The Next, Episode #47

Blue Zones, Ozempic side effects, and changing local food laws

Hi there, and welcome to The Next - my take on health, wellness, and company building.

In the last few years I’ve founded 3 health brands (Kettle & Fire, Perfect Keto, Surely non-alc wine), which do tens of millions in revenue. I’m now working on TrueMed, which allows health and wellness brands to accept HSA/FSA funds. Previously, I worked in tech and had no experience in CPG, DTC, or any other 3-letter industries.

If you missed past episodes, I recommend checking out Episode 42 on finding work you love and why I’m worried about environmental toxins. Otherwise, let’s dive in! 

🆕 What’s new

Some of you may have seen the Blue Zones documentary that’s getting a lot of attention. 

Blue Zones are places in the world where there are many people living to 100 or more. By studying Blue Zones, the thinking goes, we can unlock the secrets to longevity and healthspan. 

https://twitter.com/DKThomp/status/1701627410649600465

Unfortunately, as Derek points out in this tweet, it seems like a lot of the Blue Zones stuff is fake. Blue Zones seemingly are more a function of poor birth certificate tracking than they are a sign that we’ve discovered the fountain of youth. 

That said, I don’t think the conclusion to draw here is to write Blue Zones off as simply a recordkeeping issue. I can't help but watch the centenarians in the documentary and think how much more vital they look than your average senior citizen. The group they profiled is far from the Denny’s crowd: they were sharp, laughing, engaged, and moving around. In short, they were healthy!          

In many places where these so-called Blue Zones exist, the people in them have had the tremendous benefit of growing up in the 20s, 30s and 40s. Yes, that meant hard times, occasional famine, all those things. But purely from a health and environmental standpoint, almost everyone now in their 80s, 90s and 100s grew up eating organic food by default, away from screens, and an in environment with far lower levels of toxin exposure. They lived in community, had more local foods, and were often religious. 

Back in the US, our life expectancy rates are going down for pretty much the first time ever, largely due to the increase in chronic disease. My fear is that this is just the start of a very, very long-term trend. It's hard for me to imagine this trend reversing given just how bad all health trendlines are today. Who knows: it may be just impossible for the human organism to thrive in an environment riddled with environmental toxins, to combat deep levels of loneliness and social isolation, and to eat foods far less nutrient-dense than in the last 50 years. 

In many ways, life expectancy and health span were something we got for free by simply living in an environment appropriate for the human organism. Now that that's gone, there's only so much that medicine can do. 

My guess is that we are a decade out from a time when debates around “health equity” will resemble today’s income inequality debates. In an environment like the US where the default outcome is 74% of the country is overweight and 6 in 10 Americans have one or more chronic diseases, there are going to be shocking differences in health outcomes that are only going to become more stark. 

I’d love to see more experimentation (like Blue Zones, or Vitalia) around what makes a given community healthy. If anyone is working on this, please let me know. But for now, I’m feeling pretty blue on the future of health in the US. 

💪 Health stuff

I wrote about Ozempic, Wegovy, and other GLP-1 agonists/weight loss drugs back in episode 40. It probably goes without saying that I’m extremely skeptical that we can simply medicate our way out of a broken food system and a toxicant-riddled environment. 

Though I think they are likely to become the most profitable class of drugs pharma has ever seen, I also have serious concerns on the health front. Maybe I’m naive, but I literally cannot think of a single pharmaceutical intervention rolled out to millions of Americans that came without side effects. 

Unfortunately, it seems like we are learning more about the downsides of Ozempic and the like. A recent study found that - compared to another weight loss drug (bupropion-naltrexone) - users of semaglutide and liraglutide had 9.09x higher risk of pancreatitis, 4x higher risk of bowel obstruction, and 3.67x the risk of gastroparesis (stomach paralysis). 

One way semaglutide works is by hugely slowing down how quickly the stomach empties, which creates a feeling of satiety. As you might imagine, this can cause complications: the stomach can become effectively “paralyzed,” meaning that even when the use of the drug ceases, normal digestion does not resume. The makers of these drugs are already starting to see lawsuits around this issue, 

Beyond pancreatitis and stomach paralysis, studies with rats and mice also show that these drugs caused thyroid tumors, something that’s been known for over a decade. Whether these drugs also cause thyroid tumors in humans is unknown - as there are no long-term human studies on this class of drugs that are being suggested for 100M+ Americans - as of June this year, the European Medicines Agency is requiring manufacturers to dig deeper. 

To me, this is concerning. Sure, maybe these drugs make sense for the average person who has struggled with weight for decades, or as part of a targeted intervention for a few months, followed by a program to get off a regimen of lifetime daily injections. 

For practically all of human history, one’s weight was naturally constrained by the culture and environment humans found themselves. Our historical food environment has been replaced by one that favors yield, flavor, and convenience, and the outputs are not good. 130 years ago, the world’s fattest man was enough of an anomaly that he (Chauncey Morlan) was part of a circus exhibit. Today, Chauncey would hardly stand out at your average movie theater. 

