TODAY'S AJENDA #64

Welcome to the GLP-1 era—a moment that’s been 20 years in the making. While the FDA first approved GLP-1s in 2005, 6% of Americans are now on medications like Ozempic, Wegovy, Mounjaro, and Zepbound, and 12% of US adults have tried a GLP-1—and that number keeps climbing. 

However, I’ve noticed that the guidance around GLP-1s can often feel pretty reductive: Eat less. Take your weekly shot. Lose weight. But that’s far from the full picture. 

On May 30, four major medical organizations published new guidelines on how to support people on GLP-1s, and they made one thing very clear: GLP-1s alone aren’t enough. 

The Full GLP-1 Picture

GLP-1s drive 5-18% weight loss in clinical trials, but they’re not without trade-offs. Potential side effects include nausea and vomiting, nutrient deficiencies, and muscle and bone loss. 

This is why doctors can’t simply prescribe a GLP-1 and send a patient off on autopilot.  Patients need comprehensive support and follow-up, and that’s exactly what these new guidelines emphasize. 

Their research found that patients who pair GLP-1 therapy with structured nutrition and behavioral support are more likely to be consistent with treatment, lose more weight, and actually maintain that weight loss after stopping medication. 

Sounds great! But what does this care look like? Let’s start with nutrition:  

Protein: The Biggest Part of The GLP-1 Puzzle

Here’s something most people don’t realize: When you lose weight, you’re losing a mix of fat and muscle. And for people taking GLP-1s, that muscle loss tends to be more pronounced. 

This is important because lean body mass is critical for long-term health, strength, metabolism, and aging well. So we need to be smart about how to minimize this risk.

The good news is you can mitigate it by lifting weights at least three times per week and eating enough protein. The bad news is that we still haven’t reached a consensus on how much protein is “enough” (you’d think we’d have solved this by 2025). 

• Here’s Why: The National Academy of Medicine's long-standing recommendation of 0.8 grams per kilogram of body weight was created to prevent disease rather than to optimize good health. 

So what should you aim for? Most clinicians now recommend 80-120 grams of protein per day, or about 16–24% of your total calories on a 2,000-calorie diet. 

But if I were your doctor? I’d recommend you divide your current body weight by 2.2, then multiply it by 1.6. That number gives you a solid target range to account for fluctuating calorie intake (which is super common on GLP-1s). 

Muscle Mass vs. Muscle Weight

We’ve covered preventing muscle loss. But the guidelines bring up another important piece of the puzzle—muscle health. There’s a big difference, because you can maintain muscle mass on paper but still get weaker and lose the ability to do everyday activities. 

Beyond Food and Exercise 

Here's where these guidelines get interesting—they emphasize that your physical health is deeply connected to everything else in life. That means paying attention to:

• Sleep Quality: Poor sleep messes with the hormones that control hunger, which can work against your GLP-1 medication. Aim for 7-9 hours of sleep every night. 

• Alcohol Intake: Not only will it mess with your sleep quality, but excessive drinking can increase the risk of GLP-1 side effects. 

• Stress Management: Chronic stress induces cortisol, which can increase cravings for high-calorie foods. Find ways to mitigate stress through yoga, therapy, meditation, or walks (without your phone).

• Social Support: This is where behavioral support comes in. Having people who understand your health journey makes you more likely to stick with it. Try to find accountability partners or support groups.  

This Takes Time, Attention, and Partnership 

The final message of these new guidelines is one I emphasize with Ajenda members, friends, and past patients every day: GLP-1 medications aren’t a magic bullet—they’re a tool. And like any tool, their effectiveness depends on how we use them.

That means adding nutritional monitoring, regular check-ins, and individualized adjustments as part of your treatment plan. Because the women who see the best long-term results? 

They treat their GLP-1 medication as one piece of a comprehensive health strategy, not the entire strategy itself.

