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Practical Application Start with protein and vegetables: Activates L-cells early, triggers initial GLP-1 release Add healthy fats: Sustains L-cell activation, slows gastric emptying Include complex carbohydrates: Provides sustained nutrient flow to L-cells Finish with fruit (optional): Final fiber and polyphenol boost Protein source: 25-30 grams (palm-sized portion) Non-starchy vegetables: 2-3 cups (fiber and volume) Healthy fat: 1-2 tablespoons olive oil or avocado Complex carbohydrate: -1 cup quinoa, sweet potato, or legumes Example L-Cell Optimizing Meals: Breakfast: Greek yogurt with berries, ground flaxseed, chopped walnuts, and a drizzle of honey Lunch: Grilled chicken over mixed greens with chickpeas, avocado, and olive oil dressing Dinner: Baked salmon with roasted Brussels sprouts and quinoa, side of sauerkraut Advanced Strategy: Time-Restricted Feeding The Science: L-cells demonstrate circadian rhythms in their GLP-1 secretion capacity

Figure 12: Photograph Professor Vincent Marks (1930-2023), credit: Seaton)

Patients must accept that theyll be on the drug, or an alternative, for life

ShedRx: Advertises compounded semaglutide and tirzepatide with a stated 10% body weight loss guarantee within 9 months for eligible new users

Lancet 2009;373:108396