within a few years, a daily oral version had been developed, again for diabetes, but researchers running those clinical trials noticed a surprising side effect: People’s appetites diminished.

How Does Ozempic Work?

In a way, GLP-1 agonist drugs work like birth control pills. The Pill mimics placental hormones, thereby tricking our body into thinking we’re pregnant all the time. Ozempic-type drugs mimic GLP-1, thereby tricking our body into thinking we’re eating all the time. That’s how it dials down our hunger drive.

Ozempic for Weight Loss

In the longest trial to date, more than 17,000 individuals were randomized to injections of either high-dose semaglutide or placebo for four years. Overall, those on the drug lost 9 percent more body weight than those in the placebo group, but all the weight was lost in the first 65 weeks. Even though they continued to get injected every week for three more years, they didn’t lose any more weight over the subsequent 143 weeks.

Weight loss tends to plateau because the same amount of effort to cut calories—whether through willpower, drugs, or surgery—is met with growing resistance as ongoing weight loss increasingly activates our feedback control circuit, stimulating our appetite. In the case of the GLP-1 drugs, the weight loss caused by the initial drop in appetite is undercut by an apparent exponential increase in caloric intake as our body ratchets up our hunger again. Within 12 months, this resistance, combined with the decreased caloric needs from being lighter, matches the persistent effort to cut calories, and weight loss plateaus. And, as soon as we stop taking the drugs, our full appetite resumes and we start regaining the weight we initially lost.

The Cost of Ozempic

Wegovy, the high-dose Ozempic used for weight loss, costs up to $1,350 a month, which, again, may have to be paid in perpetuity since any lost weight can pile back on if you stop taking it. So, that could cost more than $16,000 a year if paid out-of-pocket for those whose insurance doesn’t cover it.

Ozempic Side Effects

The most common side effects include nausea, vomiting, diarrhea, and constipation. Gallbladder issues are another side effect; excess cholesterol shed from fat cells can crystalize in our bile like rock candy, forming gallstones.

Rare but serious adverse effects are also emerging. The package inserts for both semaglutide and tirzepatide list a series of “warnings and precautions” that include thyroid tumors, acute inflammation of the pancreas (pancreatitis), acute gallbladder disease, acute kidney injury (that may stem from dehydration due to excess vomiting or diarrhea), allergic reactions, a heightened risk of bottoming out blood sugars while on blood sugar–lowering medications, worsening eye disease for those with type 2 diabetes, an increase in heart rate requiring monitoring, and suicidal thoughts and behaviors.

What Is “Ozempic Face”?

“Ozempic face” is a term used to describe a distorted facial appearance among users of the drug. (Similar accounts have been made of “Ozempic butt.”) Media reports have linked the drug with facial aging, but the sagging appearance has been ascribed simply to the accelerated loss of fat in the face. While this interpretation seems logical, a review of the phenomenon concluded that “this explanation cannot fully account for the markedly accelerated facial aging….” Other factors suspected as being responsible for the appearance of premature facial aging include the loss of facial muscle mass, diminished structural integrity of the skin, and changes in stem cell function and hormonal secretion.

Is Ozempic Safe?

In the first quantitative benefit-versus-harm balance analysis, the researchers concluded that those achieving a 10 percent weight loss had a more than 90 percent chance that the benefits of taking the drugs outweigh the harms, but the opposite was found for individuals achieving only a 5 percent weight loss.

At this time, we don’t know about the long-term harms or benefits because some of these drugs and dosing schedules are so new. To complicate matters, the American Academy of Pediatrics has suggested offering these drugs for teens and even tweens as young as age 12. These drugs work by acting on the brain, so who knows what effect they might have on childhood development and beyond if young people end up taking them for the rest of their lives. Although we now have evidence of near-term benefit over a few years, we cannot assume long-term safety until it has been demonstrated.

