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この動画では、瘦せ薬として話題のGLP-1について医師が解説します！・注射は週１回でいいの？・効きすぎる！？・内服と注射の違いは？・副作用は？など、気になる疑問にお答えしていきます😊本編もご覧ください！ ========================================== GLP-1とは・・・？「痩せホルモン」とも呼ばれるホルモンの一種で、誰もが持っていますが、痩せている人ほど多く、太っている人ほど少ないとされています。このホルモンを自己注射や経口摂取で補うことで、体重減少（ダイエット効果）が期待できます。 ========================================== 動画が役に立ったと思ったら、ぜひ高評価やチャンネル登録をお願いします！質問や気になることがあればコメント欄で教えてくださいね✨ ▼施術名【PSC】 https://private-skin.clinic/slimming/glp1diet/ ▼プライベートスキンクリニックHP https://private-skin.clinic/ ▼LINE公式アカウント http://bit.ly/2zPkqnZ ▼インスタグラム instagram http://bit.ly/2Pwfauu ▼X（旧Twitter） http://bit.ly/2PulbrJ ▼プライベートスキンクリニック　梅田本院〒530-0002 大阪府大阪市北区曽根崎新地1-3-16 京富ビル2階

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Drs Piña and Borlaug discuss the CMR substudy from the SUMMIT trial of tirzepatide in HFpEF/obesity. How does weight loss affect pericardial fat and skeletal muscle? https://www.medscape.com/viewarticle/how-do-glp-1s-affect-cardiac-structure-and-skeletal-muscle-2025a10001qm?src=soc_yt --TRANSCRIPT-- Ileana L. Piña, MD, MPH: Hello. I’m Ileana Piña, from Thomas Jefferson University in Philadelphia, Pennsylvania, and this is my blog. It’s a little bit different blog because I’m really interviewing a good friend about these glucagon-like peptide 1 (GLP-1) inhibitors. Some of our heart failure patients are getting their GLP-1 inhibitors from their primary care physicians, but many questions have arisen with the trial called SUMMIT. With us today is Barry Borlaug, who is in charge of the research section with the cardiovascular section of Mayo, and that is Mayo, Rochester, where it must be much colder even than here in Philadelphia. Barry, congratulations on that trial. Tell our audience a little bit about how the trial was structured because it’s important how we get into your information. SUMMIT Recap Barry A. Borlaug, MD: Thanks, Ileana. SUMMIT was a randomized, double-blind, placebo-controlled trial, testing the GLP-1/glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide vs placebo in patients with heart failure with preserved ejection fraction (HFpEF). Unlike some other trials, this was real HFpEF with an ejection fraction of 50% or above. Patients were randomized 1:1 to tirzepatide, titrated up to 15 mg once weekly, or placebo and treated for a minimum of 52 weeks. The dual primary endpoints were worsening heart failure or cardiovascular death and quality of life by the Kansas City Cardiomyopathy Questionnaire (KCCQ) clinical summary score. The median duration of follow-up was 2 years. We continued follow-up until the last patient enrolled completed the full 52-week period of treatment. We found that, as compared to placebo, tirzepatide reduced the risk of worsening heart failure or cardiovascular death by 38%, which was statistically significant, and also improved the KCCQ clinical summary score. In addition to that, we also looked at other patient-centered outcomes like 6-minute walk distance and biochemical markers like C-reactive protein (CRP). We saw that there was also a significant improvement in exercise function measured by 6-minute walk distance and about a 40% decrease in CRP levels. Piña: How long did the total trial last, including the time that the drugs were being administered? Borlaug: The longest duration of follow-up was 3 years, and the median follow-up was 2 years. Piña: Were any of these patients also on sodium-glucose cotransporter 2 ( SGLT2) inhibitors ? Borlaug: Yeah, a minority of patients were also on SGLT2 inhibitors, about 17%. Piña: What was the baseline KCCQ score? Borlaug: Very poor. A s you know, physician-reported heart failure severity often doesn’t agree with patient reports. Overall, 72% of the patients were judged by their physicians to have class II heart failure, but the mean KCCQ score was just over 53, so pretty severe patient-reported limitations or severe HFpEF. Despite this — and this is often the case in HFpEF and obesity-related HFpEF — the median N-terminal pro-B-type natriuretic peptide ( NT-proBNP) was only 175. Piña: I was very surprised at that. Very surprised. That really is low. That was NT-proBNP. That wasn’t BNP. Transcript in its entirety can be found by clicking here: https://www.medscape.com/viewarticle/how-do-glp-1s-affect-cardiac-structure-and-skeletal-muscle-2025a10001qm?src=soc_yt

