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Drs Piña and Kosiborod discuss semaglutide in obesity-related HF with and without diabetes. Both STEP HFpEF trials show similar HF benefits despite less weight loss in patients with diabetes. https://www.medscape.com/viewarticle/semaglutide-benefits-hfpef-take-step-beyond-weight-loss-2024a10006z2?src=soc_yt -- TRANSCRIPT -- Ileana L. Piña, MD, MPH: Hello, and welcome to my blog. Today, I'm at the American College of Cardiology in Atlanta. I want to introduce and welcome Dr Kosiborod: from the Mid America Heart Institute, who has presented a very impactful paper, STEP HFpEF DM, that is in The New England Journal of Medicine right now. This is about semaglutide. A lot of patients ask me to give them that pill that makes them lose weight. I see primarily patients with heart failure (HF). So, Mikhail, congratulations on your presentation. Give us a little synopsis of what the trial is about. The STEP HFpEF Program Mikhail N. Kosiborod, MD: First of all, it is always a pleasure to be with you. Maybe a quick word about the STEP HFpEF program that included two trials: The first is STEP HFpEF, which was a trial of patients with obesity-related HF with preserved ejection fraction (HFpEF) who did not have diabetes, which we presented and published at European Society of Cardiology in August last year. The second installment of the program is the STEP HFpEF diabetes trial, which is essentially the same population of patients except they also have type 2 diabetes. I guess your question would be why we did two trials instead of just doing one trial that included patients, both with and without diabetes. I'll come back to that shortly. The crux of the hypothesis behind the program is that we all know the prevalence of HFpEF has increased dramatically in the past couple of decades. When I was a fellow in training, it was rare for me to see a patient with HF who had preserved EF. A majority of patients had HF with reduced EF. Now, the majority of people we see have HFpEF: Why did that happen? There are a lot of different reasons for the dramatic change in epidemiology. But certainly, one of them, at least in our opinion, is that the obesity epidemic has a lot to do with it. In fact, if you look at the population of patients with HFpEF in the United States, 80% of them are living with overweight or obesity. The hypothesis behind the program was that obesity is not just a comorbidity. It doesn't just happen to coexist by accident in this patient population, it may in fact be causing their HF. It may be a critical factor in the development and progression of HFpEF. In order to test our hypotheses, patients were randomly assigned to semaglutide, with the target dose of 2.4 mg once a week or matching placebo and treated for 52 weeks, or 1 year. The reason we did two separate trials is because part of that hypothesis was that if obesity is in fact the cause of HF, then certainly, weight loss would be probably not the only factor but "an important factor in the potential benefits of semaglutide in this patient population, provided that semaglutide is beneficial which of course we ultimately demonstrated. But what we knew from weight-loss trials — not HF trials but weight-loss trials of medications like semaglutide and also other anti-obesity medications like tirzepatide and others — is that people with diabetes tend to lose a lot less weight. With these medications, there's about a 40% less weight loss in people with type 2 diabetes. Lots of theoretical reasons why that could be the case. Nobody really knows for sure. We knew from the beginning that the weight loss likely was going to be different. Then, of course, there are other things that happen in people with diabetes: They have more severe HFpEF phenotype, and people with more severe disease sometimes don't respond to treatment the same way as those with less severe disease. Finally, we knew when we started the trial, which was back around 2019, 2020, that people with diabetes would be more likely to be treated with sodium-glucose cotransporter 2 (SGLT2) inhibitors. At the time, we didn't have the data for SLT2 inhibitors in HFpEF, but we knew that were going to be tested. There was, of course, an expectation that they may well be beneficial. For all of these reasons, we said, "You know what, the treatment effects may well be different between the patient population, but let's study them separately." Transcript in its entirety can be found by clicking here: https://www.medscape.com/viewarticle/semaglutide-benefits-hfpef-take-step-beyond-weight-loss-2024a10006z2?src=soc_yt

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Juan Rivera Keto Gummies have been making waves in the health and wellness community. These gummies are a convenient and delicious way to incorporate ketosis into your daily routine. But what exactly are Juan Rivera Keto Gummies, and how do they work?

What are Juan Rivera Keto Gummies?

Juan Rivera Keto Gummies are a new type of dietary supplement that is designed to help you achieve ketosis quickly and efficiently. Ketosis is a metabolic state where your body burns fat for energy instead of carbohydrates. By taking these gummies regularly, you can kickstart ketosis and start burning fat for fuel, leading to weight loss and increased energy levels.

These gummies are made with all-natural ingredients, including exogenous ketones, MCT oil, and organic fruit extracts. They are free from artificial colors, flavors, and preservatives, making them a safe and healthy choice for those looking to enhance their ketogenic lifestyle.

Many users have reported that Juan Rivera Keto Gummies have helped them lose weight, boost their energy levels, and improve their overall health. These gummies are also convenient and easy to take on-the-go, making them a popular choice for busy individuals who want to stay in ketosis while on the move.

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When you consume Juan Rivera Keto Gummies, the exogenous ketones in the formula enter your bloodstream and signal your body to enter ketosis. This process helps your body burn fat for energy instead of carbohydrates, leading to rapid weight loss and increased energy levels.

In addition to promoting ketosis, the MCT oil in these gummies provides a quick source of energy for your body and brain. This can help improve mental clarity, focus, and performance, making it easier to stick to your ketogenic diet and exercise routine.

