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Can Ozempic Cause Constipation? Yes, But It Doesn’t Have To

Written by Michael Ruscio on May 16, 2024

Hannah Wright

Written by Michael Ruscio on May 16, 2024 — Reviewed by Hannah Wright Hannah Wright

Natural Strategies for Improving Ozempic Constipation

Ozempic has skyrocketed in popularity for its blood sugar benefits and potential to induce significant weight loss. But, as with most medications, it can have side effects—especially in the GI tract.  

In this article, I’ll share science-backed tips for mitigating Ozempic constipation (and other side effects). And since this drug is being prescribed off-label for weight loss, I’ll also dig into the best ways to build a healthy foundation for reaching and maintaining a healthy weight. 

Let’s start off with a little background on Ozempic and how it works.

What is Ozempic?

You’ve likely heard of Ozempic and Wegovy but may not realize what these drugs are and what they do. Let me share some background before getting into how to mitigate their potential side effects.

Ozempic is the brand name of an injectable drug called semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA). It’s a diabetes medication prescribed (along with diet and exercise) for adults with type 2 diabetes mellitus to better control blood sugar levels 1. 

In addition to better blood sugar (glucose) control, Ozempic can also help to reduce the risk of stroke, heart attack, or death in people with type 2 diabetes who also have a heart or blood vessel problem 1.  

Said more simply, Ozempic is meant to help people with type 2 diabetes avoid the serious complications that can come with unmanaged blood sugar and to help improve their overall health 1.

Wegovy is another form of semaglutide that helps people with obesity or excess weight (and possibly high blood pressure, type 2 diabetes, or high cholesterol) lose weight 1. 

With that background out of the way, let me get into how these drugs work.

How Does Ozempic Work?

People with type 2 diabetes have too much sugar hanging out in their bloodstream because they either don’t produce enough insulin or they can’t use their insulin effectively. Insulin is the pancreatic hormone that helps move sugar from the bloodstream into the cells so it can be used for energy. 

If blood sugar levels stay too high over time, serious health complications like diabetic retinopathy, heart disease, and kidney problems can result. This is where semaglutide drugs come to the rescue—they help the pancreas release the right amount of insulin to lower blood sugar when needed, allowing for better blood sugar control.  

For those of you who want more detail—semaglutide activates receptors in the pancreas and brain called GLP-1 receptors. GLP-1 receptor activation increases the efficiency of a gastrointestinal hormone called incretin. Incretin tells the pancreas to produce insulin when blood sugar levels are too high so the sugar can be moved out of the bloodstream. In addition to increasing insulin secretion when needed, semaglutide also 2:

  • Stops the release of a pancreatic hormone (glucagon) that increases blood sugar.
  • Reduces the amount of sugar the liver produces, when fasting and after meals.
  • Helps the beta cells in the pancreas work better to produce insulin. 
  • Helps the body become more sensitive to insulin.

All of these benefits lead to better blood sugar control to help prevent type 2 diabetes complications, but semaglutide drugs are not a cure for diabetes and are not used to treat low blood sugar (hypoglycemia) 1.  

Where Does Weight Loss Come In

Ozempic is prescribed to treat people who have type 2 diabetes, but both Ozempic and Wegovy are being used as weight loss drugs. If you’re wondering how they support weight loss, it seems to be related to appetite changes and GI-related drug side effects, and here’s how.

Semaglutide drugs may slow down the movement of food through the stomach. When motility is slower, appetite may be reduced—eating less food may translate into weight loss 1 2. 

But research suggests that these drugs aren’t a great tool for significant weight loss on their own 1. A strong meta-analysis showed that taking semaglutide drugs for 6–12 months led to a loss of about 7.2 pounds. And when used for more than a year, the average weight loss was about 6 pounds. This suggests that the weight loss benefits may decrease over time 3.

You may know people who have lost a significant amount of weight on Ozempic or Wegovy. What explains these outliers if the research suggests that weight loss isn’t a significant effect of semaglutide? It could be simple calorie reduction due to the impact semaglutide drugs can have on appetite. But may also be related to unwanted GI side effects. One 2021 literature review suggested that some people may lose a significant amount of weight on these drugs due to nausea and vomiting 4. 

GI-related side effects are fairly common with Ozempic. So, let me unpack how this drug impacts the GI tract before I get into what can be done to mitigate some of those effects.

Ozempic Side Effects

As with most medications, Ozempic can come with unwanted side effects. Some are more bothersome than others, and not surprisingly, higher doses of Ozempic tend to be more problematic 3.  

The most common side effects of Ozempic are digestive system-related and may impact more than 5% of patients taking the medication 5. A 2022 study of 5,442 cases of semaglutide side effects in people with type 2 diabetes found the following GI symptoms and their prevalence 6:

  • Nausea (44%)
  • Vomiting (25%)
  • Diarrhea (22%)
  • Constipation (12%)
is constipation a side effect of Ozempic

Constipation appears to be the least-reported side effect, but that doesn’t mean it should be ignored. It’s not clear as to why Ozempic causes constipation, but it may be related to:

  • Delayed gastric emptying—when GLP-1RA activates GLP-1 receptors, it may slow down gut motility, making it easier for stool to back up in the colon 4.
  • Central nervous system effects 4.
  • Feeling too full (an effect of the medication) to drink an adequate amount of fluid to keep stool moving through the GI tract 7.

Other less common possible side effects of Ozempic may include indigestion, burping, flatulence, heartburn or GERD, and gastritis (stomach inflammation) 5.

Outside of the gut-related impact, Ozempic may have some serious side effects that affect the kidneys, liver, mood, and heart, and could increase the risk of acute pancreatitis and thyroid cancer (thyroid tumors) 1 6.

If you’re taking Ozempic and struggling with constipation (or other GI side effects), there are many natural strategies for getting things moving in the right direction, so let’s discuss. 

