Sources of depletion can include: Mitochondrial energy production (a normal and essential process, but creates harmful byproducts like ROS) Chronic infections, gut dysbiosis (including SIBO and Candida ), and ongoing inflammation Air pollution, heavy metals, and environmental toxins 17 Ultra-processed foods, sugar-sweetened beverages, and foods high in advanced glycation end products (heavily browned foods) 18 Pesticides and herbicides 19 Alcohol and smoking Psychological stress Even vigorous exercise (a healthy stressor that still creates oxidative byproducts) 20 Understanding this helps explain why simply eating well sometimes isnt enough, and why targeted nutritional strategies make a meaningful difference
New medications (like GLP-1 agonists) and bariatric surgery are safe, evidence-based options for select children, and can be life-changing when used correctly
Imaeda notes, and the true nonrespondersthose with less than 5% body weight lossare rare
Initially developed for type 2 diabetes, these agents are increasingly used for weight management, with landmark trials such as STEP and SELECT demonstrating double-digit weight loss and reduced risk of major cardiovascular events
I believe we need a clinical trial to determine if semaglutide significantly reduces the risk of arthrofibrosis returning after surgery, beginning treatment before surgery and continuing for three months post-op