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Issue #10 (August 2015)

From the Editor

Volume 1

Which of these two topics is more exciting?

  1. Nootropics are a class of supplements (or drugs, depending on who you ask) that could improve your memory, attention span, and a variety of other mental processes. You know, like Bradley Cooper in Limitless. That could be you … the world-beater you’ve always wanted to be.

  2. Water is essential to many bodily processes.

Yeah, so I stacked the deck. The first description is long, mentions a blockbuster movie and a People’s Sexiest Man Alive, and plays to your hopes and dreams. The second description is straight out of your fifth grade health textbook. That’s what marketing is like, though.

People ask us to cover their pet supplements all the time. And why not? Pet supplements are fun! (not literally supplements for their pets, I mean supplements that they really believe in and tell people about whether those people want to hear it or not). But nobody ever asks “Can you include more studies on water?”.

Therein lies the rub: important factors for health are old hat. Nobody wants to keep hearing about the importance of sleep and stress relief, and ways to optimize these factors, they want to hear about the new supplement that improved muscle protein synthesis by 320% over placebo. But we’ve already covered a randomized trial on water in NERD, which suggested that high water intakes might help a decent number of people improve their moods. Sure, the study wasn’t conducted exactly how we may have wanted, and thus you can’t be 100% sure how water is related to mood. But everyone has access to water, and drinking some more water each day is very unlikely to hurt you (other than that whole peeing a lot thing).

Now I have nothing against nootropics. They gave fictional Limitless guy powers that were beyond cool. Well, by way of a fictional nootropic. But how did fictional Limitless guy make all that money and gain all that power? He sat in a room and did work. He grinded it out, reading and reading and reading.

That’s how most successful people become successful, and that’s how ripped people get ripped. Not by trying every new supplement. Although an amazing number of ripped people work very hard and then attribute their ripped-a-tude to some supplement. I imagine not many of them are reading ERD though.

So if I was fictional Limitless guy, and the fictional nootropic stopped working and gave me nosebleeds instead, what would I do? I’d try to optimize the things that I already KNOW are important, rather than looking for the newest shortcut. The types of fatty acids you eat? Pretty important for cardiovascular health. The order of food you eat? Turns out it’s important for those with diabetes (as seen in this issue of ERD). And water … increased water intake will never be compared to nootropics in RCTs, but I’m not so sure water would lose. It’s much easier to beat up on placebos.

Kamal Patel,
Editor-in-chief, Nutrition Examination Research Digest

Volume 2

“What's in a name? That which we call a rose, by any other name would smell as sweet.”

The Bard was onto something there, and not just applying to love in difficult circumstances. During the last week, I’ve seen a few discussions on naming for diets and disease, and man oh man are people staunch in their views! Apparently, in all the years since 1592, we still haven’t collectively understood the dividing power of semantics.

The meaning of a given term can be very personal. Take, for example, the condition chronic fatigue syndrome (CFS) / myalgic encephalomyelitis (ME), which has recently acquired the moniker of systemic exertion intolerance disease (SEID). If you were a patient, would you feel comfortable telling people that you had chronic fatigue syndrome? Maybe not, since a common reply is “Have you tried improving your sleep hygiene?”. Some doctors secretly (or openly) believe it doesn’t exist, but it’s quite clear to a CFS/ME/SEID patient that it does. This condition doesn’t mean you’re a bit more tired than average. It can be life-altering.

Another great example comes from the dieting world: the famous/infamous helpful/dangerous proven/fad low-carb diet. It’s improved the health of many people while being scoffed at by many others. The literature on its efficacy is vast, with a rigorously conducted trial covered in this very issue of NERD. But, what exactly is a low-carb diet?

You’d think it would be obvious. There’s only one variable at play: carbs. “Low” is sometimes defined as under 100 grams. But lower than the typical American diet could be around 150 grams. Very low could be 50 grams. Do the foods you eat matter at all? If you eat 100 grams of Pixy Stix, but no other carbs, is that more of a low-carb diet than 120 grams of tubers and fruit?

A third example is the obviously-vaguely-defined “whole foods diet” or “unprocessed food diet.” Does that mean you only get your foods at that Austin-based powerhouse market? Coconut oil is processed, in that you can’t easily grab a coconut and squeeze out the oil. White potatoes aren’t processed except for the heat used to cook them, and they’re often eliminated in unprocessed diets. So there’s a carb component, a bias against white-fleshed plants, and a little person bias involved.

It’s easy to point out flaws in naming conventions. But naming is here to stay, partly because not everyone has the time and interest to do a ton of nutrition research on their own. If you’re a single mother of three balancing a couple jobs to provide for your family, you may have a bit less exposure to incisive health analysis, compared to a recent biology graduate crossfitter with no kids.

The point of all this isn’t that naming is stupid. It’s that precision is a worthy goal when you’re speaking or writing about health, but don’t act like a pompous ivory tower fool if someone asks “Is low-carb the same as paleo?”. It’s nice to be nice.

Kamal Patel,
Editor-in-chief, Nutrition Examination Research Digest

See other articles in Issue #10 (August 2015) of Study Deep Dives.