Resolving Ozempic Constipation & Other Side Effects

Normal, healthy bowel movements are key for ridding the body of toxins. But they’re also important for quality of life—if you’ve ever experienced a bout of constipation, you know what I mean, it can be miserable. While it’s one of the less common complaints of patients taking Ozempic, constipation still may impact 12% of users 6. The great news here is we don’t have to just tough it out, there are a lot of natural options for managing Ozempic constipation.

Nutrition for Ozempic Constipation

I’m a food-first clinician, which means I believe diet is one of the most impactful ways to improve overall health and quality of life. So, it’s not surprising that a healthy, balanced diet is a foundational tool for preventing and treating Ozempic constipation 7. There isn’t a one-size-fits-all diet, but here are some general tips to consider when planning your meal pattern 7:

  • Consider opting for whole, unprocessed foods over ultra-processed ones (the Mediterranean or Paleo meal plans are great examples)
  • Experiment with adding more dietary fiber from fruits, vegetables, whole grains, and beans
  • Cook food well
  • Limit cheese or other foods that may tend to cause constipation
  • Incorporate more foods that have high water content, like soups, fruits, and vegetables
  • Avoid concentrated sweets
  • Limit dressings and spicy foods if they cause symptoms

If you’re not sure which foods constipate you, you can always keep a food journal for a week or so to track your symptoms—this is a great way to pinpoint any foods that may cause symptoms outside of constipation as well 7. 

What we eat is important for constipation, but how we eat also matters. The process of digestion is extremely complex with a lot of moving parts—if we tend to grab food on the go or eat mindlessly in front of the TV, we may be more likely to experience constipation. 

I encourage my clients to prepare their bodies to accept and digest food well by practicing a few minutes of deep breathing before meals. When it’s time to enjoy food, avoid distractions, consider choosing smaller portions, eat more slowly, and chew thoroughly. 

I also encourage my clients to pay careful attention to how they’re feeling and to stop eating when they’re full 7. And instead of lying down or sitting after meals, consider some physical activity—a brisk walk can help improve post-meal blood sugar and also reduce bloating 8 9. 

Along with eating wholesome foods and creating a digestion-friendly meal environment, it’s important to focus on hydration. When we’re not hydrated, it’s more difficult for stool to move smoothly through our digestive tract. A good rule of thumb is to drink about 70–105 ounces  (9–13 cups) of water per day, depending on body weight, activity, and age 10. And consider avoiding straws when drinking as they can introduce air into the GI tract and lead to constipation 7. 

Exercise for Ozempic Constipation

We’ve already seen that walking after meals can improve bloating, but exercise, in general, may help to improve the symptoms of constipation. In a 2019 meta-analysis, people with constipation who exercised aerobically had improved constipation symptoms, along with better quality of life and well-being 11. Additionally, a 2020 systematic review showed exercise improved constipation related to hormonal issues 12. 

While a brisk walk after meals is probably helpful, it may be best to avoid intense exercise right after eating to avoid constipation 7.

Additional Natural Therapies for Ozempic Constipation

Nutrition and exercise are foundational for preventing and resolving constipation, but additional supportive measures like reducing stress and adding in some supplements can also aid in regulating bowel movements.

Stress Management for Constipation

Unmanaged stress is a known trigger for irritable bowel syndrome symptoms like constipation 13 14 15 16 17 18 19. While we can’t eliminate all of our stress, there are many natural strategies we can use to mitigate it.

I’m a huge fan of spending time outdoors in nature, and research supports this practice for managing stress and improving mood. Taking a 20-minute walk outside without sunscreen is a great way to boost vitamin D levels, capitalize on the stress-relieving benefits of nature, and promote healthy digestion 20 21 22 23 24 25 26 27. 

Additionally, even 5 minutes of mindfulness meditation or breathing exercises 28 29 and three yoga sessions a week are also very effective 17 30.

Supplements for Constipation

When it comes to supplements for constipation, probiotics have a lot of research supporting their use.   

High-quality clinical trials show that probiotics improve IBS symptoms, including bloating, abdominal pain, gas, diarrhea, and constipation 31 32 33 34 35 36 37. Research also shows that the beneficial bacteria in probiotic supplements help improve constipation by:

  • Significantly improving stool frequency 38 39 40
  • Increasing intestinal transit time 38 39 40
  • Improving stool consistency 39
  • Reducing bloat 39
  • Improving quality of life of 41

In addition to probiotics, psyllium (a soluble fiber supplement) may be helpful for Ozempic constipation. Research suggests psyllium improves constipation and global IBS symptoms 42 43 44 45. I encourage my clients to pay close attention to their symptoms, as fiber can trigger bloating, gas, and stomach pain in some people 42. 

And finally, digestive enzymes improve constipation. In a 2018 randomized controlled trial, digestive enzymes doubled the amount of bowel movements, improved stool consistency, and reduced IBS-like abdominal discomfort in people with moderate constipation 46.

You’ve probably noticed that the strategies to improve Ozempic constipation are also foundational strategies for better gut and overall health. I would be remiss if I didn’t point out that creating a healthy foundation that addresses nutrition and lifestyle can be very effective for blood sugar and weight control—and these strategies rarely have side effects. I’m not anti-medication, and I’m not recommending that anyone discontinue a medication prescribed by their healthcare provider—my hope is to provide a road map to better health that may also potentially reduce your need for medication.  

Building a Foundation for Better Health

If you’re taking Ozempic or considering taking it to help with weight management, you may want to reflect on your current nutrition and lifestyle habits. If you feel they could use some work, here are some science-backed tips for helping you reach your weight loss goals. 

Nutrition for Weight Loss

Again, there’s no one perfect diet for everyone—the key is to find what works best for your body. High-quality research has found whole-food diets like Paleo, ketogenic, and Mediterranean (when combined with exercise) to induce significant weight loss 47 48 49 50 51 52.

These diets all have one thing in common—they focus on whole, unprocessed foods. Choosing whole foods can significantly increase the amount of calories burned during digestion when compared to processed foods 53. And incorporating intermittent fasting may also support healthy weight loss 54 55 56 57 58 59 60 61 62.

