4 ms·

The next line of the article after that 40% quote: > Carla Prado, a nutrition researcher in the Faculty of Agricultural, Life & Environmental Sciences and lead

The next line of the article after that 40% quote: > Carla Prado, a nutrition researcher in the Faculty of Agricultural, Life & Environmental Sciences and lead author on the commentary, explains this rate of muscle decline is significantly higher than what is typically observed with calorie-reduced diets or normal aging and could lead to a host of long-term health issues — including decreased immunity, increased risk of infections and poor wound healing. The rather obvious problem is that these GLP1 agonists don't improve your diet. If you continue to eat a protein and nutrient deficient diet (which is probably a majority of Americans) with caloric restriction on top of that, that leads to excessive muscle loss that you wouldn't see in a weight loss diet. This normally doesn't happen without GLP1 agonists, because these diets are too difficult to stick to for most people. Those who stick to them usually turn to nutritious high satiety whole foods that help combat the negative effects of caloric restriction. Losing weight without losing muscle mass is very hard. It requires extreme diets like a protein sparring modified fast where 80%+ of your calories are from lean protein while running a 50% caloric deficit. If this research is correct, then using GLP1 agonists shortcuts the feedback loops that make the diets hard to stick to, but they shift the tradeoffs from weight to overall nutrition. "When a measure becomes a target, it ceases to be a good measure" and all that.

