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372 points Eumenes | 14 comments | | HN request time: 2.223s | source | bottom
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tomhoward ◴[] No.42201055[source]
I'm not commenting specifically on the heart-muscle aspect of the study, but it shouldn't be a surprise that the weight loss from this drug is significantly attributable to muscle loss; it almost always is when dieting. It's the same with keto/low-carb or any other kind of caloric-restrictive dieting (which Ozempic facilitates).

The modern weight-loss programs I'm seeing now (at least those aimed mostly at middle-aged men) emphasize consuming significant amounts of protein (2g for every 1kg of body weight each day) and engaging in regular resistance training, in order to maintain muscle mass.

The article addresses this:

To keep muscle strong while losing weight, Prado says it is essential to focus on two main things: nutrition and exercise. Proper nutrition means getting enough high-quality protein, essential vitamins and minerals, and other “muscle-building” nutrients. Sometimes, this can include protein supplements to make sure the body has what it needs.

Perhaps there needs to be more formal research into this, and a strong recommendation made to everyone using these drugs that this kind of diet and exercise plan is vital.

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1. Sheeny96 ◴[] No.42202761[source]
Whilst it is 95% calories in calories out, keto (not low carb, as low carb doesn't include high fat) can be good for muscle retention whilst in a defecit - as more foods that you consume naturally have higher protein (I utilise keto when looking to drop body fat, consuming a lot of slightly higher fat cuts of meat as a replacement for the carb calories, so chicken thighs instead of breast, 10% ground beef,etc). The higher fat content correlates to higher testosterone count, and higher protein means greater muscle retention.
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2. greentxt ◴[] No.42203873[source]
Carbs are harder to control for many people, and less forgiving. A side effect of keto is decreased appetite. A side effect of carbs is overeating.
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3. hombre_fatal ◴[] No.42204616{3}[source]
Only when "carbs" is a euphemism for junk food. Which probably exists because Americans don't eat carbs like beans and broccoli. And instead of eating them, they get told online that they should avoid all carbs.

It's a devious euphemism that screws the people over the most that should be eating more beans and broccoli (et al).

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4. s1artibartfast ◴[] No.42205238{4}[source]
Carbs is also colloquialism for calorie dense grains and cereals. Broccoli is like 5% carbs by mass. Bread is 50% carbs by mass. It is a hell of a lot easier to overconsume the latter, spike your insulin, and get into a cycle of cravings.

There is no boogie man trying to scare people away from broccoli.

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5. Wytwwww ◴[] No.42206040{4}[source]
> broccoli

Have almost no carbs or any calories, they are basically just water. Like you'd need to eat 1kg just to get 300 calories (less than in e.g. 100g chickpeas).

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6. consteval ◴[] No.42206429{5}[source]
> There is no boogie man trying to scare people away from broccoli

I disagree, everyone I know who has been on a keto dietic consumes little to no fruits or fiber. Honestly, I'm not sure how they use the bathroom successfully with such little fiber ingestion.

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7. bityard ◴[] No.42206764{6}[source]
I ate only keto for years and I'm getting back to it now so I have some experience to speak of.

You are correct, fruit is mostly sugar so no fruits. Some keto adherents allow the occasional handful of berries, but I found that just made me unreasonably hungry later on. Not everyone has this reaction, though.

There is plenty of fiber in above-ground vegetables. And even if there wasn't, it's not like eating only meat would kill you, humans evolved on the plains and/or jungles of Africa where meat was almost all that was easily available.

8. s1artibartfast ◴[] No.42206808{6}[source]
If you are talking very specifically about a ketogenic diet, then fruits actually do have too many carbs to maintain ketosis. In that case, it isn't some irrational fear, but reality.

Re fiber, A significant portion of the population (maybe a majority) doesn't need much fiber to use the bathroom. It seems like this need is a common situation that people assume is a universal truth. Further, fiber can lead to constipation for many people.

9. cthalupa ◴[] No.42207567{6}[source]
Fruits, yes, because it will kick you out of ketosis. Fiber, every keto adherent I knew would eat fiber in reasonably large quantities because keto often causes constipation, and a lot of the substitutes for things with "regular" carbs were high in fiber.
10. Kirby64 ◴[] No.42208224{3}[source]
Adherence may be a concern for lots of types of carbs, but that doesn't change the conclusion that keto (i.e., very little to no carbs) is worse for muscle retention when keeping caloric content equal. Also, as others have pointed out, not all carbs lead to overeating necessarily. Likewise, not all keto diets are going to lead to decreased appetite.
11. hombre_fatal ◴[] No.42209984{5}[source]
They are 75% carbs. Don't miss the point in your focus on one thing that I said. Replace it with sweet potatoes, carrots, and any other health promoting vegetable that Americans don't eat (and when they do, without slathering in sugar/fat).
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12. s1artibartfast ◴[] No.42211165{6}[source]
How are you getting 75%? I see 10g of garbs in 150g of broccoli. That is closer to 7%.
13. Sohcahtoa82 ◴[] No.42216005{6}[source]
> They are 75% carbs.

75% of the calories in broccoli is from carbs, sure, but because the overall calorie content of broccoli is so low, it's still considered low carb.

https://www.nutritionix.com/food/broccoli/1-cup

A 1-cup, 156-gram serving is 55 calories, 11g carbs, and 5g fiber, so is only 6g of net carbs for keto purposes.

14. xenonite ◴[] No.42240852{6}[source]
Well the answer to that is to eat more fat.