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Semaglutide linked to lower predicted dementia risk

alz-journals.onlinelibrary.wiley.com

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Re: Semaglutide linked to lower predicted dementia risk

#231

Earlier quoted context omitted.

But there's the exercise paradox, which is that it doesn't work. https://en.wikipedia.org/wiki/Exercise_paradox Possibly it works in the extremes, but if so, it's modern and unnatural.

Exercise and basic activity absolutely, unequivocally "works" for removing glucose from blood, which was the foundation of this argument. I'm not giving people diet advice. Indeed, we were talking about frosted flakes, and there are cyclists that have glucose energy drinks -- massive dumps of glucose -- that they consume while riding, and the impact on their blood sugar is utterly negligible. Because activity is an i…

You say they did little exercise ("their activity not particularly large", "little exercise routine") and yet they stayed lean, QED. But also you say they didn't achieve much. I don't know what you're saying. I suppose this flailing around is a kind of exercise, and you like exercise.

I know the study said nothing about "extreme exercise", I put that part in to appease you by providing a way in which you might be right.

OK, reading again, you mention "basic activity" at the start, which is reasonable, in contrast with your massively strenuous starvation bike rides. If the thesis is "move around a little in order to accomplish the basic energy expenditure which is as good as it gets," then fair enough.

Re: Semaglutide linked to lower predicted dementia risk

#232
post #180

Earlier quoted context omitted.

It wasn't even funded in the way funding a study usually means. That an entity handed over money to a research group. The study was done by employers in their work time for their salary. Its a Novo Nordisk study, and as you say its right there in the open. Pointing an llm against the paper to (wrongly) realize this is a real tragedy of literacy.

I think it rubs plenty of laymen the wrong way to not make it a bit more explicitly known. The world could use a bit less nuance in our headlines these days.

> [...] not make it a bit more explicitly known.

Honest question, how could it be made more explicitly known? It's literally under ACKNOWLEDGMENTS, in the most clear language possible.

Re: Semaglutide linked to lower predicted dementia risk

#233

Earlier quoted context omitted.

GLP-1 does a lot more than just stomach signaling. It shrinks visceral fat, it's been shown to clear liver fat, and it actually increases mitochondrial efficiency similar to if you were to do endurance work/cardio. There's a lot going on with it. That's kind of what the parent is talking about, all these second-order effects that were not obvious. There is also evidence of down-regulated mTOR signaling and epigenetic…

> It shrinks visceral fat, it's been shown to clear liver fat The brain is 60% fat, so I'm not running to the pharmacy yet.

Myelin and membranes aren’t triglyceride stores. There’s no lipolytic pathway that strips a neuron’s membrane the way a caloric deficit empties an adipocyte.

Re: Semaglutide linked to lower predicted dementia risk

#234

Earlier quoted context omitted.

> The medical establishment and big pharma simple ignores the fact that the biggest health risk for a human being is the "modern" high sugar diet The medical establishment isn’t ignoring this at all. They’ve been pushing for healthier diets forever. Primary doctors have always been pushing for healthy eating. That doesn’t mean patients welcome the advice or follow it. Everyone knows that eating high sugar diets and b…

There was a fringe that said being overweight was not unhealthy, but the more salient points were the following: 1. BMI was basically just pulled out of a hat, and it turns out that for many health concerns, the overweight class does better than the normal weight class, with the actual “clearly worse” outcomes really coming up as you trend into obesity. 2. Environmental and genetic factors are huge contributors to pe…

> despite in many ways being as genetic as getting breast cancer.

This claim is utterly silly on its face. Look at pictures of folks in the US 60 years ago compared to today. The population did not randomly mutate a genetic condition towards the propensity of obesity. Folks who come from societies that are not all that overweight did not magically develop a genetic condition upon immigrating to the US. This claim is entirely non-credulous and most folks claiming such are doing so in bad faith.

Environmental is by far and away the largest factor. Meaning most everyone lives surrounded by highly palatable horrible-for-you food and lives extremely sedentary lifestyles entirely optimized for convenience.

It's really not something that needs ANY more examination than that. Fixing it is the hard bit. Everything else on top of this is a rounding error and not something that needs to even be discussed until the first order factor is fixed. Then we can start discussing nuance, outliers, and details. It's a waste of time otherwise.

GLP-1s are the only thing that has turned the tide even a little bit. Because people eat less. Any other benefit from that is again - secondary and perhaps interesting, but not the primary mode of action. GLP-1s proved it is the American diet that is the problem.