chunky1994 2y ago
I'd like to see the diets in the study that are specified as the "calorie-reduced diets". (Can't seem to find the paper). If it's the same as the Standard American Diet, this muscle loss is quite explainable. I think the mitigation is relatively easy though, if you want to shift the p-ratio, recommending a daily high protein shake would do a lot to stave off muscle loss (and even more if resistance training is applied of course). The exercise addition is probably the hardest to adhere to.
- groby_b 2y ago
  I'd be surprised if either mice or human cells eat "the Standard American Diet"
loeg 2y ago
I'm pretty skeptical of the "this rate of muscle decline is significantly higher than what is typically observed with calorie-reduced diets" claim. I suspect we're comparing apples to oranges rather than doing like-for-like comparisons at equivalent calories.
andy_ppp 2y ago
Yeah, my four donuts per day fill me up just fine or an extra large milkshake and a burger and I’m done for the day with food is definitely happening for some people. Let’s wait and see these drugs might prove to be very beneficial and more testing definitely needed.
zemvpferreira 2y ago
>Losing weight without losing muscle mass is very hard. I was with you up to here. In my experience it's easy to maintain a huge proportion of your lean tissue during a weight loss diet: Do some resistance training, get some protein, and don't lose weight too quickly. There's no need to go to the extreme of a PSMF - which will still have you lose a bunch of muscle on account of being too big a deficit. If you can keep your calories reasonable while on a GLP1 agonist, there doesn't seem to be any reason you'll lose an exaggerated amount of muscle.
- hehehheh 2y ago
  Intuitively, if you can lift a modest bench press (not novice, maybe beginner-intermediate) and you keep training and you consume a few fewer calories (not starve) why would you lose your strength.
  - Panzer04 2y ago
    Because the body does not make it easy to keep the same muscle with less fat. For most people, it just doesn't really matter, because their strength is so far below their peak capability it won't be hard to cut some weight while maintaining strength. The closer you get to the edge of capabilities, though, the more it will matter.
  - cthalupa 2y ago
    If you are outside of your noob gains period and keep up your protein intake and resistance training you will minimize your muscle loss, but you'll still see some. Bodybuilders will even take AAS that explicitly reduce catabolism of muscle mass like Anavar and still lose some muscle on cuts.
- Kirby64 2y ago
  For the average overweight person? I disagree. The average obese person does little to no resistance training, eats very little protein, and wants to lose weight fast so they're not paying for expensive GLP1 drugs for a long period of time. You're asking folks to make three separate changes: start exercising, change their diet to add protein, and use GLP1s to reduce food amount. And reducing food amount already goes against adding protein, so whatever protein they were getting is going to get cut even further.
llamaimperative 2y ago
> The rather obvious problem is that these GLP1 agonists don't improve your diet My understanding from initial anecdotes is this is actually literally wrong. Which was surprising to me, too. But people on GLPs tend to prefer more nutritious food (high protein and high fiber). I'm not sure if this has been studied directly in clinical trials yet but I know that food manufacturers have been reorienting their products toward healthier meal configurations in response to the GLPs. I predicted the exact opposite of this, but so far I appear to have been wrong.
- throwup238 2y ago
  I’ve heard that anecdote from HN users many times but based on my meatspace social group of (mostly) California yuppies, that effect is vastly overstated. Even some of the diabetics I know on Ozempic have started using it as an excuse for a shittier diet. Now my sample size is barely ten people on Ozempic/Wegovy so take it with a grain of salt and what not, but I’m skeptical. I bet there’s a large group of people - possibly over represented on HN and other online communities - that just need a little nudge to suppress their cravings and eat healthier, but that’s far from universal. For a lot of people, they wouldn’t even know where to start to eat healthier except choosing a salad over a burger at the takeout menu. Even with drugs masking cravings, many people just haven’t had good health or culinary education.
  - llamaimperative 2y ago
    Odd Lots (Bloomberg finance podcast) had an episode back in June or something interviewing a food design consultant, and their focus groups came back very strongly in favor of healthier meal compositions. Agreed though, it's hard to know things :) Hopefully some real studies on this will be done soon.
    - leoqa 2y ago
      Industry led focus group is not a legitimate source.
      - 2y ago
ohyes 2y ago
> Losing weight without losing muscle mass is very hard. Yes it is. > It requires extreme diets like a protein sparring modified fast where 80%+ of your calories are from lean protein while running a 50% caloric deficit. I’m not any sort of expert but that sounds frankly, dangerous. I don’t see how you do something like that without damaging your liver. It’s very possible to lose weight and gain muscle, but you have to be at just the right body composition (not lean and not obese) and then there’s a question of “over what period of time”? Any duration under a month is probably pointless to measure unless you have some special equipment. Any duration over a month and it’s kind of obvious that it is possible. Eat a balanced diet without junk, work out regularly, and keep the calories to only what is necessary.
- throwup238 2y ago
  > I’m not any sort of expert but that sounds frankly, dangerous. I don’t see how you do something like that without damaging your liver. I haven’t seen any credible research that a healthy person can damage their liver from excessive protein intake. Someone suffering from liver disease needs to be careful, sure, but evidence that it would harm a healthy liver is practically nonexistent. That said, PSMF is explicitly not a sustainable diet and proponents generally don’t claim it to be. It’s a short term diet meant to preserve muscle mass under extreme caloric restriction (under 1.2k calories). > Eat a balanced diet without junk, work out regularly, and keep the calories to only what is necessary. If it were as simple as that, we wouldn’t be having this conversation.
  - turbojet1321 2y ago
    > If it were as simple as that, we wouldn’t be having this conversation. It pretty much is that simple. The problem is that simple is not easy.
pottertheotter 2y ago
This is true. I just lost 30 pounds over 3 months and 17% was muscle. I thought I was eating a lot of protein, but I’ve upped it today. I did an InBody scan the day I started (8/21) and just happened to have done my second one this morning.
- sheepscreek 2y ago
  I don’t think we can expect to retain 100% of muscle mass, and losing just 1/5th sounds like a good outcome. I’ve understood that generalizing anything in today’s time is a losing game. I know many people with IBS/GI issues and I am also sure they have different underlying causes. Our gut biome and how digestion works in general needs to be researched much more. I don’t know why progress has generally been so slowly on that front. For instance, GLP-1 was discovered in the 1970s. It took us another 40 years to commercialize it in the form of Semaglutide and another 10 years to get it ready for human consumption.
throwaway2037 2y ago
> nutrient deficient diet (which is probably a majority of Americans) This is bullshit. Literally, I Googled for: what percent of americans have nutrient deficient diet? First hit is some blogspam trying to sell me "Nutrient Therapy". Second hit is CDC: https://www.cdc.gov/nutrition-report/media/2nd-nutrition-report_508_at-a-glance.pdf https://www.cdc.gov/nutrition-report/media/2nd-nutrition-rep... > The Second Nutrition Report found less than 10% of the U.S. population had nutrition deficiencies for selected indicators. Another thing that people frequently overlook, since post WW2, the US has been "fortifying" grains with essential minerals and vitamins. That means when people eat cereal and bread from the supermarket (usually highly processed), there are plenty of minerals and vitamins. Say what you like about the highly processed part, few are nutrient deficient.
- anon291 2y ago
  Part of the problem is that the standards are incorrect. If you go by dietary standards, you are eating way too many carbohydrates and likely eating too many times a day, especially if you do not have an active job. Most people should mainly be eating fat and protein with a decent amount of grains and fruit and vegetables. However, the standard advice is to eat a lot of grains, some fruit and vegetables, a modest amount of protein, and little fat. This is awful and leads to very high hunger. Especially if you eat multiple meals a day, as is also commonly recommended, this is a recipe for being ever hungrier day by day. It wasn't until I eschewed all advice, started eating one big meal a day and maybe one snack and matching my carb intake with my fat intake that the hunger that I had known since childhood magically disappeared and I lost 25 lbs (and am losing more). Finally a 'normal' weight seems not only in sight, but extremely easy!
throwaway2037 2y ago
> Losing weight without losing muscle mass is very hard. Lots of amateur body builders can do it. There are whole training guides about how to lose body fat, but maintain as much muscle mass as possible. Granted, they are probably a minority because they have higher discipline and motivation than the average population.
- cthalupa 2y ago
  Even pros on high doses of testosterone and multiple AAS lose some muscle mass when preparing for a show.
uxp100 2y ago
Nutrient deficient, sure, protein deficient? Probably not.
voisin 2y ago
> If you continue to eat a protein and nutrient deficient diet (which is probably a majority of Americans) Is it true the majority of Americans eat a protein deficient diet? I always thought there was too much protein in the western diet - nearly at every meals versus how we would have evolved with somewhat limited access.
- dgfitz 2y ago
  So, lots of foraging for food that grows on plants and the occasional bison? Would that we could convert the world to diets like that.
- whythre 2y ago
  A lot of what Americans consume is really crappy carbs and sugar, unfortunately. Even fatty meats would be better than that.
ipsento606 2y ago
The claim that "a majority of Americans" eat a protein deficient diet is absurd on its face.
bongodongobob 2y ago
Americans eat a shit ton of protein. No idea where you got idea that from.
anon291 2y ago
Part of the problem is that doctors recommendunhealthy diets and will dismiss healthy diets.
wisty 2y ago
Losing glycogen stored in muscle is not a huge issue IMO, as it should come back fast. Stuff that's easy to gain is usually easy to lose and vice versa.
- hollerith 2y ago
  Uh, GP is talking about losing muscle itself, not the glycogen in muscle.
  - cthalupa 2y ago
    Well, these studies look at FFM, which does include your water weight and glycogen stores, so they do make up a portion of it.
    - hollerith 2y ago
      The point is that there is a big difference between depleting the store of glycogen, which can reliably be refilled in about 2 hours and the body's disassembling half the muscle mass, which takes many months to build back up if you even can build it back up to the original mass (unlikely if you are old).
      - cthalupa 2y ago
        No one is disputing that you can restore glycogen or water weight quickly. But the issue is all of the studies I have looked at look at total FFM which does include the loss there. If you are on these GLP-1s there is water weight you are going to lose and keep off while on them due to the anti-inflammation effects, etc., and that water weight is going to be part of their calculations of FFM that has been lost.
        hollerith 2y ago
        I understand now. Sorry for being slow to get it. >Fat-free Mass (FFM) Encompasses all of the body's non-fat tissues, including the skeleton, water, muscle, connective tissue, and organ tissues.

