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#511: Null By Design – When “No Effect” Doesn’t Mean No Effect

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Numerous nutrition studies present findings of “no effect,” but interpreting such results requires caution. A null finding, indicating an absence of impact from a nutrient or exposure, may not necessarily suggest a lack of effect overall. Instead, it could stem from issues related to the study’s design, the nature of the exposure, or participant characteristics.

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#510: Social Comparison: Evidence on its Impacts & What We Can Do – Shannon Beer

In Podcasts by Danny LennonLeave a Comment

Social comparison theory, developed by psychologist Leon Festinger in the 1950s, posits that individuals determine their own social and personal worth based on how they stack up against others. This theory suggests that people engage in social comparisons to evaluate their abilities, opinions, and attributes, often choosing relevant others for comparison.

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#508: Why Athletes Can Achieve High Performance During an Energy Deficit – Jose Areta, PhD

In Podcasts by Danny LennonLeave a Comment

Although severe energy deficiency can impair physical capacity, it’s noteworthy that humans can enhance aerobic fitness and strength even in the presence of significant energy deficits. Strikingly, many elite athletes compete at the highest levels despite displaying evident signs of energy deficiency. To discuss some potential reasons for this ability to maintain peak physical performance while suppressing energetically demanding physiological traits, researcher Dr. Jose Areta of LJMU is on the podcast to discuss his work in this area.

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#505: Oslo Diet-Heart Study: Cholesterol-lowering Diets & Cardiovascular Events

In Podcasts by Danny LennonLeave a Comment

The Oslo Diet-Heart Study was one of the earliest randomized controlled trials to explore the relationship between diet and heart disease. It aimed to investigate the impact of dietary interventions, specifically the reduction of saturated fat intake and an increase in polyunsaturated fat intake, on cardiovascular health.

The Oslo Diet-Heart Study involved 412 men who had already suffered a myocardial infarction 1-2 years before the start of the intervention.

Despite some known limitations, the Oslo Diet-Heart Study played a role in shaping early understanding on the relationship between dietary fat, cholesterol levels, and heart disease. Subsequent research and larger studies have contributed to a more nuanced understanding of the complex factors influencing cardiovascular health.

In this episode we discuss why this trial is important in the history of diet-heart research and how it connects to other seminal work in the field.

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#503: Lyon Diet Heart Study – Canola Oil, “Mediterranean” Diets & Minimizing Bias

In Podcasts by Danny LennonLeave a Comment

The Lyon Diet Heart Study is often cited as one of the pivotal studies that helped establish the Mediterranean diet as a recognized and recommended dietary pattern for cardiovascular health. It showed significant reduction in cardiac death could be achieved in secondary prevention patients using a dietary intervention. Here we dig into some of the deatils.

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#500 – The Big Unanswered Questions in Nutrition Science

In Podcasts by Danny LennonLeave a Comment

To mark the 500th episode of the podcast, Danny and Alan take a look at some of the current outstanding questions in nutrition science, what areas have largely been resolved, and how their own thinking has evolved and changed over time.
This brings them into areas such as personalized nutrition, ultra-processed foods, time-restricted eating, salt & health, and the difference between being “evidence-based” and “reference-based”.

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#498: The PROPEL Trial & Weight Loss Interventions in Primary Care – John Apolzan, PhD

In Podcasts by Danny LennonLeave a Comment

The PROPEL (Promoting Successful Weight Loss in Primary Care in Louisiana) trial was a cluster-randomized weight loss trial is specifically tailored to address the pressing health concerns of an underserved population in Louisiana, where obesity rates have reached alarming levels. In this episode we have the opportunity to delve deeper into the intricacies of the PROPEL trial and gain insights from one of its lead researchers, Dr. John Apolzan of the Pennington Biomedical Research Center.

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SNP21: Sick Individuals and Sick Populations

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In 1985 a paper titled “Sick Individuals and Sick Populations” was published in the International Journal of Epidemiology. In this episode, Danny and Alan discuss the central themes of the paper, why they are so crucial to understand, and what this means for our understanding of diet and chronic disease prevention.