Whichever dietary pattern you choose, consider prioritizing protein. 

Higher-protein diets (15–25% of calories from protein) appear to increase the metabolic rate and promote muscle growth, which can help with weight and body fat loss. This doesn’t appear to be the case for lower-protein diets (about 5% of calories from protein) 63 64 65 66 67 68.

Exercise for Weight Loss

Exercise tends to build and maintain lean body mass—the higher amount of lean body mass, the higher the resting metabolic rate and the more calories burned 69. 

As with diet, there’s not a perfect exercise prescription—pay attention to what works for your body. Recent evidence suggests that resistance training, about 3 days per week, can raise the metabolic rate 70. 

I’m a supporter of balance, so I encourage my clients to create a well-rounded exercise routine that includes both cardiovascular and resistance training exercises and as much walking as possible. 

Lifestyle for Weight Loss

We probably hear the most about diet and exercise when it comes to weight loss. But restful sleep, stress management, and building a supportive community are equally important for weight loss success. Here’s a table with some tips for creating a healthy foundation in these areas:

Lifestyle Strategy Tips for Success
Restful Sleep
  • Set a bedtime routine and a consistent bedtime and waking time 71
  • Avoid all-nighters and shift work if possible 72
  • Try to eat dinner at least two hours before bedtime
  • Avoid bright lights and screen use for at least two hours before bed 73
  • Modify the bedroom environment (temperature, lights, sounds) to support good sleep 74
  • Address breathing problems, like mouth breathing, snoring, sleep apnea, or allergies, by consulting with a medical professional 75 76 77
  • Exercise regularly, but avoid vigorous exercise close to bedtime 78
  • Try taking melatonin to help you fall asleep quickly, and try probiotics for general sleep support 79 80 81 82 83 84 85
Stress Management
Community
  • Create and nurture healthy relationships 87 88 89 90
  • Get involved with people who have common interests
  • Learn a new activity with family or friends 91 92
  • Volunteer at a local food bank or pet shelter 93 94 95
  • Join a hiking or walking group 96 97

Combat Ozempic Constipation with Natural Strategies

Ozempic and other semaglutide drugs are in the spotlight for their blood sugar and weight management benefits. But as with most medications, they can come with side effects like constipation, nausea, and diarrhea. The good news is it’s possible to mitigate many of these side effects by using natural strategies.

A wholesome meal plan (with adequate fluid) and routine exercise lay the foundation for preventing and mitigating Ozempic constipation (and other side effects). If these don’t provide significant relief, it’s worth it to consider layering in a daily stress management technique and supplements like probiotics, fiber, and digestive enzymes. If Ozempic constipation continues despite employing these, it’s best to seek medical advice from your healthcare professional.

To learn more about healing gut-related side effects, check out my book, Healthy Gut, Healthy You for a step-by-step guide. If you’d like a more tailored approach, contact us for an appointment at the Ruscio Institute for Functional Health.

The Ruscio Institute has developed a range of high-quality formulations to help our clients and audience. If you’re interested in learning more about these products, please click here. Note that there are many other options available, and we encourage you to research which products may be right for you. The information on DrRuscio.com is for educational purposes only and is not a substitute for professional medical advice or treatment.

Dr. Michael Ruscio is a DC, natural health provider, researcher, and clinician. He serves as an Adjunct Professor at the University of Bridgeport and has published numerous papers in scientific journals as well as the book Healthy Gut, Healthy You. He also founded the Ruscio Institute of Functional Health, where he helps patients with a wide range of GI conditions and serves as the Head of Research.