chunky1994 2y ago

I'd like to see the diets in the study that are specified as the "calorie-reduced diets". (Can't seem to find the paper). If it's the same as the Standard American Diet, this muscle loss is quite explainable. I think the mitigation is relatively easy though, if you want to shift the p-ratio, recommending a daily high protein shake would do a lot to stave off muscle loss (and even more if resistance training is applied of course). The exercise addition is probably the hardest to adhere to.

groby_b 2y ago
I'd be surprised if either mice or human cells eat "the Standard American Diet"

loeg 2y ago

I'm pretty skeptical of the "this rate of muscle decline is significantly higher than what is typically observed with calorie-reduced diets" claim. I suspect we're comparing apples to oranges rather than doing like-for-like comparisons at equivalent calories.

andy_ppp 2y ago

Yeah, my four donuts per day fill me up just fine or an extra large milkshake and a burger and I’m done for the day with food is definitely happening for some people. Let’s wait and see these drugs might prove to be very beneficial and more testing definitely needed.

zemvpferreira 2y ago

>Losing weight without losing muscle mass is very hard. I was with you up to here. In my experience it's easy to maintain a huge proportion of your lean tissue during a weight loss diet: Do some resistance training, get some protein, and don't lose weight too quickly. There's no need to go to the extreme of a PSMF - which will still have you lose a bunch of muscle on account of being too big a deficit. If you can keep your calories reasonable while on a GLP1 agonist, there doesn't seem to be any reason you'll lose an exaggerated amount of muscle.