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Jillian Michaels: Don't believe the keto diet hype New videos DAILY: https://bigth.ink Join Big Think Edge for exclusive video lessons from top thinkers and doers: https://bigth.ink/Edge ---------------------------------------------------------------------------------- Getting older is inevitable. But with diet, exercise, and some insight into how the human body works, you can do your best to keep your body from aging prematurely. Meal timing, combined with 12 hours of fasting, can actually do more for your body than you might realize. Did you know stress can literally alter your DNA? And did you know that biological ways to combat the stress can even be passed down to your kids? ---------------------------------------------------------------------------------- JILLIAN MICHAELS: Jillian Michaels is a fitness expert and wellness coach with over 20 years experience, and is a New York Times bestselling author of numerous books including Master Your Metabolism, Unlimited: How to Build an Exceptional Life, and her most recent The 6 Keys: Unlock Your Genetic Potential for Ageless Strength, Health, and Beauty. Jillian's passion for fitness training originates from 17 years of martial arts practice in Muay Thai and Akarui-Do, in which she holds a black belt. Her first comprehensive 90-day weight loss system, Jillian Michaels Body Revolution, is available in retail stores across North America, and JILLIAN MICHAELS BODYSHRED, an intense group fitness class based on Jillian's highly-effective 3-2-1 interval system, is taught worldwide. ---------------------------------------------------------------------------------- TRANSCRIPT: JILLIAN MICHAELS: Aging is a subject matter that for no good reason seems to be shrouded in all kinds of mystery. And the reality is that there is nothing in our genes that tells us to age or tells us to die. So we naturally have to ask then why do we? And it appears that there are six hallmarks of aging, six body processes that are responsible for how we age and they can work for us or they can work against us. And how we live is what determines the outcome of those results. So the first key, this is kind of how we've listed them, myself and my cool author Myatt Murphy who is fantastic, is stress, stress adaptation. So when we think of stress we often think stress is evil, stress is the devil, it's so bad, but in reality stress is designed to make us stronger, whether it's emotionally or physically, like we can be literal here. Somebody has osteoporosis or osteopenia, their bone density is becoming compromised with old age. Well, why do we recommend working out, in particular with weights? The idea is that stress is an injury, we're injuring the muscles, we're enjoying the bones, stress with regard to fitness in this particular case, and it creates these little micro fissures in the bone. Well of the body, we jump to our second key, which is inflammation, has an inflammatory response, sends in bone cells and says all right whoa we've got to heal this, we've got to get all this back together. The bone remodels and becomes more dense. So again, stress when properly managed, be it emotional or physical, is designed to either make you wiser, smarter, stronger, more depth, more empathy or your bones become more dense, your muscles become leaner and stronger. And when you look at all of the amazing things that our body does to adapt to stress you see that it's there to make you better. The second being inflammation. So without inflammation you couldn't cure the common cold. However, when information becomes chronic, just like stress you've got this little army of white blood cells are like we've got to go to war with somebody, well when the key of inflammation becomes ongoing and chronic it starts to attack healthy tissue. This is when you get into issues like rheumatoid arthritis, for example, a perfect example. Another big one is metabolism. We're looking at a body process in particular called autophagy. So autophagy is really where our body goes in and culls dead cells. It's like the garbage trucks come in, they break down the old and they rebuild the new. When we're eating constantly, so food timing is very important, and not only that but how much we eat is very important. So when we consume food we've got to break it down, we oxidize the food, which creates oxidative stress. So okay the less food we eat, within reason we're not trying to starve ourselves, but we also don't want to eat too much food and we put this in a place of what I call calorie restriction. So calorie surplus you're at a healthy weight and you're eating more than you burn in a day, that's too much food we need to restrict that and match calories in with calories out so it's the simple law of thermodynamics. And unless you have weight to lose we don't want to get... For the full transcript, check out https://bigthink.com/videos/how-do-i-prevent-aging