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#496: ATBC Cancer Prevention Study – Crucial Lessons

In Podcasts by Danny LennonLeave a Comment

The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC) stands as a seminal and pioneering research endeavor within the domain of epidemiology and cancer prevention. Conducted in Finland, the study aimed to examine the potential protective effects of alpha-tocopherol (vitamin E) and beta-carotene supplementation against the occurrence of various cancer types, particularly lung cancer, among male smokers.

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#494: Multiple Risk Factor Intervention Trial

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The Multiple Risk Factor Intervention Trial (MRFIT) was a groundbreaking clinical trial conducted in the 1970s and 1980s. Its main objective was to investigate the relationship between various risk factors and the incidence of heart disease.

In this episode we take a look at why this is such seminal research, as well as the contribution of one of the greatest researchers ever in the field, Jeramiah Stamler.

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#493: The Keys Equation – How Dietary Fats Impact Blood Cholesterol

In Podcasts by Danny LennonLeave a Comment

One of the most important and influential papers in nutrition science is one by Ancel Keys and his colleagues that was published in The Lancet in 1957. This seminal paper examined the relationship between dietary fat intake and serum cholesterol levels. The most important aspect of this paper is the presentation of the ‘Keys Equation’; a predictive equation for the impacts of saturated, monounsaturated, and polyunsaturated fats, and dietary cholesterol, on blood cholesterol levels.

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SNP20: The Cumulative Exposure Model of LDL-C & Heart Disease

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It has been clearly demonstrated that elevated LDL-cholesterol (LDL-C), or perhaps more specifically pro-atherogenic lipoproteins, is causal in atherosclerosis development in humans. One crucial concept within this is that the risk relates not only to the magnitude of elevated LDL-C, but the duration of exposure. Thus, the role of LDL-C in driving atherosclerosis is referred to as a “cumulative, integrated exposure over the lifecourse”.

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#490: How Does Exercise Impact Beta-cell Function in Type 2 Diabetes? – Mark Lyngbæk, MD

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The management of type 2 diabetes has long been a challenge, but a new study conducted by researcher Mark Lyngbaek and his colleagues has the potential to add important considerations to the approach to treatment. Titled the “DOSE-EX” randomized clinical trial, their study uncovers the impact of exercise and weight loss on beta-cell function, a key factor in diabetes progression.

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#489: Inequalities in Diabetes Outcomes for African & Caribbean Communities – Prof. Louise Goff

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In the UK, there is a threefold higher incidence of type 2 diabetes in UK African and Caribbean (AfC) communities, compared to the general population. And ethnic inequalities in type 2 diabetes treatment and outcomes have been documented. Differences in outcomes relate to physiological differences as well as pragmatic issues and structural barriers. Professor Louise Goff has done pioneering work in relation to both aspects.

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#487: Weight Cutting in Combat Sports – Jordan Sullivan

In Podcasts by Danny Lennon2 Comments

To discuss the science, practical application and dangers of weight cutting strategies, performance dietitian Jordan Sullivan is on the podcast. Jordan has been the performance dietitian for several years to Israel Adesanya, Alexander Volkanovski, Leon Edwards, Dan Hooker, Kai Kara-France, and many other well-known names.

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#486: Blood Glucose Spikes: How High is Too High? – Mario Kratz, PhD & Nicola Guess, PhD

In Podcasts by Danny Lennon4 Comments

Introduction Peaks in blood glucose (or “blood sugar spikes”) are commonly highlighted as something harmful to health. And, of course, an excessively high blood glucose response to a meal can be problematic, or at least indicate there is a problem. However, elevations in blood glucose after eating are a normal physiological response. And “bad” blood glucose responses are those that stay high for a prolonged period; i.e. after elevating, they don’t return to normal within an appropriate period of time. But now many normoglycemic people are worrying about normal blood glucose responses, due to information that portrays even moderate elevations …

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#485: Does Menopause Alter Appetite?

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Menopause is commonly associated with hormonal changes and physical symptoms, such as hot flashes, mood changes, sleep issues, and weight gain. Based on anecdotal reports, another interesting question emerges: what is the potential impact of menopause on appetite?

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SNP18: What is a Healthy Low-Carb Diet?

