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.
Danny takes a look at some of the criticisms that gets levelled at nutrition epidemiology. Are they fair or misguided?
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”.
The study made a huge splash due to the rarity in nutrition of having large RCTs with hard endpoints. In addition, it had results of a large magnitude; showing a 30% reduction in cardiovascular events.
Food frequency questionnaires (FFQs) have been widely employed in nutrition research to assess dietary intake patterns among study participants. However, debates surrounding the reliability of FFQs have persisted both inside and outside the academic community.
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.
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.
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.
Ask Me Anything (AMA) episode with Dr. Alan Flanagan, PhD.
Here we will discuss some of the common underlying neurochemical and metabolic responses to TBI, even though each instance of TBI is unique and affected people exhibit varied degrees of impairment, distinct areas of damage, and different recovery profiles. It may be possible to identify supporting nutritional therapeutic options for early intervention by recognising these recurring features.
The ‘exposure of interest’ refers to the variable or factor that is being studied to determine its relationship with a particular health outcome.
In this episode, Danny and Alan go through the most crucial aspects to understand about the exposure of interest in nutrition, hopefully leading to an enhanced understanding of interpreting nutrition research.
In this episode, clinical psychologist Dr. Nicole Lippman-Barile is on the podcast to discuss what we currently know about diet and depression, what issues exist with current studies, and why many nutrition-mental health studies are being incorrectly interpreted.
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 …
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.
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.
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.
In this ‘Ask Me Anything’ episode, Alan & Danny answer a range of listener questions. Topics include obesity rates, lowering blood pressure, cholesterol drugs, PCOS, and what issues they have changed their minds on.
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.
A recent study reported a higher risk of developing melanoma in people who ate a relatively high intake of fish. This study caused headlines and it was picked up by many outlets. In this episode, Alan and Danny dig into the nuances of this study to see if the headlines are justified.
In this episode Alan Flanagan discusses the concept of the GRADE system, and specifially how it applies to evaluating nutrition research and coming to conclusions for practice.
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?
What is a biobank? How are biobanks used in nutrition science? Dr. Niamh Aspell explains all with examples of research using biobank data.
One propsed intervention that has garnered a lot of excitement, owing to some interesting research, is the potential use of fasting to increase longevity and/or healthspan. Within this broad category, various different dietary interventions have been suggested, including various forms of intermittent fasting, time-restricted eating, dietary restriction of certain nutritients, calorie restriction or a “fasting-mimicking” diet.
But what does the current evidence tell us? Do the conclusions match the excitement? Which claims are grounded in solid science and which ones are pseudoscientific extrapolations?
The pathogenesis of obesity is clearly complex. And the need to have a comprehensive model to explain this pathogenesis is important. One such model, termed the Energy Balance Model, has largely been the consensus paradigm of obesity scientists to this point. However, there are others who propose that this is not the correct model of obesity, but rather that obesity pathogenesis can be better explained by a model called the Carbohydrate-Insulin Model (CIM) of obesity.
Dr. David Nunan, PhD is a Lecturer and Senior Research Fellow in the Centre for Evidence-Based Medicine at the University of Oxford. There, he is the Director of the Postgraduate Certificate in ‘Teaching Evidence-Based Health Care’ and the lead tutor for the internationally-renowned ‘Teaching Evidence-Based Medicine’ course.
He is a principal investigator with research interests in prevention and treatment of lifestyle-related conditions, improving the understanding and use of research evidence, and meta-epidemiology (research on research). David has experience in a breadth of methodologies including diagnostic studies, statistical analysis, qualitative research and clinical trials.
Bruce Neal is Executive Director at The George Institute for Global Health Australia; and Professor of Medicine, UNSW Sydney. Bruce has a longstanding interest in high blood pressure and diabetes and the potential for both clinical interventions and changes in the food supply to deliver health gains.
We discuss how machine learning could solve some current research limitations, as well as potential problems with its increased use.
Anthony Fardet, PhD is a nutrition science researcher in the Human Nutrition Unit at Université Clermont Auvergne, France.
His work has focused on a number of related areas; the consequences of the reductionist and holistic approaches applied to nutrition research, the relevance of a new classification of foods based on their degree of processing, and the role of the complex structure of the food in its health potential (“matrix effect”).
In this episode nutritionist Simon Hill discusses the barriers to eating a healthy diet, steps that can be taken to shift both individuals and the general population to a healthier dietary patten, and a number of other topics.
Dr. Mario Kratz is a clinical researcher in the areas of nutrition, obesity, and cardiometabolic disease, with more than 20 years of experience running clinical studies in a variety of populations. He is a former research associate professor at the University of Washington in the departments of Medicine and Epidemiology. And is also formerly an Associate Professor at the Fred Hutchinson Cancer Research Center in Washington state.
Prof. David Jacobs, PhD is Professor of Public Health, in the Division of Epidemiology and Community Health, at the University of Minnesota. He has published highly inflential work in nutritional epidemiology and health epidemiolgy for decades. A number of his papers have brought up crucially important ideas about how to do good nutrition science. Specifically, he has talked about think of whole diet or foods as the exposure of interest, rather than individual nutrients. Essentially warning against the pitfalls of applying a biomedical lens to nutrition research.
We take a look at three more “quacks” who spread misinformation; Dr. Michael Greger, Eric Berg, and Dr. Paul Saladino. We give reference to some specific examples.
To celebrate our 400th episode, we take a look at two “quacks” who spread misinformation; Dr. Aseem Malhotra and Dr. James DiNicolantonio. We give reference to some specific examples.
A common claim is that high intakes of omega-6 PUFA leads to inflammation, and subsequently heart disease. But is this correct?
Dr. Leigh Frame, PhD is Director of Integrative Medicine at George Washington School of Medicine and Health Sciences in Washington DC. Dr. Frame received her PhD in Human Nutrition, as well as a Master of Health Science degree in Molecular Microbiology and Immunology, from the Johns Hopkins Bloomberg School of Public Health.
In this episode Danny and Alan talk with Dr. Deirdre Tobias about nutrition epidemiology, study design and diet collection methods.
Guest BioBrenda Davy, PhD, RDN Dr. Davy, is a Professor in the Department of Human Nutrition, Foods and Exercise at Virginia Tech. She conducts research investigating the role of diet and physical activity behaviors in the prevention and treatment of obesity and related comorbidities, beverage consumption and weight management, and dietary assessment methodologies. Dr. Davy received a BS in Nutrition in 1989 and an MS in Exercise Physiology in 1992 from Virginia Tech, and a PhD degree in Nutrition from Colorado State University in 2001. Dr. Davy is a Fellow of the American College of Sports Medicine and The Obesity Society, …