That 3 PM energy crash despite having a salad for lunch? It’s not in your head. More often than not, the salad is to blame. Many are too small to keep you full, drenched in sugary dressings, and loaded with refined carbohydrates (*cough* croutons) that cause your energy to spike and then nosedive. 

The salads that fuel you have a trifecta of protein, fiber, and healthy fat. That’s why I built my Summer 2025 Super Salad around these pillars! With 25g of plant-forward protein (or you could use chicken or salmon too) and 12-14g of fiber, it’s nutrient-dense, puts clean fuel in my tank, and tastes great. 

Before you think this recipe is coming from some kitchen guru, let me tell you: I am not a good cook, nor do I even really enjoy cooking. But I love eating. 

Here’s the recipe (and why it works): 

The Summer Salad of 2025 Ingredients

• 4 oz firm tofu: A powerhouse of protein and calcium. Tofu also contains isoflavones, which may help modulate estrogen receptors (a big plus for women in menopause!). 

• 4 cups mixed greens: Kale and baby spinach = fiber, antioxidants, and indole-3-carbinol compounds that support estrogen metabolism. 

• ½ cup red cabbage (shredded): Red cabbage gets its purple hue from anthocyanins, an antioxidant linked to reduced inflammation and better brain function. 

• ½ cup shaved broccoli: Brimming with iron, calcium, and potassium. 

• ½ cup roasted sweet potato: A complex carb rich in potassium and beta carotene. Sweet potato gives staying power to a salad and keeps blood sugar more stable than refined grains.

• 1 Gala apple (thinly sliced): Has soluble fiber to feed the gut microbiome.

• 2 tbsp pickled onions: For a little tang, prebiotic fiber, and a flavor punch. 

• 1 tbsp crumbled feta cheese: A hit of calcium and protein.

• 1 tbsp pepitas + 1 tbsp sunflower seeds (optional): Healthy fats, magnesium, and zinc (all key for bone health and hormone function). 

• ¼ cup shelled edamame + ½ cup chickpeas (optional): More protein, fiber, and a steady source of phytonutrients that support heart health and blood sugar regulation.

Assembly: Toss all the ingredients together in a big bowl. No cooking, cutting, or oven required. As for the dressing? Mix 1½ tbsp olive oil with a squeeze of lemon juice before adding a pinch of salt and pepper.

As a doctor and nutritionist, I’d strongly recommend you use extra virgin olive oil (EVOO) in this recipe (and in all your other dishes!). EVOO is a great source of heart-healthy fats, vitamins, and polyphenols. 

That last one is key. Polyphenols are powerful antioxidants that have been shown in several studies to reduce inflammation and promote heart health. 

And right now, my go-to extra virgin olive oil is Brightland.* This woman-owned business is based in my birth state of California and creates high-quality and absolutely delicious extra virgin olive oil (and the packaging they use could seriously double as kitchen decor!). 

Honestly, this salad wouldn’t taste as good—or pack as much of a nutrient punch—without Brightland. I’ve been obsessed with their olive oils and use them in pretty much everything. 

I reached out to the Brightland team, and they were kind enough to offer a 15% discount for Ajenda subscribers. Use the code DRJASHTON at checkout!  

Shop energy-boosting olive oil today! 🫒

It’s not every day you find yourself writing about whether cow birth milk has health benefits for humans, but the wellness world always has something new up its sleeve. 🙃 Let’s chat bovine colostrum supplements, shall we? 

Wait, What’s Colostrum?

Colostrum is the first milk produced right after delivery. It’s packed with bioactive compounds to jumpstart a newborn’s immune system and gut. 

But the commercial supplements come from cows—they’re usually collected within 24-48 hours after calving. (My first thought here is that unless you’re a baby cow, you should not be consuming cow colostrum, but I digress.) 

Why Bovine Colostrum Specifically? 

Why not use human colostrum? Because it’d be both ethically questionable and logistically impossible. Human colostrum is produced in tiny amounts and is essential for newborns. 