➕ References

  1. Semaglutide Injection: MedlinePlus Drug Information [Internet]. [cited 2024 Mar 19]. Available from: https://medlineplus.gov/druginfo/meds/a618008.html
  2. Mahapatra MK, Karuppasamy M, Sahoo BM. Semaglutide, a glucagon like peptide-1 receptor agonist with cardiovascular benefits for management of type 2 diabetes. Rev Endocr Metab Disord. 2022 Jun;23(3):521–39. DOI: 10.1007/s11154-021-09699-1. PMID: 34993760. PMCID: PMC8736331.
  3. Yao H, Zhang A, Li D, Wu Y, Wang C-Z, Wan J-Y, et al. Comparative effectiveness of GLP-1 receptor agonists on glycaemic control, body weight, and lipid profile for type 2 diabetes: systematic review and network meta-analysis. BMJ. 2024 Jan 29;384:e076410. DOI: 10.1136/bmj-2023-076410. PMID: 38286487. PMCID: PMC10823535.
  4. Smits MM, Van Raalte DH. Safety of Semaglutide. Front Endocrinol (Lausanne). 2021 Jul 7;12:645563. DOI: 10.3389/fendo.2021.645563. PMID: 34305810. PMCID: PMC8294388.
  5. https://rsc.niaid.nih.gov/sites/default/files/1.14.2.2-package-insert-ozempic.pdf [Internet]. [cited 2024 Mar 19]. Available from: https://rsc.niaid.nih.gov/sites/default/files/1.14.2.2-package-insert-ozempic.pdf
  6. Shu Y, He X, Wu P, Liu Y, Ding Y, Zhang Q. Gastrointestinal adverse events associated with semaglutide: A pharmacovigilance study based on FDA adverse event reporting system. Front Public Health. 2022 Oct 20;10:996179. DOI: 10.3389/fpubh.2022.996179. PMID: 36339230. PMCID: PMC9631444.
  7. Gorgojo-Martínez JJ, Mezquita-Raya P, Carretero-Gómez J, Castro A, Cebrián-Cuenca A, de Torres-Sánchez A, et al. Clinical Recommendations to Manage Gastrointestinal Adverse Events in Patients Treated with Glp-1 Receptor Agonists: A Multidisciplinary Expert Consensus. J Clin Med. 2022 Dec 24;12(1). DOI: 10.3390/jcm12010145. PMID: 36614945. PMCID: PMC9821052.
  8. Bellini A, Nicolò A, Bazzucchi I, Sacchetti M. The Effects of Postprandial Walking on the Glucose Response after Meals with Different Characteristics. Nutrients. 2022 Mar 4;14(5). DOI: 10.3390/nu14051080. PMID: 35268055. PMCID: PMC8912639.
  9. Hosseini-Asl MK, Taherifard E, Mousavi MR. The effect of a short-term physical activity after meals on gastrointestinal symptoms in individuals with functional abdominal bloating: a randomized clinical trial. Gastroenterol Hepatol Bed Bench. 2021;14(1):59–66. PMID: 33868611. PMCID: PMC8035544.
  10. Institute of Medicine, editor. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, D.C.: National Academies Press; 2005. DOI: 10.17226/10925.
  11. Gao R, Tao Y, Zhou C, Li J, Wang X, Chen L, et al. Exercise therapy in patients with constipation: a systematic review and meta-analysis of randomized controlled trials. Scand J Gastroenterol. 2019 Feb;54(2):169–77. DOI: 10.1080/00365521.2019.1568544. PMID: 30843436.
  12. Yesildere Saglam H, Orsal O. Effect of exercise on premenstrual symptoms: A systematic review. Complement Ther Med. 2020 Jan;48:102272. DOI: 10.1016/j.ctim.2019.102272. PMID: 31987230.
  13. Zhao S-R, Ni X-M, Zhang X-A, Tian H. Effect of cognitive behavior therapy combined with exercise intervention on the cognitive bias and coping styles of diarrhea-predominant irritable bowel syndrome patients. World J Clin Cases. 2019 Nov 6;7(21):3446–62. DOI: 10.12998/wjcc.v7.i21.3446. PMID: 31750328. PMCID: PMC6854400.
  14. Lackner JM, Jaccard J, Keefer L, Brenner DM, Firth RS, Gudleski GD, et al. Improvement in gastrointestinal symptoms after cognitive behavior therapy for refractory irritable bowel syndrome. Gastroenterology. 2018 Jul;155(1):47–57. DOI: 10.1053/j.gastro.2018.03.063. PMID: 29702118. PMCID: PMC6035059.
  15. Peters SL, Muir JG, Gibson PR. Review article: gut-directed hypnotherapy in the management of irritable bowel syndrome and inflammatory bowel disease. Aliment Pharmacol Ther. 2015 Jun;41(11):1104–15. DOI: 10.1111/apt.13202. PMID: 25858661.
  16. Miller V, Carruthers HR, Morris J, Hasan SS, Archbold S, Whorwell PJ. Hypnotherapy for irritable bowel syndrome: an audit of one thousand adult patients. Aliment Pharmacol Ther. 2015 May;41(9):844–55. DOI: 10.1111/apt.13145. PMID: 25736234.
  17. Kavuri V, Raghuram N, Malamud A, Selvan SR. Irritable bowel syndrome: yoga as remedial therapy. Evid Based Complement Alternat Med. 2015 May 6;2015:398156. DOI: 10.1155/2015/398156. PMID: 26064164. PMCID: PMC4438173.
  18. Shah K, Ramos-Garcia M, Bhavsar J, Lehrer P. Mind-body treatments of irritable bowel syndrome symptoms: An updated meta-analysis. Behav Res Ther. 2020 May;128:103462. DOI: 10.1016/j.brat.2019.103462. PMID: 32229334.
  19. Elbers J, Jaradeh S, Yeh AM, Golianu B. Wired for threat: clinical features of nervous system dysregulation in 80 children. Pediatr Neurol. 2018 Dec;89:39–48. DOI: 10.1016/j.pediatrneurol.2018.07.007. PMID: 30343833.
  20. Bray I, Reece R, Sinnett D, Martin F, Hayward R. Exploring the role of exposure to green and blue spaces in preventing anxiety and depression among young people aged 14-24 years living in urban settings: A systematic review and conceptual framework. Environ Res. 2022 Nov;214(Pt 4):114081. DOI: 10.1016/j.envres.2022.114081. PMID: 35973463.