Ozempic Alternatives

We don’t need to take GLP-1-mimicking drugs. Not only can the ingestion of a plant-based meal more than double GLP-1 secretion, compared to a meat meal, but plant-based diets can also cause weight loss by boosting our resting metabolic rate and incorporating “calorie-trapping” high-ﬁber foods that flush calories away. The largest study of people eating strictly plant-based found they are about 35 pounds lighter on average.

When we eat a donut, its fat, sugar, and starch get absorbed quickly, high up, before reaching the part of our digestive tract where we produce most of the hormone that suppresses our appetite, GLP-1. Since the cells that produce GLP-1 in response to calorie exposure are concentrated at the end of our digestive tract, while the majority of the calories we consume are absorbed early on, most calories never make it down far enough. That’s why our appetites aren’t suppressed very much these days. From a GLP-1 standpoint, when we have that donut, it’s like we never ate much of anything. No wonder we reach for donut number two.

Our prehistoric ancestors are believed to have consumed as much as 100 daily grams of fiber, which is more than six times what most of us are getting these days. We evolved eating massive amounts of whole plant foods—the only places fiber is found in abundance. That enabled out natural satiety mechanisms to keep us from overeating. By eating the way nature intended, we can release GLP-1 the way nature intended. That helps explains why in the medical literature, compared to any other way of eating that didn’t involve portion control, a whole food, plant-based diet has been shown to lead to greater average weight loss than any other diet.

For more in-depth information on Ozempic and GLP-1, check out these resources:

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February 11, 2025
‘A dietitian saved my life’
In this special episode for Feeding Tube Awareness Week, we’re joined by Alison Black, a world-renowned TV producer whose life took a drastic turn after a cancer diagnosis. Alison shares her powerful story of how tube feeding became part of her treatment and the profound impact her dietitian, Nina Bonner, had on her recovery. Feeding Tube Awareness Week is an important opportunity to raise awareness and support those living with feeding tubes. You’ll hear firsthand insights into the emotional and psychological aspects of tube feeding, and learn how dietitians can foster trust and support in these challenging times.

Hosted by Bec Sparrowhawk

Biography

Alison Black is a Logie-winning television producer behind two groundbreaking Australian documentary series, Choir of Hard Knocks and Changing Minds (ABC). Originally trained as a journalist, she worked in the UK before moving to Australia nearly 20 years ago. Now, she helps companies, charities and individuals refine their branding and messaging, alongside ghostwriting and filming life stories for those with life-limiting illnesses. In 2011, Alison was diagnosed with head and neck cancer. Now cured, she leads a dynamic life running her own business and volunteering at her local hospice.
In this episode, we discuss:

Alison’s journey from TV producer to cancer survivor

Navigating the emotional challenges of tube feeding

The pivotal role of dietitians in cancer treatment and recovery

Trust-building with healthcare providers

Three key tips for dietitians working with tube-fed patients
Additional resources

This episode discusses sensitive topics related to body image and disordered eating. If these topics are triggering, please listen with care and we encourage you to seek support from a healthcare professional. For support, visit Butterfly Foundation.

Click here to learn more about Feeding Tube Awareness Week

Click here for Dietitians Unite 2025 tickets in Melbourne on 30 May

The content, products and/or services referred to in this podcast are intended for Health Care Professionals only and are not, and are not intended to be, medical advice, which should be tailored to your individual circumstances. The content is for your information only, and we advise that you exercise your own judgement before deciding to use the information provided. Professional medical advice should be obtained before taking action. The reference to particular products and/or services in this episode does not constitute any form of endorsement. Please see  here  for terms and conditions.
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February 8, 2025
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Maz has been to more showbiz parties than The Clooneys in Oscar season, and down more red carpets than a Dyson vacuum. Her contacts contain bigger names than the toilet queue at the Oscars, and if you can stick a name plate on it and hand it over to loud applause, she's won it – BAFTAs, Logies, ASTRAS, Royal Television Society Awards, UK Comedy Awards, and a Bronze Rose De Montreux. If you'

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