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In this episode, Danny discusses what health outcomes may result from low-carb diets, and what distinguishes a “healthy low-carb diet” from an “unhealthy low-carb diet”. This includes some pragmatic tips for nutritionists, health professionals and consumers, who are choosing to use a low-carbohydrate diet.

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#484: Is Metabolic Adaptation an Illusion? – Eric Trexler, PhD

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Some people have framed metabolic adaptation as so significant that it makes weight loss attempts futile. While others, including in research, have referred to metabolic adaptation as an “illusion”. So what do we actually know about this concept and what is the pragmatic significance of it? To discuss the nuances of the topic, Alan and Danny are joined by Dr. Eric Trexler, who has published on this topic and has followed recent publications closely.

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#483: What are the Effects of Very High Fiber Intakes?

In Podcasts by Danny Lennon4 Comments

Most dietary guidelines recommend dietary patterns that provide adults with 30-35g of dietary fiber per day. However, what do we know about intakes beyond this? Do we continue to see benefit in a linear fashion? Is there a ceiling to benefit? At what level would we see “optimal” benefit or the greatest magnitude of risk reduction?

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#481: Why Saturated Fat Really Does Impact Heart Disease Risk

In Podcasts by Danny Lennon2 Comments

While it has long been acknowledged that high intakes of saturated can increase risk of atherosclerotic cardiovascular disease due to their impact on blood lipids, there are some who question the association between saturated fat and heart disease.

Specifically, they may state that the evidence for this association is weak or non-existant, typically by pointing to some commonly cited studies that show null associations between saturated fat and CVD outcomes.

On this basis, they may conclude that there is no basis to aim to limit saturated fat intake to current recommended levels or that reducing saturated fat intake will not actually improve health outcomes.

In this episode, Alan and Danny look at the four most commonly cited publications showing a null association, highlighting some key issues. Beyond that, they look at a number of other lines of evidence on saturated fat that allows one to come to a confident answer on this question.

So does reducing saturated fat intake to recommended levels actually reduce heart disease risk? Let’s discuss…

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SNP16: A Dairy Fat Paradox? – Saturated Fat, Food Matrices & Heart Disease

In Podcasts by Danny LennonLeave a Comment

Substantial evidence shows that a high intake of saturated fat in the diet has the potential to significantly raise LDL-C and ApoB-containing lipoproteins in many people, and in turn increase their risk of developing atherosclerotic cardiovascular disease (ASCVD).

However, people may raise what seems to some contradictory evidence, or what is sometimes thought of as a paradox: the impact of full-fat dairy on CVD risk.

This paradox arises because given the saturated fat content of full-fat milk, yogurt and cheese, we typically don’t see the same impact on blood lipid profiles. In addition, epidemiology can often show such foods in a favourable light. And the dairy fat story gets more interesting when we look at evidence showing there is a huge difference in the impact of consuming different dairy foods (e.g. butter vs cheese/yogurt).

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#477: Effect of Different Diets on Cholesterol, Lipoproteins and Discordance – Ian Davies, PhD

In Podcasts by Danny LennonLeave a Comment

Introduction Discordance between low-density lipoprotein particle (LDL-p) and low-density lipoprotein cholesterol (LDL-C) occurs when the levels of these two biomarkers do not match up as expected. Discordance between Apolipoprotein B (ApoB) and low-density lipoprotein cholesterol (LDL-C) is similar, except rather than counting just LDL particles, ApoB is a measure of the numbers of lipoproteins that have an ApoB attached. Discordance between ApoB and LDL-C can lead to either an underestimate or overestimate of ASCVD risk. And therefore there may be important implications for someone who does have discordance. Additionally, it is such cases that suggest that a measurement of ApoB …

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#475: Is Food Addiction Real? – Charlotte Hardman, PhD

In Podcasts by Danny LennonLeave a Comment

The concept of food addiction suggests that there may be a biological explanation for this behavior, and that certain foods may be especially “rewarding” to the brain, leading to a kind of addiction. In this podcast, we will explore the latest research on food addiction with Dr. Hardman. We will delve into the evidence for and against the idea of food addiction, as well as discuss the potential implications for public health and policy.