  21. Shuda Q, Bougoulias ME, Kass R. Effect of nature exposure on perceived and physiologic stress: A systematic review. Complement Ther Med. 2020 Sep;53:102514. DOI: 10.1016/j.ctim.2020.102514. PMID: 33066853.
  22. Sudimac S, Sale V, Kühn S. How nature nurtures: Amygdala activity decreases as the result of a one-hour walk in nature. Mol Psychiatry. 2022 Nov;27(11):4446–52. DOI: 10.1038/s41380-022-01720-6. PMID: 36059042. PMCID: PMC9734043.
  23. Sudimac S, Kühn S. A one-hour walk in nature reduces amygdala activity in women, but not in men. Front Psychol. 2022 Sep 27;13:931905. DOI: 10.3389/fpsyg.2022.931905. PMID: 36248579. PMCID: PMC9556704.
  24. Roe J, Mondschein A, Neale C, Barnes L, Boukhechba M, Lopez S. The urban built environment, walking and mental health outcomes among older adults: A pilot study. Front Public Health. 2020 Sep 23;8:575946. DOI: 10.3389/fpubh.2020.575946. PMID: 33072714. PMCID: PMC7538636.
  25. Gong Y, Palmer S, Gallacher J, Marsden T, Fone D. A systematic review of the relationship between objective measurements of the urban environment and psychological distress. Environ Int. 2016 Nov;96:48–57. DOI: 10.1016/j.envint.2016.08.019. PMID: 27599349.
  26. Zhang Y, Wang M, Li J, Chang J, Lu H. Do greener urban streets provide better emotional experiences? an experimental study on chinese tourists. Int J Environ Res Public Health. 2022 Dec 16;19(24). DOI: 10.3390/ijerph192416918. PMID: 36554800. PMCID: PMC9779198.
  27. van den Berg MMHE, Maas J, Muller R, Braun A, Kaandorp W, van Lien R, et al. Autonomic nervous system responses to viewing green and built settings: differentiating between sympathetic and parasympathetic activity. Int J Environ Res Public Health. 2015 Dec 14;12(12):15860–74. DOI: 10.3390/ijerph121215026. PMID: 26694426. PMCID: PMC4690962.
  28. Balban MY, Neri E, Kogon MM, Weed L, Nouriani B, Jo B, et al. Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Rep Med. 2023 Jan 17;4(1):100895. DOI: 10.1016/j.xcrm.2022.100895. PMID: 36630953. PMCID: PMC9873947.
  29. Zamani M, Alizadeh-Tabari S, Zamani V. Systematic review with meta-analysis: the prevalence of anxiety and depression in patients with irritable bowel syndrome. Aliment Pharmacol Ther. 2019 Jul;50(2):132–43. DOI: 10.1111/apt.15325. PMID: 31157418.
  30. Shree Ganesh HR, Subramanya P, Rao M R, Udupa V. Role of yoga therapy in improving digestive health and quality of sleep in an elderly population: A randomized controlled trial. J Bodyw Mov Ther. 2021 Jul;27:692–7. DOI: 10.1016/j.jbmt.2021.04.012. PMID: 34391308.
  31. Ford AC, Quigley EMM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, et al. Efficacy of prebiotics, probiotics, and synbiotics in irritable bowel syndrome and chronic idiopathic constipation: systematic review and meta-analysis. Am J Gastroenterol. 2014 Oct;109(10):1547–61; quiz 1546, 1562. DOI: 10.1038/ajg.2014.202. PMID: 25070051.
  32. Yuan F, Ni H, Asche CV, Kim M, Walayat S, Ren J. Efficacy of Bifidobacterium infantis 35624 in patients with irritable bowel syndrome: a meta-analysis. Curr Med Res Opin. 2017 Jul;33(7):1191–7. DOI: 10.1080/03007995.2017.1292230. PMID: 28166427.
  33. Tiequn B, Guanqun C, Shuo Z. Therapeutic effects of Lactobacillus in treating irritable bowel syndrome: a meta-analysis. Intern Med. 2015;54(3):243–9. DOI: 10.2169/internalmedicine.54.2710. PMID: 25748731.
  34. McFarland LV, Dublin S. Meta-analysis of probiotics for the treatment of irritable bowel syndrome. World J Gastroenterol. 2008 May 7;14(17):2650–61. DOI: 10.3748/wjg.14.2650. PMID: 18461650. PMCID: PMC2709042.
  35. Whelan K. Probiotics and prebiotics in the management of irritable bowel syndrome:  a review of recent clinical trials and systematic reviews. Curr Opin Clin Nutr Metab Care. 2011 Nov;14(6):581–7. DOI: 10.1097/MCO.0b013e32834b8082. PMID: 21892075.
  36. Ishaque SM, Khosruzzaman SM, Ahmed DS, Sah MP. A randomized placebo-controlled clinical trial of a multi-strain probiotic formulation (Bio-Kult®) in the management of diarrhea-predominant irritable bowel syndrome. BMC Gastroenterol. 2018 May 25;18(1):71. DOI: 10.1186/s12876-018-0788-9. PMID: 29801486. PMCID: PMC5970461.
  37. Sun Y-Y, Li M, Li Y-Y, Li L-X, Zhai W-Z, Wang P, et al. The effect of Clostridium butyricum on symptoms and fecal microbiota in diarrhea-dominant irritable bowel syndrome: a randomized, double-blind, placebo-controlled trial. Sci Rep. 2018 Feb 14;8(1):2964. DOI: 10.1038/s41598-018-21241-z. PMID: 29445178. PMCID: PMC5813237.
  38. Wen Y, Li J, Long Q, Yue C-C, He B, Tang X-G. The efficacy and safety of probiotics for patients with constipation-predominant irritable bowel syndrome: A systematic review and meta-analysis based on seventeen randomized controlled trials. Int J Surg. 2020 Jul;79:111–9. DOI: 10.1016/j.ijsu.2020.04.063. PMID: 32387213.
  39. Zhang C, Jiang J, Tian F, Zhao J, Zhang H, Zhai Q, et al. Meta-analysis of randomized controlled trials of the effects of probiotics on functional constipation in adults. Clin Nutr. 2020 Oct;39(10):2960–9. DOI: 10.1016/j.clnu.2020.01.005. PMID: 32005532.
