The Wellcast

The Wellcast Ep1: Four Minutes, Creatine and a GLP-1 Recall

2026-11-04

• Four minutes a day for older adults. In a Penn State randomized trial, 97 inactive adults aged 65 and older (average age 74) who had trouble walking did a 4-minute home workout every day for 12 weeks: 30 seconds each of push-ups, chair stands, band rows and step-ups. Compared with a wait-list group, they did about 4 more chair stands in 30 seconds, stood on one leg about 3.6 seconds longer, and were about 2.3 seconds faster on a five-times sit-to-stand test. They did the workout on 81% of days. The authors say it doesn't show that four minutes is enough for heart health or body composition.
• Creatine during injury and rehab. A review of six small placebo-controlled trials (118 young people, mean ages 15–24, limbs immobilised for one to two weeks) found creatine did not clearly prevent muscle loss while a limb was immobilised. In two trials, people taking creatine during resistance-based rehab regained more muscle size and strength. These were small studies in young people.
• A compounded tirzepatide recall. Apothecary Pharma LLC, a compounding pharmacy in Cary, North Carolina, voluntarily recalled its compounded Tirzepatide Injection, 18 mg/mL, 4 mL multi-dose vials (NDC 85091-001-18). The FDA lists the reason as "lack of assurance of sterility." The recall covers 22 vials in lots AP-202622 through AP-202644 (AP-202626 is not on the list), with beyond-use dates from 7 Oct to 26 Nov 2026, distributed nationwide. The firm started the recall on 24 Sep; the FDA classified it Class II on 8 Oct and posted it in its Enforcement Report on 14 Oct. It is still listed as ongoing. This is a compounded product from one pharmacy. It is not brand-name Zepbound or Mounjaro. Anyone with questions about their own vial can compare the pharmacy name and lot number with the FDA listing and ask their prescriber or pharmacy.
• [OPTIONAL] Ketone supplements for recovery. A review found 16 trials of ketone supplements after exercise and pooled seven of them. It found no significant effect on soreness, glycogen refill or a muscle-damage marker, and no consistent improvement in physical recovery. Most participants were physically active men.
• [OPTIONAL] Strength training and mood. A University of Limerick randomized trial of 55 young women (average age about 22) with high, sub-clinical anxiety compared eight weeks of twice-weekly strength training at 70–80% of one-rep max with a low-intensity comparison group that lifted at 20%. Depressive symptoms dropped in both groups and stayed down a month later; the difference between groups was not significant. Symptoms were self-reported.
• [OPTIONAL] WHO report on inequalities. On 20 Oct the World Health Organization released its first global "State of inequality" report on noncommunicable diseases. Among its findings: women are less likely to be sufficiently physically active, insufficient activity tends to rise with age, and unemployment is linked to higher levels of inactivity.

Sources

1. Brief daily functional strength training to improve functional performance in older adults with mobility disability: A randomized trial (PLOS One 21(3): e0336748, Public Library of Science (PLOS), 2026-03-12)
   https://doi.org/10.1371/journal.pone.0336748

   “Mobility disability is associated with functional decline in older adults. Resistance training (RT) improves mobility disability, but adherence to national RT guidelines is poor.”

2. Just 4 minutes a day can dramatically improve strength after 65 (ScienceDaily (Penn State release), 2026-10-21)
   https://www.sciencedaily.com/releases/2026/10/261020085025.htm

   “A daily strength training routine lasting just four minutes can significantly improve strength, balance, and mobility in older adults, according to new research led by Penn State College of Medicine. The findings suggest that maintaining physical independence with age may require much less exercise than many people assume.”

3. Effects of creatine supplementation on lean mass, muscle size and muscle performance during immobilisation and rehabilitation: A systematic review (Experimental Physiology, Wiley, for The Physiological Society, 2026-10-29)
   https://doi.org/10.1113/EP093965
4. FDA openFDA drug enforcement record D-0036-2027: Apothecary Pharma LLC, Tirzepatide Injection 18 mg/mL, 4 mL multi-dose vial (NDC 85091-001-18), Lack of Assurance of Sterility (openFDA drug enforcement (reason_for_recall), U.S. Food and Drug Administration, 2026-10-14)
   https://api.fda.gov/drug/enforcement.json?search=recall_number:%22D-0036-2027%22

   “Lack of Assurance of Sterility”

5. FDA Enforcement Report (search recall D-0036-2027) (U.S. Food and Drug Administration, 2026-10-14)
   https://www.accessdata.fda.gov/scripts/ires/
6. Effects of exogenous ketones on post-exercise recovery: A systematic review and meta-analysis (Journal of Sports Sciences, Taylor & Francis, 2026-10-29)
   https://doi.org/10.1080/02640414.2026.2750608

   “Exogenous ketone supplementation has gained attention as a potential strategy to enhance post-exercise recovery. This systematic review and exploratory meta-analysis evaluated its effects on recovery outcomes in adults.”

7. Resistance exercise training compared to a low-intensity sham for depressive symptoms in young women with analogue generalized anxiety disorder: A randomized controlled trial (Journal of Affective Disorders 413: 122228, Elsevier)
   https://doi.org/10.1016/j.jad.2026.122228
8. WHO report examines inequalities in noncommunicable diseases and their risk factors (World Health Organization, 2026-10-20)
   https://www.who.int/news/item/20-10-2026-who-report-examines-inequalities-in-noncommunicable-diseases-and-their-risk-factors

   “The State of inequality: noncommunicable diseases and their risk factors report published today by the World Health Organization (WHO) provides a global assessment of inequalities in noncommunicable diseases (NCDs) and their risk factors, examining differences between population groups within countries.”