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#472: Compared To What? – Understanding Food Substitution Analysis & Adjustment Models

In Podcasts by Danny LennonLeave a Comment

Introduction When thinking about the effect of eating or not eating a certain food or nutrient, we can’t consider this in isolation. Meaning, we need to evaluate the impact within the context of what such an inclusion/exclusion does to an individual’s overall diet pattern. Thinking about this concept, the phrase “compared to what?” has been colloquially used. And while this is an important idea, there has been some misapplication of this principle. In nutrition science, this is related to the concept of food or nutrient “substitution”. And this concept is crucial to understanding the issues that can arise in nutrition …

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#469: Chrononutrition – New Findings & Updated Views

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Chrononutrition is a research area that looks at the relationship between temporal (time-related) eating patterns, circadian rhythms, and metabolic health. In this episode, we look at recent research (including that from the Big Breakfast Project) and how understanding and conclusions from the field have shifted over time.

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SNP12: The Big Breakfast Study

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In October 2022, Ruddick-Collins et al. published results of a RCT looking at the impact of different calorie distribution across the day. This study was one from the ‘Big Breakfast Study’ project. In this episode, Dr. Alan Flanagan discusses.

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#462: Gyorgy Scrinis, PhD – Ultra-Processed Foods, Nutritionism and Current Food Systems

In Podcasts by Danny Lennon4 Comments

Over the past decade, the increasing uptake and acceptance of the Nova food processing classification system has placed focus on one of the categories in Nova; ultra-processed foods (UPFs). Ultra-processed foods (UPFs) are products created from deconstructed (and recombined) food components, usually with the goal of creating a highly palatable, convenient, and profitable product. This typically means such products are high in nutrients of content (e.g. sugar, sodium, saturated fat, etc.). But in addition, they have other characteristics that may make them detrimental to health, particularly when they replace unprocessed or minimally processed foods in the diet. Dr. Gyorgy Scrinis, is on the podcast to discuss his work in the area.

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#461: Prof. Emma Boyland – How Food Marketing Impacts Eating Behaviour

In Podcasts by Danny Lennon2 Comments

What does the current evidence tell us about the exact effect of marketing on food choices? And beyond that, what strategies are likely to yield the best results in terms of mitigating the harms of food marketing on eating behaviour, particularly in children and adolescents? To help answer these questions, subject area expert Prof. Emma Boyland is on the podcast to discuss what is currently known.

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SNP11: The Death of Domain Expertise

In Podcasts by Danny Lennon2 Comments

Never before has there been greater access to information about nutrition and health. But never before has there been such a low barrier to being seen as an “expert”. There are large numbers of people getting information from, and basing their health decisions on, people who don’t have direct expertise in the field in which they are talking about. Moreover, some promote the lack of domain expertise as a feature, not a bug. They claim that those that were conventionally seen as domain experts are either brainwashed, lazy in their thinking, or outright corrupt. And the solution is instead to look to those with a fresh perspective that can illuminate us on the “truth”. In this episode, Alan and Danny discuss this “death of domain expertise”, how it plays out online, and its ramifications for people’s ability to get good information.

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#460: Dr. Priya Sumithran – Body Fat Regulation, Pros & Cons of Weight Loss Interventions, and GLP-1 Receptor Agonists

In Podcasts by Danny LennonLeave a Comment

In this episode, Dr. Priya Sumithran discusses this physiologic control of body mass, in addition to environmental and behavioural factors that make weight loss maintenance difficult. Dr. Sumithran also discusses what this means for setting weight loss targets, choosing the correct intervention, and looking to non-weight-centric approaches for certain individuals. We also discuss the evidence on GLP-1 receptor agonist drugs, such as Semaglutide, as a treatment for obesity.

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#459: Nicky Keay, MB BChir – Hormones & Healthspan: The Endocrine System Across the Life Course

In Podcasts by Danny LennonLeave a Comment

The endocrine system plays a central role in growth, development, metabolism, reproduction, and physical well-being throughout life. Hormones interact in complex networks, orchestrating a range of critical functions. Over the life course, we experience various changes in hormone levels, fluctuations, patterns, and actions. Additionally, lifestyle factors and disease processes can impact the levels and functions of hormones.

