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Alcohol and glucose

When we talk about lifestyle factors in diabetes managing we don’t often include alcohol. Can drinking alcohol lead to compromised blood glucose management in the long term? Does alcohol affect beta cell function and/or insulin sensitivity?

Shifting perspectives

This is a two part question: 1) Are there any things that you've changed your mind about or had your position shift significantly on in the last year or two? Not even necessarily a reversal of position, but a significant change in credence on a topic would qualify. 2) Do you have any predictions about things you might change your mind about in the next year or two? Like, is there a perspective that you currently hold (and currently think is most likely), but where you expect certain evidence might emerge in the next year that would shift it significantly? Thanks as always for the amazing work you guys do.

Nutrition/Supplements for Joint Health

Are there are any nutrients or supplements with good/ strong evidence for improving joint health? Most I find seem to have only a neutral or small positive impact (despite some places making very big claims, which seem unfounded; like collagen for example, where the evidence on it doing anything seems weak?).

Recommended serves of fruit and vegetables

Around the world, there are different government recommendations for serves of fruit/veg per day. Australia recommends 2 fruit and 5 veg, yet less than 10% of the population achieve this. Is the target too high? What would happen if the target was reduced to something like the UK guidelines? What is the evidence around setting these guidelines to make sure that they are realistic enough for people to achieve them, without being so unrealistic that they discourage people from eating fruit/veg?

What is your assessment of the 2020 Hooper, et al review in Cochrane?

The systematic reviews done by Hooper, et al in Cochrane (in 2001, 2011, 2016 and then 2020) all report no association between modification or reduction of saturated fat intake with cardiovascular mortality, total mortality, non-fatal MI. The only significant effect reported was a relative risk reduction in combined cardiovascular events. Danny and Alan have frequently and strongly supported the idea that dietary replacement of saturated fat with PUFA and healthy carbs improves cardiovascular outcomes. But this Hooper study seems to consistently show that the only effect is on combined events. How should we - meaning non-experts - interpret these reviews, and can you point us to any other data that more strongly demonstrates a direct impact of saturated fat intake on cardiovascular risk outside of its impact on ApoB (the authors of the review specifically state increase in ApoB alone would not explain their findings for various outcomes). Thanks for all your great content. This podcast has changed my life.