  40. Miller LE, Ouwehand AC, Ibarra A. Effects of probiotic-containing products on stool frequency and intestinal transit in constipated adults: systematic review and meta-analysis of randomized controlled trials. Ann Gastroenterol. 2017 Sep 21;30(6):629–39. DOI: 10.20524/aog.2017.0192. PMID: 29118557. PMCID: PMC5670282.
  41. Kommers MJ, Silva Rodrigues RA, Miyajima F, Zavala Zavala AA, Ultramari VRLM, Fett WCR, et al. Effects of Probiotic Use on Quality of Life and Physical Activity in Constipated Female University Students: A Randomized, Double-Blind Placebo-Controlled Study. J Altern Complement Med. 2019 Dec;25(12):1163–71. DOI: 10.1089/acm.2019.0134. PMID: 31657615.
  42. El-Salhy M, Ystad SO, Mazzawi T, Gundersen D. Dietary fiber in irritable bowel syndrome (Review). Int J Mol Med. 2017 Sep;40(3):607–13. DOI: 10.3892/ijmm.2017.3072. PMID: 28731144. PMCID: PMC5548066.
  43. Moayyedi P, Quigley EMM, Lacy BE, Lembo AJ, Saito YA, Schiller LR, et al. The effect of fiber supplementation on irritable bowel syndrome: a systematic review and meta-analysis. Am J Gastroenterol. 2014 Sep;109(9):1367–74. DOI: 10.1038/ajg.2014.195. PMID: 25070054.
  44. Furnari M, de Bortoli N, Martinucci I, Bodini G, Revelli M, Marabotto E, et al. Optimal management of constipation associated with irritable bowel syndrome. Ther Clin Risk Manag. 2015 May 30;11:691–703. DOI: 10.2147/TCRM.S54298. PMID: 26028974. PMCID: PMC4425337.
  45. Bellini M, Gambaccini D, Salvadori S, Tosetti C, Urbano MT, Costa F, et al. Management of chronic constipation in general practice. Tech Coloproctol. 2014 Jun;18(6):543–9. DOI: 10.1007/s10151-013-1093-9. PMID: 24272606.
  46. Weir I, Shu Q, Wei N, Wei C, Zhu Y. Efficacy of actinidin-containing kiwifruit extract Zyactinase on constipation: a randomised double-blinded placebo-controlled clinical trial. Asia Pac J Clin Nutr. 2018;27(3):564–71. DOI: 10.6133/apjcn.122017.03. PMID: 29737803.
  47. Frączek B, Pięta A, Burda A, Mazur-Kurach P, Tyrała F. Paleolithic Diet-Effect on the Health Status and Performance of Athletes? Nutrients. 2021 Mar 21;13(3). DOI: 10.3390/nu13031019. PMID: 33801152. PMCID: PMC8004139.
  48. Muscogiuri G, El Ghoch M, Colao A, Hassapidou M, Yumuk V, Busetto L, et al. European Guidelines for Obesity Management in Adults with a Very Low-Calorie Ketogenic Diet: A Systematic Review and Meta-Analysis. Obes Facts. 2021 Apr 21;14(2):222–45. DOI: 10.1159/000515381. PMID: 33882506. PMCID: PMC8138199.
  49. Amini MR, Aminianfar A, Naghshi S, Larijani B, Esmaillzadeh A. The effect of ketogenic diet on body composition and anthropometric measures: A systematic review and meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2022;62(13):3644–57. DOI: 10.1080/10408398.2020.1867957. PMID: 33443451.
  50. Esposito K, Kastorini C-M, Panagiotakos DB, Giugliano D. Mediterranean diet and weight loss: meta-analysis of randomized controlled trials. Metab Syndr Relat Disord. 2011 Feb;9(1):1–12. DOI: 10.1089/met.2010.0031. PMID: 20973675.
  51. Huo R, Du T, Xu Y, Xu W, Chen X, Sun K, et al. Effects of Mediterranean-style diet on glycemic control, weight loss and cardiovascular risk factors among type 2 diabetes individuals: a meta-analysis. Eur J Clin Nutr. 2015 Nov;69(11):1200–8. DOI: 10.1038/ejcn.2014.243. PMID: 25369829.
  52. Ajala O, English P, Pinkney J. Systematic review and meta-analysis of different dietary approaches to the management of type 2 diabetes. Am J Clin Nutr. 2013 Mar;97(3):505–16. DOI: 10.3945/ajcn.112.042457. PMID: 23364002.
  53. Quatela A, Callister R, Patterson A, MacDonald-Wicks L. The Energy Content and Composition of Meals Consumed after an Overnight Fast and Their Effects on Diet Induced Thermogenesis: A Systematic Review, Meta-Analyses and Meta-Regressions. Nutrients. 2016 Oct 25;8(11). DOI: 10.3390/nu8110670. PMID: 27792142. PMCID: PMC5133058.
  54. Patikorn C, Roubal K, Veettil SK, Chandran V, Pham T, Lee YY, et al. Intermittent Fasting and Obesity-Related Health Outcomes: An Umbrella Review of Meta-analyses of Randomized Clinical Trials. JAMA Netw Open. 2021 Dec 1;4(12):e2139558. DOI: 10.1001/jamanetworkopen.2021.39558. PMID: 34919135. PMCID: PMC8683964.
  55. Gu L, Fu R, Hong J, Ni H, Yu K, Lou H. Effects of Intermittent Fasting in Human Compared to a Non-intervention Diet and Caloric Restriction: A Meta-Analysis of Randomized Controlled Trials. Front Nutr. 2022 May 2;9:871682. DOI: 10.3389/fnut.2022.871682. PMID: 35586738. PMCID: PMC9108547.
  56. Allaf M, Elghazaly H, Mohamed OG, Fareen MFK, Zaman S, Salmasi A-M, et al. Intermittent fasting for the prevention of cardiovascular disease. Cochrane Database Syst Rev. 2021 Jan 29;1(1):CD013496. DOI: 10.1002/14651858.CD013496.pub2. PMID: 33512717. PMCID: PMC8092432.
  57. Yang F, Liu C, Liu X, Pan X, Li X, Tian L, et al. Effect of Epidemic Intermittent Fasting on Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Nutr. 2021 Oct 18;8:669325. DOI: 10.3389/fnut.2021.669325. PMID: 34733872. PMCID: PMC8558421.
  58. Zhang Q, Zhang C, Wang H, Ma Z, Liu D, Guan X, et al. Intermittent Fasting versus Continuous Calorie Restriction: Which Is Better for Weight Loss? Nutrients. 2022 Apr 24;14(9). DOI: 10.3390/nu14091781. PMID: 35565749. PMCID: PMC9099935.