In this episode, Dr. Nicky Keay, a medical doctor with expertise in the field of exercise endocrinology, is on the podcast to discuss a variety of endocrine-related issues, including: hormone diurnal variation, bone health, amenorrhoea, HRT, perimenopause, and thinking about hormones and aging.

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SNP10: What Are Stable Isotopes? How Are Tracers Used in Nutrition Research?

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Stable isotopes have been used as tracers in human nutritional studies for many years. But what are they? Why do we use ‘tracers’ in nutrition studies? And what are some practical examples?

In this episode, Dr. Alan Flanagan explains what stable isotope tracers are, how they are used to answer nutrition science questions, and some examples that you may come across.

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#457: Austin Robinson, PhD – Salt Sensitive vs Salt Resistant, Impacts of Sodium on Health, & Racial Differences in Risk

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Introduction Hypertension (elevated blood pressure) is a condition that significantly increases the risk of several diseases and is a major cause of premature death worldwide. In the US, recent estimates suggest that about half of the adult population has hypertension. At a population level, high sodium intake is one of the main dietary risk factors. All population health guidelines recommend keeping sodium intake below certain levels. While, on average, blood pressure correlates with sodium intake, there is a wide range of responses on an individual level. People who see increasing sodium intake lead to increased blood pressure are termed “salt …

SNP8: “Calories In, Calories Out is Stupid” – Quack Asylum

In Podcasts by Danny Lennon4 Comments

One passionately debated concept is that of “calories-in, calories-out” (CICO). This is colloquial phrasing for how energy balance relates to bodily energy stores. And this gets translated as shorthand for indicating how energy balance influences gain/loss of body mass.

When looking at some of the commentary related to CICO, there are two opposing positions that are both incorrect. On one hand you have people who clearly focus too heavily on calories alone. But on the other you have people claiming that “CICO is wrong” and that looking at energy balance as the main driver of changes in body mass is misguided.

In this episode, we focus in on the latter of those positions, i.e. the claim that “CICO is a myth”, or “calories don’t matter” or “fat loss has nothing to do with CICO” or several other similar statements that we’ll look at one by one.

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#451: Potassium & Blood Pressure: Influence of Sex & Sodium

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It has been consistently shown in research that elevated dietary sodium consumption is associated with high blood pressure and an increased risk of cardiovascular disease. In addition, low levels of dietary potassium intake are associated with these same risks. However, there is some debate on how to characterize these relationships.

In a study published in European Heart Journal in July 2022, using data from the EPIC-Norfolk study, researchers attempted to answer whether the associations between potassium and both blood pressure and cardiovascular disease: 1) differ between men and women? and 2) depend on daily sodium intake.

In this episode Dr. Alan Flanagan and Danny Lennon discuss the details of this study and then link it to the overall evidence base and what this may mean for potassium (and sodium) intake considerations.

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#450: Megan Rossi, PhD, RD – Diet For a Healthy Gut: Diversity, Fiber Types & Gut Health Pseudoscience

In Podcasts by Danny LennonLeave a Comment

With the advances in understanding the importance of the gut (including its bacterial contents) for human health, much interest and attention has been placed on how to eat to promote positive ‘gut health’. This has led to many exciting research questions and labs doing fascinating work.

However, on the opposite side, it has led to a spike in opportunistic quacks to jump on the wave of enthusiasm and promote diets, supplements, testing kits and products that don’t reflect the current evidence base.

So what do we actually know? What aspects of diet should we focus on to improve gut health? For those with gut symptoms (bloating, pain, irritable bowel, etc.) is it possible to include more vegetables and fiber without the pain?

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#448: Prof. Norman Temple – Can Science Answer Diet-Health Questions?

In Podcasts by Danny Lennon4 Comments

While we’ve never known more about diet and health, there remain many unanswered questions in nutrition science. However, there is often disagreements on how best to answer these questions, particularly in relation to informing practical diet advise that meaningfully improves health.

Prof. Norman Temple is one academic who has written on a number of these issues. One issue he highlights is the large discrepency in the practical value we have attained from cohort studies and RCTs, relative to mechanistic research. Another is the limitations of RCTs for nutrition-specific research questions.