Humans are a reflection of their environment. When your environment is sick, humans in that environment get sick. Thanks to this class of drugs, I am certain that people will lose weight. Yet however much weight is lost, the deeper issue - the fact that we are living at odds with our natural environment - will remain. 

🤑 Biz stuff

I rarely write about the relation between business and politics, but this month there’s an important issue that I want to draw attention to. 

Back in the 1960s, the USDA started to roll out regulations that centralized meat processing, and led to the closing of tens of thousands of small, local butcheries. Many of the ills of our food system come with scale, and USDA regulations rolled out around this time mandated that only certain USDA-approved facilities - ones that required millions in startup capital and annual compliance cost - could do any kind of butchery. 

By the 1990s, roughly 5 companies controlled 80% of all meat products consumed in the US. Today, that problem continues, as farmers and ranchers across the country lack practical access to small-scale, affordable butchering options (as I talked about way back in Episode 9). This lack of access means that farmers and ranchers often have to schedule a year out to get on a butcher’s calendar, and do so at great trouble and expense. 

The main thing preventing more people from accessing well-raised, local meat is the Federal Meat Inspection Act, which turns farmers into felons if they sell you meat that doesn't first go through a USDA processing facility. 

Thanks to current regulations, it costs many millions to open a new, USDA-inspected butcher shop. So farmers, ranchers, and those who want real, local food suffer through long waits and monopoly prices. I’ve talked to many in the agriculture and ranching world and all of them mentioned how big an issue this was. 

Well, excitingly, there’s now an act - the PRIME Act - that represents the first substantive change to US meat regulation in almost two generations. This act would allow farmers to meet demand for locally produced meat by unlocking access to local slaughterhouses. Right now in parts of the country, farmers have to book a slaughterhouse slot as much as 1-1/2 to 2 years out. Moreover, farmers often have to transport their animals for several hours, increasing their expenses and stressing out the animals which could affect the quality of the meat. 

In my opinion, this is one of the best bills you could possibly support to nudge the country towards a more local food system. Apparently, the average bill gets fewer than 10 calls or emails about its passage. Please do call or email your local legislators and ask them to support the passage of the PRIME Act. 

You can find your Congressional representative here, and your senators here. Simply reach out via call or email and ask them to sign onto HR 2814 (if they’re in the House) or S907 (if they’re in the Senate). Simply saying something like “Please support the passage of HR2814 / S907 and enable farmers to meet demand for locally produced and butchered meat.” will go a long way. 

Let’s hope this works! 🤞

😌 Dope stuff on the internet

Some of my favorite things since the last newsletter (note: I don’t get paid to recommend anything here):

• 📰  Article - This study showed that those who didn’t eat meat experienced approximately twice the frequency of depressive episodes of meat eaters, along with higher rates of stroke, allergies, and cancer. When taken in tandem with this study showing that Austrian adults who consume a vegetarian diet are less healthy (in terms of cancer, allergies, and mental health disorders), I think the research is starting to finally reflect the obvious, that eating meat - a food that humans have eaten since time immemorial - is in fact good for you.
  

• 📚 Book rec - If you haven’t read The Order of Time, I’d strongly recommend it. It’s a mind-bending book that’s guaranteed to change the way you think about time. I really enjoyed it, and it hits the perfect sweet spot of wildly interesting but also well-written and accessible.
  

• ⌚ Cool product - Seed-oil-free french fries from my friends (disclosure, I’m an investor) at Zero Acre Farms have hit Shake Shack… and they’re apparently awesome. Personally, I can’t wait to try them in a few short weeks, but have heard rave reviews!
  

• 🎵 Music  - New season, new Lane 8 mixtape! This one comes with a warning though: at around the 2 hour mark, for some reason he throws in just about the worst song I’ve ever heard on one of his mix tapes. It’s awful and makes me question whether or not I should recommend it. But as his music has tickled my ear holes for nearly a decade, the least I can do is stand by him in this moment of artistic oversight. Enjoy 🕶️
  

• 🏀 Random - I went on the Danny Miranda podcast to talk about dating markets, health, and a bunch of random, fun stuff. If you’re curious to learn more about how I think about the world, give it a listen. Podcasts are fun, and I’ve enjoyed the last 2-3 I’ve done quite a bit.
  

• 🔥Hot take - 70% of psychologists are females, 80%+ of relationship therapists are female. Most therapy exists for females, by females, and I think much of the practice is done in a way that the majority-female therapists themselves would want to resolve things.
  

• 🙋‍♂️ Ask - A company I’m involved in is looking for a general manager/CEO to run a small consumer brand. If you (or someone you know) is interested in taking the leap and running a company with huge ownership and upside, let me know! 

***

This is a bit of a different episode for me: rather than just complain about our food and health systems like I normally do, I’m hopeful that we can take some much-needed action and pass an important bill. Let’s hope this happens 🫰.

• Justin