  59. Yuan X, Wang J, Yang S, Gao M, Cao L, Li X, et al. Effect of Intermittent Fasting Diet on Glucose and Lipid Metabolism and Insulin Resistance in Patients with Impaired Glucose and Lipid Metabolism: A Systematic Review and Meta-Analysis. Int J Endocrinol. 2022 Mar 24;2022:6999907. DOI: 10.1155/2022/6999907. PMID: 35371260. PMCID: PMC8970877.
  60. Wang X, Li Q, Liu Y, Jiang H, Chen W. Intermittent fasting versus continuous energy-restricted diet for patients with type 2 diabetes mellitus and metabolic syndrome for glycemic control: A systematic review and meta-analysis of randomized controlled trials. Diabetes Res Clin Pract. 2021 Sep;179:109003. DOI: 10.1016/j.diabres.2021.109003. PMID: 34391831.
  61. Schoenfeld BJ, Aragon AA, Krieger JW. Effects of meal frequency on weight loss and body composition: a meta-analysis. Nutr Rev. 2015 Feb;73(2):69–82. DOI: 10.1093/nutrit/nuu017. PMID: 26024494.
  62. Stockman M-C, Thomas D, Burke J, Apovian CM. Intermittent fasting: is the wait worth the weight? Curr Obes Rep. 2018 Jun;7(2):172–85. DOI: 10.1007/s13679-018-0308-9. PMID: 29700718. PMCID: PMC5959807.
  63. Vogtschmidt YD, Raben A, Faber I, de Wilde C, Lovegrove JA, Givens DI, et al. Is protein the forgotten ingredient: Effects of higher compared to lower protein diets on cardiometabolic risk factors. A systematic review and meta-analysis of randomised controlled trials. Atherosclerosis. 2021 Jul;328:124–35. DOI: 10.1016/j.atherosclerosis.2021.05.011. PMID: 34120735.
  64. Hansen TT, Astrup A, Sjödin A. Are Dietary Proteins the Key to Successful Body Weight Management? A Systematic Review and Meta-Analysis of Studies Assessing Body Weight Outcomes after Interventions with Increased Dietary Protein. Nutrients. 2021 Sep 14;13(9). DOI: 10.3390/nu13093193. PMID: 34579069. PMCID: PMC8468854.
  65. Clifton PM, Condo D, Keogh JB. Long term weight maintenance after advice to consume low carbohydrate, higher protein diets–a systematic review and meta analysis. Nutr Metab Cardiovasc Dis. 2014 Mar;24(3):224–35. DOI: 10.1016/j.numecd.2013.11.006. PMID: 24472635.
  66. Zhang Y, Chen X, Allison DB, Xun P. Efficacy and safety of a specific commercial high-protein meal-replacement product line in weight management: meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr. 2022;62(3):798–809. DOI: 10.1080/10408398.2020.1829539. PMID: 33938779.
  67. Bray GA, Bouchard C. The biology of human overfeeding: A systematic review. Obes Rev. 2020 Sep;21(9):e13040. DOI: 10.1111/obr.13040. PMID: 32515127.
  68. Bray GA, Smith SR, de Jonge L, Xie H, Rood J, Martin CK, et al. Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating: a randomized controlled trial. JAMA. 2012 Jan 4;307(1):47–55. DOI: 10.1001/jama.2011.1918. PMID: 22215165. PMCID: PMC3777747.
  69. Pontzer H, Yamada Y, Sagayama H, Ainslie PN, Andersen LF, Anderson LJ, et al. Daily energy expenditure through the human life course. Science. 2021 Aug 13;373(6556):808–12. DOI: 10.1126/science.abe5017. PMID: 34385400. PMCID: PMC8370708.
  70. MacKenzie-Shalders K, Kelly JT, So D, Coffey VG, Byrne NM. The effect of exercise interventions on resting metabolic rate: A systematic review and meta-analysis. J Sports Sci. 2020 Jul;38(14):1635–49. DOI: 10.1080/02640414.2020.1754716. PMID: 32397898.
  71. Makarem N, German CA, Zhang Z, Diaz KM, Palta P, Duncan DT, et al. Rest-Activity Rhythms Are Associated With Prevalent Cardiovascular Disease, Hypertension, Obesity, and Central Adiposity in a Nationally Representative Sample of US Adults. J Am Heart Assoc. 2024 Jan 2;13(1):e032073. DOI: 10.1161/JAHA.122.032073. PMID: 38156474. PMCID: PMC10863829.
  72. Liu Q, Shi J, Duan P, Liu B, Li T, Wang C, et al. Is shift work associated with a higher risk of overweight or obesity? A systematic review of observational studies with meta-analysis. Int J Epidemiol. 2018 Dec 1;47(6):1956–71. DOI: 10.1093/ije/dyy079. PMID: 29850840.
  73. Tähkämö L, Partonen T, Pesonen A-K. Systematic review of light exposure impact on human circadian rhythm. Chronobiol Int. 2019 Feb;36(2):151–70. DOI: 10.1080/07420528.2018.1527773. PMID: 30311830.
  74. Valham F, Sahlin C, Stenlund H, Franklin KA. Ambient temperature and obstructive sleep apnea: effects on sleep, sleep apnea, and morning alertness. Sleep. 2012 Apr 1;35(4):513–7. DOI: 10.5665/sleep.1736. PMID: 22467989. PMCID: PMC3296793.
  75. Ilea A, Timuș D, Höpken J, Andrei V, Băbțan A-M, Petrescu NB, et al. Oral appliance therapy in obstructive sleep apnea and snoring – systematic review and new directions of development. Cranio. 2021 Nov;39(6):472–83. DOI: 10.1080/08869634.2019.1673285. PMID: 31588866.
  76. Cavalcante-Leão BL, de Araujo CM, Ravazzi GC, Basso IB, Guariza-Filho O, Taveira KVM, et al. Effects of respiratory training on obstructive sleep apnea: systematic review and meta-analysis. Sleep Breath. 2022 Dec;26(4):1527–37. DOI: 10.1007/s11325-021-02536-4. PMID: 34850331.
  77. Zhang F, Tian Z, Shu Y, Zou B, Yao H, Li S, et al. Efficiency of oro-facial myofunctional therapy in treating obstructive sleep apnoea: A meta-analysis of observational studies. J Oral Rehabil. 2022 Jul;49(7):734–45. DOI: 10.1111/joor.13325. PMID: 35342989.
