CardioNerds (Drs. Gurleen Kaur and Richard Ferraro) and episode FIT Lead Dr. Spencer Carter (Cardiology Fellow at UT Southwestern) discuss the clinical implementation of GLP-1 receptor agonists with Dr. Neha Pagidapati (Faculty at Duke University School of Medicine). In this episode of the CardioNerds Cardiovascular Prevention Series, we discuss the clinical implementation of glucagon-like peptide-1 (GLP-1) receptor agonists. We cover the clinical indications, metabolic and cardiovascular benefits, and potential limitations of these emerging and exciting therapies. Show notes were drafted by Dr. Spencer Carter. Audio editing was performed by CardioNerds Academy Intern, student Dr. Pacey Wetstein.
This episode was produced in collaboration with the American Society of Preventive Cardiology (ASPC) with independent medical education grant support from Novo Nordisk. See below for continuing medical education credit.
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Pearls and Quotes - Clinical Implementation of GLP-1 Receptor Agonists
GLP-1 agonists work through a variety of mechanisms to counteract metabolic disease. They increase insulin secretion, inhibit glucagon secretion, slow gastric motility, and increase satiety to limit excess energy intake.
Patients with type II diabetes and an elevated risk for atherosclerotic cardiovascular disease should be considered for GLP-1 agonist therapy regardless of hemoglobin A1c.
GLP-1 agonists offer significant ASCVD risk reduction even in the absence of diabetes. Newer data suggest a significant reduction in cardiovascular events with GLP-1 agonist therapy in patients who are overweight or obese and have a prior history of heart disease.
GLP-1 agonists should generally be avoided in patients with a history of medullary thyroid cancer or MEN2. As these medications slow gastric emptying, relative contraindications include history of recurrent pancreatitis and gastroparesis.
GLP-1 agonists should be initially prescribed at the lowest dose and slowly uptitrated to avoid gastrointestinal side effects.
Show notes - Clinical Implementation of GLP-1 Receptor Agonists
What were the groundbreaking findings of the STEP1 and SURMOUNT-1 trials and how these impact cardiovascular wellness?
The STEP1 and SURMOUNT trials demonstrated sustained clinically relevant reduction in body weight with semaglutide and tripeptide, respectively, in patients with overweight and obesity. As obesity is an important risk factor for the development of cardiovascular disease, weight reduction meaningfully contributes to cardiovascular wellness.
What were the findings of the LEADER trial and their implications for patients with type II diabetes and high cardiovascular risk?
The LEADER trial demonstrated a significant reduction in the rate of cardiovascular death, nonfatal MI, or nonfatal stroke in patients with type II diabetes treated with liraglutide. GLP-1 receptor agonist therapy should be considered in all patients with type II diabetes and elevated ASCVD risk regardless of A1c or current hyperglycemic therapy.
What are current indications for GLP1 agonists in the context of cardiometabolic disease.
GLP-1 receptor agonists should be considered in patients with type II diabetes and high ASCVD risk OR patients without diabetes who are overweight/obese and have a history of cardiovascular disease.
What are important side effects or contraindications to GLP1 agents when used for cardiovascular risk reduction and wellness?
GLP-1 receptor agonists should be avoided in patients with a history of medullary thyroid cancer or MEN2. Relative contraindications include recurrent pancreatitis, gastroparesis,
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Oprah Winfrey Keto Gummy Discover Her Favorite Weight Loss Secret
Are you tired of struggling to maintain a healthy lifestyle while also trying to lose weight? The ketogenic diet may be the answer you’ve been looking for. By reducing your carbohydrate intake and increasing your intake of healthy fats, you can put your body into a state of ketosis, where it burns fat for energy instead of carbs. However, sticking to a strict ketogenic diet can be challenging, especially when you’re on the go or craving something sweet. That’s where keto gummies come in.
What are Keto Gummies?
Keto gummies are a convenient and delicious way to support your ketogenic lifestyle. They are typically made with ingredients like gelatin, MCT oil, and natural flavors to provide a tasty treat that won’t kick you out of ketosis. These gummies can help curb your cravings for sugary snacks while also providing you with a dose of healthy fats to keep you feeling satisfied.
One of the main benefits of keto gummies is that they are portable and easy to take with you wherever you go. Whether you’re running errands, traveling, or working at the office, you can have a tasty and satisfying snack on hand to keep you on track with your keto goals. Plus, since they are pre-portioned, you don’t have to worry about overeating or guessing at portion sizes.
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Are Keto Gummies Right for You?
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Oprah Winfrey, the legendary media mogul, has been vocal about her weight loss journey throughout the years. She has tried various diets and exercise regimens in an effort to achieve her health goals. Recently, Oprah has been following a ketogenic diet, commonly known as Keto, which has sparked curiosity and interest among her fans and followers. Let’s take a closer look at Oprah’s experience with Keto and how it has impacted her weight loss path.