hehehheh 2y ago
Intuitively, if you can lift a modest bench press (not novice, maybe beginner-intermediate) and you keep training and you consume a few fewer calories (not starve) why would you lose your strength.
- Panzer04 2y ago
  Because the body does not make it easy to keep the same muscle with less fat. For most people, it just doesn't really matter, because their strength is so far below their peak capability it won't be hard to cut some weight while maintaining strength. The closer you get to the edge of capabilities, though, the more it will matter.
- cthalupa 2y ago
  If you are outside of your noob gains period and keep up your protein intake and resistance training you will minimize your muscle loss, but you'll still see some. Bodybuilders will even take AAS that explicitly reduce catabolism of muscle mass like Anavar and still lose some muscle on cuts.
Kirby64 2y ago
For the average overweight person? I disagree. The average obese person does little to no resistance training, eats very little protein, and wants to lose weight fast so they're not paying for expensive GLP1 drugs for a long period of time. You're asking folks to make three separate changes: start exercising, change their diet to add protein, and use GLP1s to reduce food amount. And reducing food amount already goes against adding protein, so whatever protein they were getting is going to get cut even further.

llamaimperative 2y ago

> The rather obvious problem is that these GLP1 agonists don't improve your diet My understanding from initial anecdotes is this is actually literally wrong. Which was surprising to me, too. But people on GLPs tend to prefer more nutritious food (high protein and high fiber). I'm not sure if this has been studied directly in clinical trials yet but I know that food manufacturers have been reorienting their products toward healthier meal configurations in response to the GLPs. I predicted the exact opposite of this, but so far I appear to have been wrong.

throwup238 2y ago
I’ve heard that anecdote from HN users many times but based on my meatspace social group of (mostly) California yuppies, that effect is vastly overstated. Even some of the diabetics I know on Ozempic have started using it as an excuse for a shittier diet. Now my sample size is barely ten people on Ozempic/Wegovy so take it with a grain of salt and what not, but I’m skeptical. I bet there’s a large group of people - possibly over represented on HN and other online communities - that just need a little nudge to suppress their cravings and eat healthier, but that’s far from universal. For a lot of people, they wouldn’t even know where to start to eat healthier except choosing a salad over a burger at the takeout menu. Even with drugs masking cravings, many people just haven’t had good health or culinary education.
- llamaimperative 2y ago
  Odd Lots (Bloomberg finance podcast) had an episode back in June or something interviewing a food design consultant, and their focus groups came back very strongly in favor of healthier meal compositions. Agreed though, it's hard to know things :) Hopefully some real studies on this will be done soon.
  - leoqa 2y ago
    Industry led focus group is not a legitimate source.
    - 2y ago

ohyes 2y ago

> Losing weight without losing muscle mass is very hard. Yes it is. > It requires extreme diets like a protein sparring modified fast where 80%+ of your calories are from lean protein while running a 50% caloric deficit. I’m not any sort of expert but that sounds frankly, dangerous. I don’t see how you do something like that without damaging your liver. It’s very possible to lose weight and gain muscle, but you have to be at just the right body composition (not lean and not obese) and then there’s a question of “over what period of time”? Any duration under a month is probably pointless to measure unless you have some special equipment. Any duration over a month and it’s kind of obvious that it is possible. Eat a balanced diet without junk, work out regularly, and keep the calories to only what is necessary.

throwup238 2y ago
> I’m not any sort of expert but that sounds frankly, dangerous. I don’t see how you do something like that without damaging your liver. I haven’t seen any credible research that a healthy person can damage their liver from excessive protein intake. Someone suffering from liver disease needs to be careful, sure, but evidence that it would harm a healthy liver is practically nonexistent. That said, PSMF is explicitly not a sustainable diet and proponents generally don’t claim it to be. It’s a short term diet meant to preserve muscle mass under extreme caloric restriction (under 1.2k calories). > Eat a balanced diet without junk, work out regularly, and keep the calories to only what is necessary. If it were as simple as that, we wouldn’t be having this conversation.
- turbojet1321 2y ago
  > If it were as simple as that, we wouldn’t be having this conversation. It pretty much is that simple. The problem is that simple is not easy.

pottertheotter 2y ago

This is true. I just lost 30 pounds over 3 months and 17% was muscle. I thought I was eating a lot of protein, but I’ve upped it today. I did an InBody scan the day I started (8/21) and just happened to have done my second one this morning.