Enter: bovine colostrum. Cows produce it in large quantities, and it's structurally similar enough to human colostrum to (potentially) provide some immune and gut-supporting benefits. It’s also rich in antibodies (especially IgG), growth factors, and anti-inflammatory compounds.

But what does the actual research show? 

The Bovine Colostrum Evidence 

1. Fewer Upper Respiratory Infections 

A handful of small clinical trials suggest bovine colostrum reduces upper respiratory infections: 

• A randomized control trial found that marathon runners taking bovine colostrum had fewer respiratory infections during training compared to placebo (Jones et al., 2016). 

• A meta-analysis discovered that regular exercisers taking the supplement had 44% fewer days with respiratory symptoms and 38% fewer respiratory infection episodes compared to placebo (Jones et al., 2016). 

On paper, it makes sense. Colostrum's high antibody content could neutralize pathogens at mucosal surfaces before they cause infection.

But whether this translates to real-world immune protection for everyday people remains open-ended. 

2. Improved Gut Health  

Gut health is where colostrum gets most of its wellness buzz. Here’s what a few short-term studies found: 

• A systematic review looked at 22 clinical trials, which showed that bovine colostrum reduced how often people had diarrhea (Hajihashemi et al., 2024). 

• A randomized trial showed that the supplement could help reduce gastrointestinal issues and maintain a healthy gut barrier in athletes (Dziewiecka et al., 2022).  

However! Most of these studies were short-term, used varied dosing, and lacked long-term safety data. More studies are needed. 

3. Metabolic and Anti-Aging Effects 

Some animal studies suggest IGF-1 (which promotes the growth of tissue and bones) and TGF-β (which can help heal wounds) in colostrum might support muscle repair or influence glucose metabolism. 

But that’s a far cry from proving benefits in humans. We need solid human trials showing clear metabolic or longevity benefits before we can back this up. 

Is There Any Harm in Taking Bovine Colostrum? 

Sure, the science might not be super compelling, but these supplements could be helpful. Is there any downside to just taking them anyway?

Generally, bovine colostrum supplements are safe. Some people report mild side effects like bloating or nausea, but they’re not serious. However, there’s one aspect that deserves closer attention: IGF-1. 

Colostrum contains insulin-like growth factor 1 (IGF-1), and elevated IGF-1 levels have been associated with increased risk of certain cancers in some studies. 

While no direct causal links have been established, this is worth considering if you have a personal or family history of hormone-sensitive cancers (like breast, prostate, or colorectal). 

And, of course, there’s the usual supplement wild west problem. Because colostrum products aren’t regulated by the FDA, what’s on the label might not match what’s on the bottle, and quality can vary dramatically between brands. 

My Bottom Line: 

Bovine colostrum isn’t useless. But it’s not a miracle either.

• For healthy adults ➜ Limited proven benefit. 

• For athletes under extreme training stress ➜ There's some evidence for gut protection and fewer respiratory infections during intense training periods.

• For people with specific GI disorders ➜ Possibly helpful, but discuss with a specialist.

• For anti-aging ➜ Save your money. There’s no meaningful evidence yet.

Here’s what I want you to remember: The fundamentals—basic nutrition, sleep, exercise, and stress management—move the needle far more than any other powder you’ll find on the supplement aisle. 

Thank you @kath_thomp for the question! To submit your own, go to my Instagram here. 

Did you enjoy Today’s Ajenda? It would mean the world if you left us a testimonial!

ABOUT DR. JEN

In her former roles as chief medical correspondent for ABC News and on-air cohost of “GMA3: What You Need to Know,” Dr. Jennifer Ashton—”Dr. Jen”—has shared the latest health news and information with millions of viewers nationwide. As an OB-GYN, nutritionist, and board-certified obesity medicine specialist, she is passionate about promoting optimal health for “the whole woman.” She has authored several books, including the national best-seller, The Self-Care Solution: A Year of Becoming Happier, Healthier & Fitter—One Month at a Time. And she has gone through menopause…

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