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Issue #12 (October 2015)

From the Editor

Volume 1

Have you ever heard the term “Invisible Illness”?

If you’re a healthcare provider, you’ve probably had patients who appear to be content and well-functioning, but face significant problems that aren’t obvious to an observer. They may try to act normally in social situations, so that people don’t catch on to their health issues. Sort of like that Smokey Robinson song “Tears of a Clown” (when there’s no one around).

Many of the health conditions covered in ERD can be classified under the umbrella of “Invisible Illness”. ADHD can make working a problematic situation, but friends and family may not realize the extent of its impact. The same goes for depression and other mental health issues. Chronic pain is a classic invisible illness, which can make day-to-day life a struggle yet be totally unknown to bystanders.

While health issues often cluster together, invisible illnesses seem to cluster even more. One example is the high prevalence of fibromyalgia coupled with depression, which often manifests in middle-aged and older women (although not to the exclusion of younger women and males).

Studying conditions like these can be incredibly hard. They are sometimes difficult to define, with varying and mysterious causative factors. Most importantly, treatment can be hard or even seemingly impossible. And even if a study shows that a certain supplement helped fibromyalgia, there’s always a question of whether the study applies in real life, to a complex patient who doesn’t mirror those in the study. It’s not like a viral infection, where a treatment addresses the virus directly. Fibromyalgia can involve factors in the nervous and musculoskeletal systems, in addition to gut and immune factors.

But with a high degree of difficulty comes great reward! For conditions like heart disease and diabetes, there may be controversy about the best treatment approaches, but very good treatment approaches are known and have been extensively studied. For fibromyalgia, patients are often trying dozens of different treatments due to no one treatment being a home run in the bulk of patients. So when there’s a well-conducted trial on fibromyalgia treatments or mechanisms, it’s a really big deal.

The audience for ERD includes many dietitians, physicians, trainers, and gym rats. Which is great! But I want to give a special call-out to those information junkies who are trying to learn more about potential treatments for their own invisible illness. It’s a tough situation to be in, when physicians don’t know what more treatments they can offer you, and the onus is squarely on you to learn more about these often complex conditions.

So just know that you are not alone. There are many, many others who depend on accurate research to help them with their personal quests for combatting invisible illness.

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

Volume 2

Why are there so many studies on a few foods like whole wheat, red meat, and milk?

Well, one reason is obvious: these are commonly eaten foods. So it’s important for researchers to find out their health effects. But a second reason is equally important. A trial can only be done if researchers can get funding for it. And the food industry happens to have a vested interest in finding health benefits for foods that they sell.

So this sets up an interesting situation: there are many foods that have very little evidence, while there are certain foods (such as wheat) that have a tremendous amount of evidence. Americans, in general, eat a ridiculously small number of foods. Much of their fat intake is composed of soy and corn oil, and wheat and sugar contribute a ton of calories. This is largely a result of modern agriculture, which produces (sometimes artificially) cheap staple crops. Packaged foods are often just permutations of a cheap oil with wheat and sugar, or high fructose corn syrup.

This topic came up at a recent conference. The national conference for the US dietetic organization always has a mix of recent research and the latest attempts by food companies to sell, sell, sell. I always keep one eye on the study funding list, because while industry funding doesn’t at all invalidate a study, you’d be surprised how impactful it can (sometimes) be.

But perhaps more importantly, studies that aren’t on popular foods just don’t get much press or attention. And that’s a shame, because there are sooooooo many foods out there, most of which the average Joe or Jane off the street hasn’t eaten or even heard of. Tubers except for potatoes? Organ meats? Tropical fruits that aren’t pineapple/mango/banana?

Some may point out that plants and animals tend to be healthy foods, so we may not need to study each and every food out there. To that, I say good point, but also keep in mind the context of public health. Much of the world is getting sicker and sicker, overconsuming unhealthy foods while getting confused and angry at seemingly (but often not really) flip-flopping nutrition study results.

Sure, there will be studies showing pros and cons of wheat and milk, for as long as there will be studies. But continuing to focus the conversation on a few mass produced foods is probably masking some substantial benefits to be had from other foods. We’ve covered a few examples, such as a potential improvement in blood sugar control from eating mangos, but these don’t get as much media coverage as you’d think.

Humans can theoretically eat a wide variety of plants and animals. Complex and skillful collection of foods -- that’s part of what makes us fairly unique animals. I love my local grocery store, but I know that the comfort of getting the same old foods week in and week out may also be a double-edged sword. So next time you see an interesting herb/spice/fruit/veggie, maybe find a way to get some. And chances are there aren’t many studies on it, so hopefully it can get some coverage in a future issue of NERD.

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

See other articles in Issue #12 (October 2015) of Study Deep Dives.