Recharge Podcast

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So, you might be thinking, ‘What’s the big deal? I know plenty of guys who struggle with erections.’ Well, let me tell you, it’s a HUGE deal. We’re talking about a serious issue that can significantly impact your quality of life, your lifespan, and even your risk of premature death.

ED is often an early warning sign of CVD. They share many risk factors, including obesity, smoking, hypertension, and diabetes. ED can precede CVD by 2-5 years, often appearing before any noticeable heart problems.

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Let's talk protein and satiety – the feeling of fullness that keeps you from raiding the fridge every hour. We all know protein is a champion for building muscle and burning fat, but did you know the way you consume it can significantly impact your hunger levels? Buckle up, because we're about to explore the science behind why solid protein reigns supreme for keeping your appetite in check.

Physiological Factors: The Gut-Brain Connection

First, we gotta talk about the intricate dance between your digestive system and your brain. Solid protein foods take center stage here.

1. Chewing & Eating Time: Chewing that juicy steak isn't just about breaking down food. It's a sensory experience that sends signals to your hypothalamus (the brain's control center) saying, "Hey, I'm eating!" This extended "chew time" allows your body to register the intake and adjust hunger hormones accordingly. A protein shake, on the other hand, is gone in seconds, leaving your hypothalamus confused and your stomach potentially rumbling for more.
2. Gastric Emptying: Solid food takes its sweet time traveling through your digestive system compared to liquids. This prolonged presence in your stomach triggers the release of a special messenger called cholecystokinin (CCK). CCK acts like a fullness alarm to your brain, letting you know it's time to chill on the snacks.
3. Hormonal Response: The act of chewing and having solid food in your gut also stimulates the release of peptide YY (PYY), another satiety hormone. This hormonal symphony orchestrated by solid protein keeps you feeling satisfied for longer.

Psychological Factors: Beyond the Physical

It's not just your gut that's involved. Protein-rich whole foods offer some psychological advantages too.

1. Visual Cues: Ever feel full just by looking at a delicious plate of food? That's not your imagination. Visual cues about portion size play a role in satiety. A protein shake, on the other hand, doesn't offer the same visual feedback.
2. Cognitive Satisfaction: The act of sitting down and enjoying a meal can be more psychologically satisfying than quickly downing a shake. This can impact your perceived sense of fullness and influence how long you stay satiated.

The Power of Fiber and Volume

Let's not forget the supporting cast. Many protein-rich whole foods (think meat, fish, legumes) come packed with fiber. Fiber adds bulk and volume to your meals, further enhancing satiety. This combination punches a one-two combo on your hunger, keeping you fuller for longer.

The Bottom Line: Prioritize Whole Foods

Protein shakes can be a convenient way to boost your protein intake, but relying solely on them might not be the best strategy for long-term satiety. For optimal hunger management, focus on incorporating a variety of solid protein sources into your meals. Remember, your body thrives on diversity, and your gut-brain connection will thank you for prioritizing whole foods.

However, as with everything in science, individual responses can vary. Some people might find liquid protein sources do the trick. But for most, a diet rich in whole-food protein sources will be a more effective hunger-hacking strategy.

So, the next time you're looking to conquer your cravings, ditch the shake and grab a solid protein-packed meal. Your brain, your gut, and your waistline will thank you for it.

AI used for intro and image only.

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There are several strategies that can help prevent or manage muscle mass loss associated with GLP-1 agonist treatment:

## Resistance Training

Incorporating resistance or strength training exercises is one of the most effective ways to preserve and build muscle mass during weight loss[1][2]. This counteracts the catabolic effects of caloric deficit by stimulating muscle protein synthesis.

## Adequate Protein Intake

Ensuring sufficient dietary protein intake, ideally 1.6-2.2 g/kg of ideal body weight per day, can help minimize muscle loss[2]. Protein provides amino acids needed for muscle maintenance and repair.

## Combining with Myostatin Inhibitors

Myostatin is a key negative regulator of muscle growth. Blocking myostatin with investigational drugs like apitegromab (SRK-439) from Scholar Rock may enhance muscle growth and prevent muscle loss when combined with GLP-1 agonists[1]. Early clinical trials are underway to test this approach.