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Time stamps 0:30 what are ketones The 3 ketone bodies are acetone, acetoacetate and beta hydroxybutyrate Your liver makes ketones from acetyl-CoA 1:02 why does breath smell weird on keto (keto breath) 1:43 what is beta hydroxybutyrate (the best ketone for brain health) 1:55 how are ketones made (ketogenesis) Ketogenesis is the pathway that makes ketones, ketogenesis happens in your liver only Long chain fatty acids are oxidized in the mitochondria to yield acetyl-CoA (beta oxidation) In a ketogenic state / keto metabolic state the acetyl-coa is favourably directed into ketogenesis instead of the tricarboxylic acid / citric acid cycle Under normal conditions (normal carbohydrate diet / fed) the long chain fatty acids are oxidized to acetyl-coa and the acetyl-coa will then enter the tricarboxylic acid / citric acid cycle In starvation states or proper keto diets, if the TCA cycle is slowed or deplete of intermediates then the acetyl-coa enters ketogenesis Ketogenesis should only happen in extreme starvation or on true keto diets 3:13 ketogenic pathway biochemistry Enzymes essential to ketogenesis… Thiolase, HMG-CoA synthase, HMG-CoA lyase, acetoacetate decarboxylase, betahydroxybutyrate dehydrogenase 4:47 acetoacetate can be cleaved to give CO2, acetone and betahydroxybutyrate 5:37 what is BHB 6:46 how do ketones give you energy (metabolism basics) Acetyl-coa is the common entry point to the tricarboxylic acid / citric acid cycle - glucose, fatty acids and amino acids can all be metabolized into ACoA ACoA can enter the TCA cycle for complete oxidation and to yield large amounts of energy Ketogenesis is when you make ketones from ACoA in the liver, the ketones then enter circulation, travel to the brain where they are converted back into ACoA, now in your brain the ACoA enters the TCA cycle for complete and rapid oxidation thus yielding large amounts of energy 9:02 How to get into ketosis / when are you in ketosis 9:37 what happens when you are starving 10:39 what is keto diet Keto diet macro distribution 5% calories from carbohydrate 25% calories from protein 70% calories from fat 11:12 why is starvation bad for you (protein sparing effect / TCA cycle depletion) 11:59 long term fasting / prolonged fasting diets 13:40 ketosis acidifies your blood and damages organs (ketoacidosis)

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The best way for you to use this video is to identify the body fat percentage bracket where you are right now. You will also want to see where dropping down into the next lower bracket. Also, you will want to watch the bracket immediately above you too. This will be your long term goal. With that said, we start at the top, in the upper 30 percent bf percentage. Without knowing the specific individual it is possible to make some generalized assessments of what may be contributing to their higher body fat levels. They likely are not physically active, or if so, are not doing it with any consistency or with enough effort to cause a change. They likely also eat and drink whatever they want, when they want. Now, to get lean, you can't make the desirable body fat level your immediate goal. Instead, I want you to look at the very next bracket and make that your immediate goal. Doing this will ensure success as you make your way from a high body fat percentage to the lowest percentage you want to achieve. For more tips on how to get lean, be sure to stay tuned to this channel and remember to subscribe so you never miss another video from a physical therapist with a pro sports background as a PT and strength coach. You can subscribe to this channel here - http://bit.ly/2b0coMW Get Your Workout & Meal Plan: 📝 https://www.athleanx.com Connect With Me: 👉 https://www.instagram.com/athleanx For complete step-by-step workout programs, head on over to athleanx.com and make sure to use the program selector to find the training plan that is best suited to your personal goals.

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