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Issue #11 (September 2015)

From the Editor

Volume 1

The paleo diet.

What’s your reaction to seeing that term? Isn’t it funny that a single adjective describing a diet can produce feelings ranging from vitriol to deep appreciation?

In case you didn’t know, the term “The Paleo Diet” is trademarked. That is neither inherently bad nor good, but it is interesting, especially because it produced some vitriol online when this was made public.

You see, paleo isn’t just on the magazine rack at your Whole Foods, and sometimes encompassing an entire section of the hot bar. Components of a paleo diet are touched on very frequently by important research, and often research that we cover in NERD. For example, in this issue we cover two paleo staples: gluten and fasting.

It’s been around ten years since I first heard of the paleo diet, and between now and then I’ve been in and out of the online “paleosphere”. The concept of ancestrally-influenced health practices intrigues me, but dogmatic adherence to a given diet isn’t my bag (and also isn’t well supported by research).

Paleo and the connotation of cavemen may be easy for some to ridicule, but if you don’t think that modern life (with its obliterated circadian rhythms, often crazy-long work days full of mental stress but devoid of varied physical activity, and freely available hyperpalatable foods of all kinds) could use a touch of ancestral influence, we’re just on different pages.

The paleo diet does very well in clinical trials — as good or better than most other diets. And eating a diet that has more identifiable plants and animals in it (and less junk food) is bound to be healthy. But there’s a story I like to tell that helps put the paleo diet and these results in perspective:

For several years, I worked at an Evidence-Based Practice Center, doing research on nutrition topics like vitamin D and fructose, as well as varied medical topics. A coworker of mine was from Nigeria, and loved to cook and eat Nigerian food. One day she finally asked “What do you think about the paleo diet?” Bum bum bum! Time to drop some evidence-based knowledge.

Well it turned out that it was a setup. No matter what fatty acids or prebiotics I talked about, she would reply that her people had been eating Nigerian food for a long time and have been quite healthy. And sometimes she ate sandwiches too, and I was crazy to mention hidden effects of gluten.

She had a good point. You don’t have to know the word “gluten” to eat healthy. There’s been some backlash against the concept of moderation, but there are indeed people who can control their intake of sweets and other unhealthy foods. Paleo doing well in trials doesn’t mean it’s the best diet. In fact, named/studied diets might not even be the best diets. And at the risk of sounding like a flower child, always hunting for optimal might not be optimal.

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

Volume 2

If you’ve haven’t seen the movie “Limitless”, you might want to see it. There are many, many males between the ages of 18-55 who are trying to figure out a way to be Bradley Cooper from this 2011 action-thriller fictionalization of a nootropic-like pharmaceutical.

By the way, what is it about males that make them want to conquer and dominate so? This may offend some ERD readers, but I sometimes laugh out loud at the grandiose gym rat quotes I see on the web: “The iron is life: it will never lie to you” … “Pain is just weakness leaving the body”. Give me a break. You’re lifting weights in order to lift more weights next time, not to help in defending your family or village. Looking good in the mirror and being healthier are great and all, but leave the drama for your mama.

Anyway, back to Limitless and nootropics. If we take a look at Google Trends for the term “Limitless Pill”, we see a spike when the movie came out in 2011, then another spike in the past year or two. What caused this spike? Well, I’d guess that it’s related to the rise of nootropics and other brain supplements. Body and mind hackers seek ways to be all that they can be, and more.

There is nothing inherently wrong with that. Just because most of these supplements aren’t found in nature doesn’t mean they’ll hurt you. True, there is a dearth of long-term evidence on most of them, but that’s also true of many things. Yet one very common argument against supplements applies even more so to brain supplements: do you really need them?

Just after Y2K, I first heard of nootropics. A little while later, I had a capping machine and a couple little canisters of powder. There was definitely some effect … I think. But I was also trying other things at the same time. Not just stacking supplements, but adding other health habits. I asked a friend of mine who was in medical school what his take was. He answered “Do you need these? Do you know how they work, if they work, and what long term side effects are?”. Hmmm … I had some juicy pubmed abstracts and nice-looking p-values. Is that enough?

Fast forward a decade and a half, and I still experiment with a variety of supplements and health habits. But a little older and a little wiser, I realize that something simple, like experimenting with sleep habits, is much more likely to be effective for brain boosting than one little brain supplement. Or even a synergistic combination of the best ones out there. I’ve also read enough studies to know that evidence is rarely quite what it appears in a pubmed abstract.

And on the flip side, I’ve actually met some people who are doing a decent job of being Limitless. They aren’t taking brain supplements or off-label pharmaceuticals though. Instead, these people are masters of their brains, able to make decisions that are best for them rather than procrastinating. How did they do it? It varies. In fact, it varies greatly. But it’s quite common for those looking for a quick fix to buy supplements, when in fact the hardest and most grinding course of action is the most rewarding. That message should look familiar -- we research nutrition and supplements for a living, and through that have realized the strengths and limitations of both. No matter what studies exist on a topic, there’s no shortcut for hard work.

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

See other articles in Issue #11 (September 2015) of Study Deep Dives.