sheepscreek 2y ago
I don’t think we can expect to retain 100% of muscle mass, and losing just 1/5th sounds like a good outcome. I’ve understood that generalizing anything in today’s time is a losing game. I know many people with IBS/GI issues and I am also sure they have different underlying causes. Our gut biome and how digestion works in general needs to be researched much more. I don’t know why progress has generally been so slowly on that front. For instance, GLP-1 was discovered in the 1970s. It took us another 40 years to commercialize it in the form of Semaglutide and another 10 years to get it ready for human consumption.

throwaway2037 2y ago

> nutrient deficient diet (which is probably a majority of Americans) This is bullshit. Literally, I Googled for: what percent of americans have nutrient deficient diet? First hit is some blogspam trying to sell me "Nutrient Therapy". Second hit is CDC: https://www.cdc.gov/nutrition-report/media/2nd-nutrition-report_508_at-a-glance.pdf https://www.cdc.gov/nutrition-report/media/2nd-nutrition-rep... > The Second Nutrition Report found less than 10% of the U.S. population had nutrition deficiencies for selected indicators. Another thing that people frequently overlook, since post WW2, the US has been "fortifying" grains with essential minerals and vitamins. That means when people eat cereal and bread from the supermarket (usually highly processed), there are plenty of minerals and vitamins. Say what you like about the highly processed part, few are nutrient deficient.

anon291 2y ago
Part of the problem is that the standards are incorrect. If you go by dietary standards, you are eating way too many carbohydrates and likely eating too many times a day, especially if you do not have an active job. Most people should mainly be eating fat and protein with a decent amount of grains and fruit and vegetables. However, the standard advice is to eat a lot of grains, some fruit and vegetables, a modest amount of protein, and little fat. This is awful and leads to very high hunger. Especially if you eat multiple meals a day, as is also commonly recommended, this is a recipe for being ever hungrier day by day. It wasn't until I eschewed all advice, started eating one big meal a day and maybe one snack and matching my carb intake with my fat intake that the hunger that I had known since childhood magically disappeared and I lost 25 lbs (and am losing more). Finally a 'normal' weight seems not only in sight, but extremely easy!

throwaway2037 2y ago

> Losing weight without losing muscle mass is very hard. Lots of amateur body builders can do it. There are whole training guides about how to lose body fat, but maintain as much muscle mass as possible. Granted, they are probably a minority because they have higher discipline and motivation than the average population.

cthalupa 2y ago
Even pros on high doses of testosterone and multiple AAS lose some muscle mass when preparing for a show.

uxp100 2y ago

Nutrient deficient, sure, protein deficient? Probably not.

voisin 2y ago

> If you continue to eat a protein and nutrient deficient diet (which is probably a majority of Americans) Is it true the majority of Americans eat a protein deficient diet? I always thought there was too much protein in the western diet - nearly at every meals versus how we would have evolved with somewhat limited access.

dgfitz 2y ago
So, lots of foraging for food that grows on plants and the occasional bison? Would that we could convert the world to diets like that.
whythre 2y ago
A lot of what Americans consume is really crappy carbs and sugar, unfortunately. Even fatty meats would be better than that.

ipsento606 2y ago

The claim that "a majority of Americans" eat a protein deficient diet is absurd on its face.

bongodongobob 2y ago

Americans eat a shit ton of protein. No idea where you got idea that from.

anon291 2y ago

Part of the problem is that doctors recommendunhealthy diets and will dismiss healthy diets.

wisty 2y ago

Losing glycogen stored in muscle is not a huge issue IMO, as it should come back fast. Stuff that's easy to gain is usually easy to lose and vice versa.

hollerith 2y ago
Uh, GP is talking about losing muscle itself, not the glycogen in muscle.
- cthalupa 2y ago
  Well, these studies look at FFM, which does include your water weight and glycogen stores, so they do make up a portion of it.
  - hollerith 2y ago
    The point is that there is a big difference between depleting the store of glycogen, which can reliably be refilled in about 2 hours and the body's disassembling half the muscle mass, which takes many months to build back up if you even can build it back up to the original mass (unlikely if you are old).
    - cthalupa 2y ago
      No one is disputing that you can restore glycogen or water weight quickly. But the issue is all of the studies I have looked at look at total FFM which does include the loss there. If you are on these GLP-1s there is water weight you are going to lose and keep off while on them due to the anti-inflammation effects, etc., and that water weight is going to be part of their calculations of FFM that has been lost.
      - hollerith 2y ago
        I understand now. Sorry for being slow to get it. >Fat-free Mass (FFM) Encompasses all of the body's non-fat tissues, including the skeleton, water, muscle, connective tissue, and organ tissues.