Re: Semaglutide linked to lower predicted dementia risk

#235
post #232

Earlier quoted context omitted.

I think it rubs plenty of laymen the wrong way to not make it a bit more explicitly known. The world could use a bit less nuance in our headlines these days.

> [...] not make it a bit more explicitly known. Honest question, how could it be made more explicitly known? It's literally under ACKNOWLEDGMENTS, in the most clear language possible.

The article title is fine. The title posted to HN (and other forums) should have outro or intro:

In a study funded by X, "Semaglutide linked to lower predicted dementia risk"

Or

"Semaglutide linked to lower predicted dementia risk", in a study funded by X.

This is a fair addendum that should be added when cross posting across websites. It need not be in the original link title. And this type of declaration should really follow most cross posted titles where a perceived bias/skepticism might otherwise be triggered without that knowledge being included. It's an explicit declaration upfront of potential conflicts.

Re: Semaglutide linked to lower predicted dementia risk

#236

Earlier quoted context omitted.

Exercise and basic activity absolutely, unequivocally "works" for removing glucose from blood, which was the foundation of this argument. I'm not giving people diet advice. Indeed, we were talking about frosted flakes, and there are cyclists that have glucose energy drinks -- massive dumps of glucose -- that they consume while riding, and the impact on their blood sugar is utterly negligible. Because activity is an i…

You say they did little exercise ("their activity not particularly large", "little exercise routine") and yet they stayed lean, QED. But also you say they didn't achieve much. I don't know what you're saying. I suppose this flailing around is a kind of exercise, and you like exercise. I know the study said nothing about "extreme exercise", I put that part in to appease you by providing a way in which you might be rig…

>You say they did little exercise

LOL, no, I didn't. You seem to have read my comment like your understanding of that study.

Moderately active hunter/gatherers consuming a massive number of calories a day for their size saw plateauing energy consumption, where increasing the activity saw a reduced climb. Again, humans are not perpetual motion machines, and anyone seriously arguing that doing more activity is magically free suffers from self-delusion.

I referred to "little exercise" relative to gluttonous people with a gross calorie excess who then add a little exercise routine and thinks they'll lose weight. They'd be massively more successful cutting calories.

This really isn't difficult to understand.

Re: Semaglutide linked to lower predicted dementia risk

#237

So has anyone managed to separate the effects of semaglutide from the effects of weight loss? If this is caused by the weight loss, it is a little disappointing that public health didn't act quicker - lots of people have been overweight for a century now, so literally 10's of millions of people could have been saved from dementia had action been taken 100 years ago.

With all the research into dementia and its causes, if there was a simple strong link to overweight I can't imagine that would not stand out in the data and be well known by now. Edit: although, there are well-known links between overweight and a lot of negative outcomes, and yet people are still too fat.

Nearly 75% of Americans are overweight. (over 30% 'overweight', over 40% 'obese').

Obviously, 75% of Americans do not develop dementia. Do more who are overweight develop dementia than those who are not? Well...it's hard to say when 3/4ths of the population is overweight.

Re: Semaglutide linked to lower predicted dementia risk

#238

Earlier quoted context omitted.

You say they did little exercise ("their activity not particularly large", "little exercise routine") and yet they stayed lean, QED. But also you say they didn't achieve much. I don't know what you're saying. I suppose this flailing around is a kind of exercise, and you like exercise. I know the study said nothing about "extreme exercise", I put that part in to appease you by providing a way in which you might be rig…

>You say they did little exercise LOL, no, I didn't. You seem to have read my comment like your understanding of that study. Moderately active hunter/gatherers consuming a massive number of calories a day for their size saw plateauing energy consumption, where increasing the activity saw a reduced climb. Again, humans are not perpetual motion machines, and anyone seriously arguing that doing more activity is magicall…

I edited a conclusion in, maybe we can agree on it.

Incidentally, because I'm puzzled by the "perpetual motion" aspect too, another lever the body can pull is to reduce or increase energy that goes to the immune system and the brain. (But in searching for the Hadza I found https://news.ycombinator.com/item?id=47042766 "Thinking hard burns almost no calories but destroys your next workout", so it's debatable.)

Re: Semaglutide linked to lower predicted dementia risk

#239
post #90

Earlier quoted context omitted.

