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Issue #19 (May 2016)

From the Editor

Volume 1

What if you could see what’s going on inside your body?

What if you could see what food and supplements did to your cells, see what stress did to your brain?

That would be the biggest breakthrough since combining peanut butter and chocolate. Although now I’m wondering what that peanut butter and chocolate is doing to my cells.

Speaking of this sweet and salty combination, let’s take salt as an example of what’s going on inside our bodies that we may be clueless about. Starting with the 1979 Surgeon General’s report, which clearly labeled salt as a cause of high blood pressure, we became a salt-wary country. I remember watching The Cosby Show as a kid, salivating over the enormous cold cut sandwiches that Cliff Huxtable tried to hide from Claire Huxtable. This is natural, as humans have a strong innate salt hunger.

Fast forward thirty years, and many researchers have now switched stances. Studies suggest that low-salt guidelines may have been misguided, and very low salt intakes are actually harmful. But aside from randomized trial results, what is the sodium from salt actually DOING in our bodies?

As always, the annoying answer is “it depends”. Usually our kidneys do a bang-up job of eliminating sodium we don’t need. Many people reading this exercise a lot, and those people will sweat out a decent amount of sodium. So those people might want to avoid low intakes.

But we know surprisingly little about the possible health effects of salt. Only in the past couple years did evidence emerge linking higher salt intakes to headaches. But (relatively) higher salt intakes could also theoretically be protective against bacterial infection, although the evidence is limited to animals right now. And it turns out that salt might not impact blood pressure just through fluid balance, it may actually increase adrenaline levels.

That’s a mishmash of seemingly unrelated and occasionally theoretical health effects. And that’s for just one, lonesome ingredient. Aside from salt, there’s debate about much more complex things we eat, like red meat or low-carb diets. Given the complexity of effects from a lone element like sodium, nobody should pretend to know with certainty what the health effects of foods and diets are, unless they can shrink down to the size of a molecule and zip around inside a human body.

On the flip side, it might be good to imagine that scenario on occasion. If you consistently eat junk food, imagine zipping through your body and seeing fat slowly accumulate in your liver, neurochemicals shooting off and desensitizing your brain, things generally going awry over time. If you mostly eat healthy and enjoy the occasional indulgence, these are likely to be blips rather than sustained physiological changes.

So imagining what goes on inside the body isn’t just a cool thought experiment, it’s also a potentially helpful heuristic, as well as a reminder that we generally don’t know what the hell is going on after we chew and swallow. But it sure is fun to follow along as researchers try to piece things together.

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

Volume 2

It’s easy to get lost in the weeds of supplements and nutrition science. Let me demonstrate by throwing out some numbers:

There are roughly 40 essential vitamins and minerals, around 20 amino acids in your body, and over a dozen major categories of phytochemicals. Then there are all the different fatty acids and fiber types, plus a bunch of widely-used supplements like creatine and glucosamine. By my rough estimate, that’s at least a hundred basic things you could supplement, without even getting into the more esoteric supplements.

Sometimes I’ll go on a podcast and get this type of question from the audience: “Should I take alpha-ketoglutarate? Does it really work?”. My first reaction is panic. Have I run across any studies in the past year? Or even in my lifetime? Should I feel bad that my mind isn’t organized into files like a T1000? Then, I relax. I don’t think alpha-ketoglutarate has been studied much since it moderately failed in trials a few years ago. But, more importantly, why does this person want to take alpha-ketoglutarate in the first place?

That’s where the proverbial rubber hits the road. Supplement purchasing decisions are all too often made inductively rather than deductively. Hear about hot new supplement, buy hot new supplement. Stop taking hot new supplement, keep bottle around just in case. Don’t forget to conduct a purge every year or so to temporarily satiate the Supplement Gods.

What if supplement purchasing was done deductively more often? Let’s say you work long hours and have a long commute. Coupled with life in general, this pattern stresses you out and your sleep suffers. Your gains in the gym have plateaued. Depression may be an issue. Now, let’s see where supplementation might fit in.

We want to address major factors in health, so we need to identify the 20% of inputs that impact 80% of outputs. Human beings tend to be pretty unhappy if sleep, stress, and sun exposure is wonky, so let’s use those as critical inputs in this example. Instead of wondering if alpha-ketoglutarate will turbo-charge your performance in the gym, ask yourself if you’re getting enough light in the daytime and curbing light exposure at night. Ask yourself if you practice reliable stress coping strategies, like deep breathing, meeting with a therapist, or hiking with friends. Are you stuck in a job you hate, and it’s time to start working on a side hustle? If you need quick help, to get over a particularly bad few days, maybe think about short term supplementation for sleep or even an “adaptogen.” If it’s wintertime, consider vitamin D or a tropical vacation (I’m not joking).

Only after you start to walk is it wise to run. Without legitimately working hard on the above factors, buying random nootropics or nitric oxide boosters is unlikely to be much more than a temporary solution. If you’ve already worked hard on sleep, stress, and sun exposure, benefits from supplementation will be icing on the cake.

I both love and hate supplements. Discovering a helpful supplement can make you feel like a health-focused Sherlock Holmes, with the fruit of your labor benefiting you directly. But the sheer number of supplements available can also be a major distraction from working on the 20% of factors that can legitimately change your life. As is always the case, hard work on what’s really important tends to pay off more than quick fixes.

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

See other articles in Issue #19 (May 2016) of Study Deep Dives.