  78. Kelley GA, Kelley KS. Exercise and sleep: a systematic review of previous meta-analyses. J Evid Based Med. 2017 Feb;10(1):26–36. DOI: 10.1111/jebm.12236. PMID: 28276627. PMCID: PMC5527334.
  79. Ferracioli-Oda E, Qawasmi A, Bloch MH. Meta-analysis: melatonin for the treatment of primary sleep disorders. PLoS ONE. 2013 May 17;8(5):e63773. DOI: 10.1371/journal.pone.0063773. PMID: 23691095. PMCID: PMC3656905.
  80. Auld F, Maschauer EL, Morrison I, Skene DJ, Riha RL. Evidence for the efficacy of melatonin in the treatment of primary adult sleep disorders. Sleep Med Rev. 2017 Aug;34:10–22. DOI: 10.1016/j.smrv.2016.06.005. PMID: 28648359.
  81. McDonagh MS, Holmes R, Hsu F. Pharmacologic treatments for sleep disorders in children: A systematic review. J Child Neurol. 2019 Apr;34(5):237–47. DOI: 10.1177/0883073818821030. PMID: 30674203.
  82. Takada M, Nishida K, Gondo Y, Kikuchi-Hayakawa H, Ishikawa H, Suda K, et al. Beneficial effects of Lactobacillus casei strain Shirota on academic stress-induced sleep disturbance in healthy adults: a double-blind, randomised, placebo-controlled trial. Benef Microbes. 2017 Apr 26;8(2):153–62. DOI: 10.3920/BM2016.0150. PMID: 28443383.
  83. Marotta A, Sarno E, Del Casale A, Pane M, Mogna L, Amoruso A, et al. Effects of probiotics on cognitive reactivity, mood, and sleep quality. Front Psychiatry. 2019 Mar 27;10:164. DOI: 10.3389/fpsyt.2019.00164. PMID: 30971965. PMCID: PMC6445894.
  84. Romijn AR, Rucklidge JJ, Kuijer RG, Frampton C. A double-blind, randomized, placebo-controlled trial of Lactobacillus helveticus and Bifidobacterium longum for the symptoms of depression. Aust N Z J Psychiatry. 2017 Aug;51(8):810–21. DOI: 10.1177/0004867416686694. PMID: 28068788. PMCID: PMC5518919.
  85. Nakakita Y, Tsuchimoto N, Takata Y, Nakamura T. Effect of dietary heat-killed Lactobacillus brevis SBC8803 (SBL88TM) on sleep: a non-randomised, double blind, placebo-controlled, and crossover pilot study. Benef Microbes. 2016 Sep;7(4):501–9. DOI: 10.3920/BM2015.0118. PMID: 27013460.
  86. Househam AM, Peterson CT, Mills PJ, Chopra D. The effects of stress and meditation on the immune system, human microbiota, and epigenetics. Adv Mind Body Med. 2017;31(4):10–25. PMID: 29306937.
  87. Wang ML, Pbert L, Lemon SC. Influence of family, friend and coworker social support and social undermining on weight gain prevention among adults. Obesity (Silver Spring). 2014 Sep;22(9):1973–80. DOI: 10.1002/oby.20814. PMID: 24942930. PMCID: PMC4435839.
  88. Holt-Lunstad J. Why social relationships are important for physical health: A systems approach to understanding and modifying risk and protection. Annu Rev Psychol. 2018 Jan 4;69:437–58. DOI: 10.1146/annurev-psych-122216-011902. PMID: 29035688.
  89. Fernandez-Portero C, Amian JG, Alarcón D, Arenilla Villalba MJ, Sánchez-Medina JA. The Effect of Social Relationships on the Well-Being and Happiness of Older Adults Living Alone or with Relatives. Healthcare (Basel). 2023 Jan 11;11(2). DOI: 10.3390/healthcare11020222. PMID: 36673590. PMCID: PMC9858722.
  90. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010 Jul 27;7(7):e1000316. DOI: 10.1371/journal.pmed.1000316. PMID: 20668659. PMCID: PMC2910600.
  91. Leanos S, Kürüm E, Strickland-Hughes CM, Ditta AS, Nguyen G, Felix M, et al. The Impact of Learning Multiple Real-World Skills on Cognitive Abilities and Functional Independence in Healthy Older Adults. J Gerontol B Psychol Sci Soc Sci. 2023 Aug 2;78(8):1305–17. DOI: 10.1093/geronb/gbad053. PMID: 37171401. PMCID: PMC10394988.
  92. Soldevila-Domenech N, Forcano L, Vintró-Alcaraz C, Cuenca-Royo A, Pintó X, Jiménez-Murcia S, et al. Interplay between cognition and weight reduction in individuals following a Mediterranean Diet: Three-year follow-up of the PREDIMED-Plus trial. Clin Nutr. 2021 Sep;40(9):5221–37. DOI: 10.1016/j.clnu.2021.07.020. PMID: 34474192.
  93. Burr JA, Han SH, Tavares JL. Volunteering and cardiovascular disease risk: does helping others get “under the skin?”. Gerontologist. 2016 Oct;56(5):937–47. DOI: 10.1093/geront/gnv032. PMID: 26035902.
  94. Michalski CA, Diemert LM, Helliwell JF, Goel V, Rosella LC. Relationship between sense of community belonging and self-rated health across life stages. SSM Popul Health. 2020 Dec;12:100676. DOI: 10.1016/j.ssmph.2020.100676. PMID: 33134474. PMCID: PMC7585135.
  95. Yeung JWK, Zhang Z, Kim TY. Volunteering and health benefits in general adults: cumulative effects and forms. BMC Public Health. 2017 Jul 11;18(1):8. DOI: 10.1186/s12889-017-4561-8. PMID: 28693551. PMCID: PMC5504679.
  96. Hanson S, Jones A. Is there evidence that walking groups have health benefits? A systematic review and meta-analysis. Br J Sports Med. 2015 Jun;49(11):710–5. DOI: 10.1136/bjsports-2014-094157. PMID: 25601182. PMCID: PMC4453623.
  97. Schnall S, Harber KD, Stefanucci JK, Proffitt DR. Social support and the perception of geographical slant. J Exp Soc Psychol. 2008 Sep 1;44(5):1246–55. DOI: 10.1016/j.jesp.2008.04.011. PMID: 22389520. PMCID: PMC3291107.

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