## Using Activin Receptor Inhibitors 

Activin receptor inhibitors like those being developed by companies like Regeneron can block activin signaling and potentially increase muscle mass when used alongside GLP-1 medications[3].

## mTOR Activators

The mTOR pathway regulates muscle protein synthesis. Drugs that activate mTOR, such as the PPAR agonist enobosarm being tested by Veru, may preserve muscle when combined with GLP-1 treatment[5].

## Adequate Vitamin D and Calcium

Ensuring sufficient vitamin D and calcium intake is important for preserving bone mineral density, which can be impacted by the weight loss and muscle loss induced by GLP-1 agonists[2].

The key is utilizing a multi-modal approach combining GLP-1 agonists with resistance exercise, optimal nutrition, and emerging muscle-preserving medications to maximize fat loss while minimizing the loss of metabolically active lean muscle mass[1][2][3].

Citations:

[1] https://pharmanewsintel.com/features/addressing-muscle-loss-associated-with-glp-1-medication-use

[2] https://www.medscape.com/viewarticle/994030

[3] https://www.tctmd.com/news/dont-worry-about-muscle-loss-glp-1-inhibitors-viewpoint-asserts

[4] https://www.uclahealth.org/news/article/rapid-weight-loss-can-lead-loss-muscle-mass

[5] https://www.drugdiscoverytrends.com/glp-1-impact-lean-mass/

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Mindset Monday - Just because you can, doesn't mean you should.

https://mitchelmd.thinkific.com/

Let's talk about hustle culture gone mad.

You, the entrepreneur, the maverick, the one who built a damn empire from scratch. You can wrangle investors, write code that would make Einstein weep, and probably even fix your leaky faucet. But here's the thing, mate: just because you can doesn't mean you should spend your precious time wrangling screwdrivers and braving the fluorescent purgatory of Home Depot for a measly wall sconce.

Your time is your currency.

Delegate that sconce duty! Focus on the big picture, the revolution you're building, not the revolution of a light fixture. Let someone else play handyman while you conquer the day.

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Filling The Confidence Bank

Three takeaways from the opening of Dr. Zinsser's book on Confidence.

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The primary concern with using glucagon-like peptide-1 (GLP-1) agonist drugs for weight loss is the potential loss of muscle mass (lean body mass) along with fat mass. Clinical studies have indicated that a significant portion of the total weight loss achieved with GLP-1 agonists like semaglutide (Ozempic) and tirzepatide (Mounjaro) results from a reduction in lean body mass, which includes skeletal muscle.

In the STEP 1 and SUSTAIN 8 trials for semaglutide, about 39-40% of the total weight lost was due to a decrease in lean mass, primarily muscle. A 2021 meta-analysis of 18 randomized controlled trials also found significant reductions in fat-free mass (lean body mass) with the use of GLP-1 agonists.

The loss of muscle mass is concerning for several reasons:

1. **Metabolic Health**: Muscle is crucial for metabolism, insulin sensitivity, and glucose uptake. Significant muscle loss can negatively impact metabolic health and increase the risk of insulin resistance and type 2 diabetes.

2. **Physical Function**: Maintaining adequate muscle mass is essential for physical function, mobility, and independence, especially in older adults who are already at risk for age-related muscle loss (sarcopenia).

3. **Quality of Life**: Excessive muscle loss can lead to weakness, fatigue, and a decreased ability to perform daily activities, potentially impacting quality of life.

4. **Bone Health**: Muscle mass is closely linked to bone health and strength. Significant muscle loss can increase the risk of osteoporosis and fractures.

While some degree of lean mass loss is expected during weight loss, the extent of muscle loss observed with GLP-1 agonists is concerning, particularly for individuals with low muscle mass or those at risk for sarcopenia.

To address this issue, researchers and pharmaceutical companies are exploring strategies to preserve muscle mass while using GLP-1 agonists for weight loss, such as combining them with muscle-preserving agents or targeting specific pathways like myostatin inhibition. Additionally, incorporating resistance training and ensuring adequate protein intake are recommended to help mitigate muscle loss during GLP-1 agonist treatment.

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Shifting From Need

Mindset is critical

Access the course library; Mitchel Schwindt, M.D.

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