I don’t consider that since it’s simply not true. When I grew up relatively poor we never ate out or ate junk food because it is ridiculously expensive in comparison. We made our food from cheap ingredients. To save money. Yes it takes more time and is far more work and is less convenient. US society has valued convenience over everything else for a few generations now. Cheaper it is not. And it holds true today with…

... It can cut both ways, and depends a lot on the 'level' of poverty and specific circumstances, although the calculus has shifted over time. If people are working crazy hours, sometimes it's a struggle to even get time to properly shop for groceries, let alone cook. There's varying degrees of that too; i.e. I remember the 3-4$ frozen pizzas that could be used as a dinner and leftovers; And yes, at least back then,…

You are describing time, not cost. I can assure you my family worked pretty demanding jobs with long hours. And spent hours preparing food on top of it.

The average American spends 4-5 hours a day on personal screen time, and this skews higher the poorer you get based on a few studies. I've found from talking with folks on the subject many of them are the ones glued to social media and/or the TV.

I agree it's much more convenient to toss a couple pizzas in the oven. I do not agree it's less expensive. I don't know where you're buying your rice or chicken, but even at $4/pizza I can't pencil that out. Chicken comes with free chicken stock if you're buying $5 rotisserie chickens (or whole chickens) and keeping the bones and vegetable ends/etc. around for stock making. This is the level of poor I was talking about. Even at $2.69/lb (the price I paid ~3 weeks ago) for chicken breast, it's going to be cheaper to feed two people than split a whole pizza. Rice is less than 30 cents a serving bought in bulk 50lb bags from a local ethnic store. $1 of rice and a $5 chicken is going to feed around 3-5 people, or give 1 person a lot of leftovers.

I agree one cannot live on just chicken and rice, but one cannot live on just the cheapest frozen pizzas either. I've kinda done both during my life. I lived probably a decade on junk food because I was either too busy or too lazy to do my own cooking like I did growing up. But this was after I started making IT money and could afford it.

> But then there's the sort of 'generational passing on' where we now have multiple generations raised on carry out, fast food, or microwaved meals. Sometimes where they were never given the teaching or responsibility of cooking because (for reasons similar to above, including more affluent cases) the general concept of 'a home cooked meal' becomes the exception case rather than the norm

I definitely agree with this one. Habits and skills are passed down generationally. Someone may not even know where to start looking at youtube for how-to videos to make their own chicken stock for close to free with a $5 crock-pot from the local thrift store these days. And that's probably intermediate level cooking skills, much less beginner level. My wife and I joke about our "depression era cooking" hobby.

I agree there are exceptions, nuance, etc. to this topic. But I get so tired of folks pretending eating home cooked meals is somehow more expensive than an equivalent quality prepared meal. Yes, you can spend as much as you want cooking at home. But the same is true eating out or buying pre-made stuff.

The time factor is certainly very true though. You get much better at it as you practice over the years, but it's always going to be easier and faster to just toss some chicken nuggets into the microwave and be done with it.

This is not moralizing or anything like that. I have lived well over half of my adult life eating junk, and only since getting married to a partner who loves cooking have I turned this back around to my childhood experiences. And we certainly do not optimize very hard for cost - just smart choices by buying stuff on sale, in-season, and in bulk when it makes sense to. I just really cannot square the claim to reality that it's cheaper to eat junk food than it is to eat moderately healthy at home. It's one of those Internet social media memes that just becomes truth by repeating it so much.

Re: Semaglutide linked to lower predicted dementia risk

#240

Earlier quoted context omitted.

I'm not sure how the medical establishment ignores this, from my understanding (and please correct me if I'm wrong as I'm not fact checking myself in this moment) - the association between the two is largely linked to vascular dementia (obesity, hypertension, yadda yadda). I think it's hard to argue "The medical establishment" ignores diet as an important factor. I think the reality a lot of the time is doctors presc…

It's easy to say "just diet ez" and it's hard to "just diet". If you can administer a treatment as a simple one and done thing, that's alright. If it's a pill you got to take every day, that's pretty bad. More than once a day? Horrible. Why? Because a lot of patients just don't have it in them to take a pill 3 times a day consistently. If it's purely an "exercise willpower" thing or a "change your lifestyle" thing? Y…

bro the problem is not eating burgers every time you see them. if eating a pill once a day will prevent somebody from having these urges people will easily make this a routine. fat people don't like being fat (body positive is the world biggest cope). if you give them something they gotta take once a day, takes 10 seconds, they will throw their money at you.
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