A recent rise is sodium-loaded electrolyte supplements
There has been a recent rise in electrolyte supplements on the market and many of them containing a lot of sodium. One popular one is LMNT which I am seeing a rise of popularity in a few sports, one being CrossFit. My concern is around people who are doing a one hour CrossFit class a day and taking this supplement daily with has a gram of sodium in. Often times, I am sure this will be on top of an already high-salt diet in many cases. Looking on their website they have an article pushing back on the FDA's recommendation against limiting sodium where they (Rob Wolf) has attacked the recommendation and stated it is wrong. Even to the point that Salt intake isn't an issue for blood pressure or heart health. The article is here: https://science.drinklmnt.com/electrolytes/the-fdas-misguidance-on-sodium/?variant=16358367199266&_gl=1*3gd4ge*_gcl_au*MTg4MzM3MDUzMS4xNzIyNTI2OTgy*_ga*MTcwNDQzMzExMS4xNzIyNTI2OTgy*_ga_BKZV7MVXM7*MTcyNDIzMDI5MC4yLjEuMTcyNDIzMDQxMi41My4wLjA. I'm hoping you can apply some nuance here and pick apart his argument. Thanks, Lewys
Metabolically healthy - BMI out of range
All my blood work indicates I am metabolically healthy (lipids, A1C, thyroid, liver) and my doctor says I am well nourished. My BMI is under 17.5%. The Veterans Administration nutritionist said if I eat 1400-1600 calories. (I am currently eating 1700) I will slowly add weight and plateau at 45 kg. My weight is not increasing but I worry if I add calories from the wrong sources my lipids and liver will have issues. Adding good fats caused my lipids to be poor and adding carbs raised my triglycerides which the endocrinologist said caused liver fibrosis. My lipids and liver are great now so how does someone determine the balance between metabolic health and healthy BMI? Lisa
Managing familial hypercholesterolemia
Hi, I am a 26-year-old man, and hypercholesterolemia runs in my family. Despite weightlifting and cardio training paired with a mostly whole-food-plant-predominant diet my ldl and total cholesterol levels are always at the top of the accepted "healthy" range. What approaches or supplements could I consider to lower those levels in a better/optimal value?
Is resistance Training helpful in the Menopause?
I have always thought that any resistance and/or strength training was good for both health and managing potential side effects of menopause such as decreased bone density etc., but a strength trainer has recently told me that unless you are consistently increasing the weights you use, then simply using weights is not enough to make a difference- is this true and how can you make this form of exercise accessible to all if this is true and this would require a gym and specialist training?
#BoPo
I am following a lot of accounts that promote body diversity as I am doing research into body image. The health information is conflicting with many of the professionals in this space notably around the impact of being in a Larger and it's impact on overall health and mortality and also (and I know you've recently covered this) the detrimental impact of dieting on health markers. Where do you stand with this movement - is body size important If behaviours are 'healthy'
Caffeine metabolism + individual variation
I'm curious to know what the literature says about the variation in how different individuals respond to caffeine. Is it true that there is a genetic predisposition to caffeine metabolism? Some seem to be able to consume it with little impact while others, such as myself, can only handle small amounts. For example, if I want to have coffee, I need to drink decaf. While I am able to have caffeinated teas (black, oolong, green, and white), I have to be very conscious about the quantity I drink, whether I have eaten food, time of day, etc. Finally, are there any recommended strategies for (1) discovering one's unique caffeine metabolism and (2) mitigating "over-caffeination"? Thank you, Danny and Alan, for all the work you do here. So grateful for the resource of Sigma. - Jessica Schroeder
Game Changers / James Wilks JRE
Years ago when these first came out I kind of stubbornly brushed them both off (that is, the Doc and also James' grilling of Chris Kresser with the help of Avi Bitterman MD) and kept my blinders on. Since then, I've came to the conclusion that actually the research behind veganism is actually pretty robust and some of the 'cons' that bodybuilding circles commonly mention such as 'nutrient deficiencies' are very weak and easily addressed (both directly but also within the argument itself) Which brings me to my question: have you watched either of the documentary and/or the JRE episode, and if so, what are/were your thoughts? As mentioned above, I did a complete 180. Thank you - big fan! Cameron
Vitamin C and Low-Carb diets