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#446: How Climate Change Impacts Nutrient Status

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Climate change has the potential to negatively impact the nutrient value of plants, soil organisms, food stuffs, via a variety of ways. Climate change puts food supplies at risk. Floods, droughts, more intense hurricanes, heatwaves and wildfires can drive down crop yields, destroy livestock, and interfere with the transport of food. And rising carbon dioxide levels from human activity can make staple crops like rice and wheat less nutritious.

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#444: Folate – Intake, Genetics & Health Outcomes

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Folate (also known as viatmin B9) actually relates to a collection of folates; both natural dietary folates and synthetic forms, primarily folic acid. This folate/folic acid that is consumed via the diet or supplementation is a precursor for the formation of tetrahydrofolate (THF), which is a carbon donor and acts a cofactor for a number of enzymes that play important roles in several processes. In this episode, Alan and Danny discuss the role of folate in the methlyation cycle, the impact of folate insufficiency/deficiency, genetics variatnts of the MTHFR gene (and other genes) that impact folate metabolism, and the impact of folate on health outcomes; including heart disease, birth defects, cancer, and brain health & cognition.

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#443: Kevin Klatt, PhD, RD – Can Choline Help Improve DHA Status?

In Podcasts by Danny LennonLeave a Comment

A recently published study by Klatt and colleagues examined the impact of choline supplementation alongside DHA supplementation, versus DHA supplementation alone, on DHA status in pregnancy. It is known that DHA is a critical nutrient at this time for healthy development of the child. And through a number of mechanisms discussed later, it has been hypothesized that choline could lead to greater DHA status.

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#442: Are Vegetables Detrimental to Health?

In Podcasts by Danny Lennon1 Comment

In this episode we address the idea that you shouldn’t eat vegetables, or that they aren’t beneficial. We will specifically look at a number of claims that relate to: 1) The claim that vegetables aren’t beneficial for health, or that there is no health benefit to high vegetable intake; 2) The claim that vegetables are actually detrimental to health, and their removal improves health.

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#441: Julie Abayomi, PhD, RD – Diet During Pregnancy

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In this episode, researcher and dietitian Dr. Julie Abayomi discusses important nutrients in pregnancy (e.g. iodine, DHA, and folic acid), as well as potentially problematic nutrients/foods (e.g. high-mercury fish and caffeine). In addition, she discusses the current debates about weight gain/loss during pregnancy, as well as what supports are needed for health professionals supporting pregnant women.

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#440: Are Dietary Guidelines Trying To Kill Us?

In Podcasts by Danny Lennon2 Comments

It has become common rhetoric for those promoting various types of diets to suggest that dietary guidelines published by government departments are at best, unhealthy, or at worst, causative in driving obesity and chronic disease in the population.

Often the claims is that following these guidelines actually harms health, rather than promote it. And the guidelines are simply a result of industry forces, long-standing bias, and shoddy science.

But do these claims hold up to scrutiny?

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SNP4: Detoxification Protocols (Quack Asylum)

In Podcasts by Danny LennonLeave a Comment

There have been many claims made about the benefits of a detoxification “protocol” or “plan”, based on specific dietary and supplemental regimens. Many of the arguments propose that many things we come into contact with are toxins and they can accumulate and compound in effect over time, causing a range of issues. Therefore, by removing these toxins (via a “detoxification protocol”), we can have better health.

And indeed it is well known that there are a large number of toxins in the environment, many of which can potentially be deleterious to health. And it also known that many nutrients are involed in processes of the body’s detoxification pathways.

However, is there any evidence that a detoxification diet, plan or “protocol” improves health? Is there any reason to suggest targeting certain nutrients or supplements leads to “better detoxification”? And do we need to avoid non-organic food, toothpaste and non-stick frying plans in avoid to avoid these toxins?

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#439: Prof. David Jenkins – Lipid-Lowering Diets

In Podcasts by Danny LennonLeave a Comment

Dr. David Jenkins and collegegues put forward the idea of a “portfolio” of specific nutrients/foods that could lower LDL-C further than the typical dietary changes. This became known as the Portfolio Diet. The four primary pillars of this portfolio diet are: soy protein, viscous fibers, nuts, and plant sterols.