The Beginning of Oprah’s Keto Journey
Oprah first revealed her interest in the Keto diet during an interview with Dr. Mehmet Oz on his television show. She shared that she had been experimenting with the Keto diet and was impressed with the results she was seeing. Oprah expressed her excitement about the potential of Keto to not only help her lose weight but also improve her overall health.
Following her initial announcement, Oprah started incorporating Keto-friendly meals and snacks into her daily routine. She shared glimpses of her Keto meals on social media, sparking a wave of curiosity and interest among her fans. Many were intrigued by Oprah’s dedication to the Keto diet and wanted to learn more about how it was helping her achieve her weight loss goals.
As Oprah continued to follow the Keto diet, she documented her progress and shared updates with her audience. She spoke about how Keto had transformed her relationship with food and helped her make healthier choices. Oprah’s transparency about her struggles and successes with the Keto diet resonated with many people who were on their own weight loss journey.
Oprah’s Keto-Friendly Recipes and Meal Plans
One aspect of Oprah’s Keto journey that captured the attention of many was her creative and delicious Keto-friendly recipes. She shared her favorite meals, snacks, and desserts that adhered to the principles of the Keto diet while satisfying her cravings. Oprah’s inventive approach to Keto cooking inspired her fans to get creative in the kitchen and explore new ways of preparing low-carb, high-fat meals.
Additionally, Oprah partnered with nutritionists and chefs to develop personalized Keto meal plans that aligned with her goals and preferences. She emphasized the importance of finding a balance between enjoying food and fueling the body with nutrient-dense ingredients. Oprah’s dedication to creating flavorful and satisfying Keto meals showcased the versatility and flexibility of the diet.
By sharing her recipes and meal plans, Oprah empowered her fans to embark on their own Keto journey and discover the benefits of a low-carb, high-fat lifestyle. Her commitment to embracing Keto as a sustainable and enjoyable way of eating inspired others to explore new dietary approaches and prioritize their health and well-being.
Oprah’s Mindful Approach to Health and Wellness
Throughout her weight loss path with Keto, Oprah has emphasized the importance of adopting a mindful approach to health and wellness. She encouraged her fans to focus on making informed choices about their diet, exercise routine, and self-care practices. Oprah highlighted the connection between mental well-being and physical health, emphasizing the need to prioritize both aspects in achieving overall wellness.
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In addition to following the Keto diet, Oprah incorporated mindfulness techniques such as meditation, journaling, and gratitude practices into her daily routine. She spoke openly about the impact of stress, emotions, and mindset on weight management and emphasized the power of self-awareness and self-care in achieving lasting results. Oprah’s holistic approach to health resonated with many individuals seeking a balanced and sustainable way of improving their well-being.
By sharing her journey of self-discovery and transformation, Oprah inspired her fans to embrace a holistic approach to health and wellness that encompassed not only physical health but also mental and emotional well-being. Her commitment to prioritizing self-care, mindfulness, and balance highlighted the importance of addressing the root causes of weight loss challenges and achieving long-term success.
Oprah’s Impact on the Perception of Keto and Weight Loss
Oprah’s openness about her Keto journey and weight loss path has had a significant impact on the public perception of Keto and dietary approaches in general. Her willingness to share her struggles, successes, and lessons learned from following the Keto diet helped demystify the concept of Keto and make it more accessible to a broader audience.
Furthermore, Oprah’s advocacy for body positivity, self-acceptance, and self-love alongside her weight loss journey with Keto challenged conventional notions of beauty and wellness. She promoted a message of empowerment, self-confidence, and self-worth that transcended physical appearance and emphasized the importance of self-care, self-compassion, and self-respect in achieving overall well-being.
As a cultural icon and influential figure, Oprah’s journey with Keto sparked conversations about body image, diet culture, and holistic approaches to health that encouraged individuals to embrace their unique paths to wellness. Her impact on the perception of Keto as a sustainable, flexible, and empowering dietary approach inspired many to explore new ways of nourishing their bodies and minds.
Conclusion
Overall, Oprah Winfrey’s exploration of the Keto diet and her weight loss path have shed light on the transformative power of embracing new dietary approaches, prioritizing holistic health and well-being, and cultivating a mindful relationship with food and self-care. By sharing her journey with authenticity, vulnerability, and resilience, Oprah has inspired countless individuals to embark on their own path to wellness and redefine their relationship with their bodies and minds. As Oprah continues to navigate her Keto journey and share her insights and experiences with the world, she serves as a beacon of empowerment, inspiration, and authenticity in the realm of health and wellness.
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