A former guest Mike Sweeney RD, had an interesting recent interview on a Keto podcast: https://m.youtube.com/watch?v=8fGQ8mU3TGo The claim is at timestamp 46:20. It was interesting to hear a registered dietitian with such *ahem* different views, but I wanted to focus on one particularly interesting claim which I have dug into myself because I previously heard the same claim within the last year. You can listen above for his exact words but the basic claim is this: "Those on low carb diets require less vitamin C than those on high carb diets. This is because Vitamin C and Glucose have a shared transporter (GLUT#). The more carbohydrate in the diet, the more glucose, the more glucose, the higher the vitamin C requirement as they compete for the same transporter. On low-carb, there is less glucose, thus less competition for the transporter, thus a lower Vitamin C requirement." I have heard that this means the RDA for Vitamin C is "irrelevant" and "doesn't apply" to low carb dieters ..... I see a couple of significant problems: (1) Competition for the transporter would only be relevant if either Vitamin C or Glucose were sufficiently high in those areas where the transporters do their job. I believe in the case of hyperglycaemia, there can be an issue with Vitamin C uptake. But where is the evidence that high carbohydrate diets, of themselves result in sufficiently high levels of glucose to make competition for these transporter an issue that would affect Vitamin C requirements? (2) Why would cell requirements for Vitamin C be lower? Rummaging in "Nutrient Metabolism: Structures, Functions and Genes" (Martin Kohlmeier), carbohydrate metabolism does not seem to require Vitamin C. Maybe he is saying that although cell Vitamin C requirements are the same, because of high glucose levels, more vitamin C is needed to outcompete the glucose and reach the cells? It all sounds pretty sketchy so would love to hear you guys take it apart.
Do you have a podcast where the current most ideal diet for people look like based on the current understanding of nutrition
Listening to multiple experts, podcast, books etc. I don't know what to eat anymore. There are like pro's and cons for everything. Is there a podcast where the best foods to eat are described. So not just protein/carb/fat, but the actual most benefical foods. etc.
Omega 3 Index Baselines in Studies
In omega 3 supplementation studies it doesn't seem to be common practice to test the omega 3 index as a baseline measurement before supplementation. Why is this? How do we know if supplementation is beneficial if people do/do not have adequate levels? It seems to be intake is measured off food frequency questionnaires which can have issues, so why don't we use this marker as a standard?
Corporate Health Recommendations
With growing health awareness it becomes increasingly important for companies to offer a work environment that pro-actively promotes health (at the very least does not harm it). This is especially crucial as demographics in most industrialized nations require companies to address topics like health to stay competetive for top young talent. If you were to advise a company to establish solid workplace health fundamentals, the 80/20 of it if you will, what would you tell them? What are the crucial elements to have in place? Thanks and keep up the good work, gents!
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.
Homocysteine
In the alternative health space it is quite popular to say that Homocysteine is causal for atherosclerosis while ApoB/LDL-P is not. There are some studies showing association with Homocysteine but also that reducing Homocysteine does not reduce risk (but were trials long enough or happened at too late a stage to make a statistically significant difference? ). Would be interested to find out more about the current science on this.
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?
"Brain health" (dementia, Alzheimer's, etc.)
First of all, really love your series on diet heart studies - great idea to make a series, in order to for listeners to get an "overall" picture :) That said, I wonder where we are, diet-/nutrition-wise, regarding brain health, i.e., dementia (risk), cognition, etc.? There might be some signal in the noise regarding Omega-3, maybe cocoa/flavanols and others, but do we have a "status" here? Any significant evidence and/or possible mechanisms at play? Where should/could we, in your opinion, have a closer look maybe?
Maximum healthy BMI in lean individual
Sometimes I hear people write-off having a BMI of above 30 as the individual in question is lean and the BMI measurement doesn't take into account body composition. But, is there evidence to suggest any kind of upper limit, where even individuals with a 'healthy' composition would start experiencing worse outcomes?
What can we make of gut microbiome research?
Hello, Recently, gut microbiome research and its application in diet and lifestyle advice has been called into question due to stool samples lacking in their capability to represent the actual intestinal tract (https://www.nature.com/articles/s41586-023-05989-7). I'm now wondering what to believe of all the "science-backed" messages out in the dietetics/nutrition world about "eating to improve your microbiome" and its associations with disease. How do we interpret this new evidence - do we have to throw out previous research? Thanks :)
Dietary iron-absorption enhancers
Hi gents, love your work. Do we need Dietary iron-absorption enhancers? I commonly hear dietitians say that you must eat vit c with non-heme iron foods, or you must avoid eating non-heme iron foods with calcium, phytates etc. But....does this actually impact iron status? Thanks!! - Paul