By incorporating Juan Rivera Keto Gummies into your daily routine, you can jumpstart your weight loss journey and achieve your health and fitness goals faster than ever before. These gummies are a convenient and delicious way to support your ketogenic lifestyle and say goodbye to stubborn fat for good.

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1. Weight Loss: Many users have reported significant weight loss results after incorporating Juan Rivera Keto Gummies into their daily routine. These gummies can help you burn fat for energy, leading to a slimmer waistline and improved overall health.

2. Increased Energy: The exogenous ketones and MCT oil in these gummies provide a quick source of energy for your body and brain. This can help combat fatigue, improve focus, and enhance physical performance throughout the day.

3. Appetite Control: By promoting ketosis, Juan Rivera Keto Gummies can help reduce cravings and curb your appetite. This can make it easier to stick to your ketogenic diet and avoid unhealthy snacking between meals.

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Many customers have raved about the effectiveness of Juan Rivera Keto Gummies in helping them achieve their weight loss goals. Some have reported losing over 10 pounds in just a few weeks of taking these gummies, while others have praised the increased energy and mental clarity they experience on a daily basis.

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Customers also appreciate the delicious taste and convenience of these gummies, making them a fun and easy way to stay on track with their ketogenic lifestyle. Overall, the feedback on Juan Rivera Keto Gummies has been overwhelmingly positive, with many users recommending them to friends and family members looking to improve their health and wellness.

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Summary and Conclusion

In conclusion, Juan Rivera Keto Gummies are a revolutionary dietary supplement that can help you achieve ketosis, burn fat for energy, and reach your weight loss goals faster than ever before. With their all-natural ingredients, delicious taste, and convenient form, these gummies are a popular choice for individuals looking to enhance their ketogenic lifestyle and improve their overall health and wellness.

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Thank you for reading our insights and reviews on Juan Rivera Keto Gummies. We hope this article has been informative and helpful in guiding your decision to incorporate these gummies into your daily routine. Here’s to a healthier, happier, and more energized you!

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Video transcript :- The ketogenic diet is a high-fat, low-carbohydrate diet that has gained popularity for its potential health benefits, including weight loss and improved metabolic health. This diet fundamentally alters the body's metabolism by significantly reducing carbohydrate intake and increasing fat consumption, leading to a metabolic state known as ketosis. In a standard diet, carbohydrates are the primary source of energy. These carbohydrates are broken down into glucose, which is used for energy. The keto diet restricts carbohydrate intake to typically less than 50 grams per day, sometimes as low as 20 grams. The body stores glucose in the liver and muscles as glycogen. When carbohydrate intake is reduced, glycogen stores are depleted within a few days. This depletion signals the body to seek alternative energy sources. In the absence of sufficient glucose, the body begins to break down stored fat into fatty acids and glycerol. The liver then converts these fatty acids into ketone bodies through a process called ketogenesis. Ketone bodies are released into the bloodstream and transported to various tissues, including the brain, which can utilize them as an energy source in place of glucose. With lower carbohydrate intake, insulin levels also decrease. This reduction promotes further breakdown of fat stores and inhibits fat storage. Now let’s discuss about the Benefits of a Keto Diet. Weight Loss. The keto diet promotes fat loss while preserving lean muscle mass. The body burns stored fat for energy, leading to a reduction in body fat percentage. In addition, ketone bodies may have appetite-suppressing effects, reducing overall caloric intake. Blood Sugar Control. By reducing carbohydrate intake, the keto diet helps stabilize blood sugar levels, making it beneficial for individuals with type 2 diabetes or insulin resistance. Lower insulin levels improve insulin sensitivity, which can help manage and prevent type 2 diabetes. Neurological Benefits. The keto diet has been used since the 1920s to manage epilepsy, particularly in children with drug-resistant epilepsy. Ketone bodies provide a stable energy source for the brain and have anticonvulsant properties. Emerging research suggests that the keto diet may have neuroprotective effects, potentially benefiting conditions like Alzheimer's disease and Parkinson's disease. Although beneficial, keto diet carries certain potential risks as well. Some of them include the following. Nutrient Deficiency. The restriction of carbohydrate-rich foods can lead to deficiencies in essential vitamins and minerals, such as vitamin C, magnesium, and potassium. Lower intake of fruits, vegetables, and whole grains can result in inadequate fiber intake, affecting digestive health. Keto Flu. As the body transitions to ketosis, some individuals may experience symptoms known as "keto flu," including headaches, fatigue, irritability, nausea, and dizziness. These symptoms are usually transient and subside as the body adapts to ketosis. So, in conclusion, the ketogenic diet induces a metabolic shift from carbohydrate reliance to fat utilization, leading to ketosis. While this diet offers potential benefits for weight loss, blood sugar control, and neurological health, it requires careful planning to ensure nutritional adequacy and manage potential side effects. #keto #ketodiet #ketorecipes #medtoday #healthbenefits #healtheducation #healthyfood #health #foodandnutrition #nutrition #medicaleducation keto diet for begginers,keto weight loss,dr berg on keto diet,keto diet,ketogenic diet,weight loss,what is keto,start keto,start ketogenic diet,keto,what is ketogenic diet,how to do keto,how to start ketogenic diet,ketogenic diet plan,ketogenic diet for beginners,what is ketosis,ketogenic,ketosis,low carb diet,keto diet dr berg,dr eric berg keto,dr berg,eric berg,dr eric berg,ketogenic diet dr berg,dr berg on keto,keto food list,keto recipes

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