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Issue #74 (December 2020)

From the Editor

While I’m not particularly great at math, I’ve always liked it. I still remember the feeling I had back in high school physics when I learned how to predict where a ball will end up depending on the angle and how hard you throw it. I felt like a fortuneteller, since I could predict the future! My mathematical interest served me well when I studied molecular biophysics (for hopefully obvious reasons) and in pharmacy school, where two of my favorite topics were pharmacokinetics and biostatistics. And my interest in the latter really serves me well when editing the NERD!

I’ve also used simple math in my everyday life. One big win I had involved choosing a new neighborhood to move to; I made a simple decision matrix and assigned a score to aspects of what I wanted in a neighborhood and took the weighted average. Of course, math isn’t everything, so I compared what the numbers told me to a gut check. While I didn’t just go on the numbers alone, the move I ultimately made was (and still is!) one I’m really happy with. And when I experiment with supplements, I also take some basic measurements and do some math to see if they work for me.

It’s probably my long-standing interest in math that makes me particularly excited about a couple of articles in this issue of the NERD. I like putting numbers on things and often prefer ballpark calculations to compelling narratives. In this issue, we cover two topics that put a number on two crucial health metrics: blood lipids and blood pressure.

The first article that particularly piqued my interest asked the interesting question of how much blood lipids, like total cholesterol and LDL-C, change per kilogram of weight lost. Not only that, but the researchers explored whether the way the weight was lost mattered. They compared weight loss from diet and exercise to drugs for weight loss and bariatric surgery. It turned out that how the weight was lost made some difference, but lifestyle changes did quite well, especially in the longer term (12 months), and that LDL-C is reduced by a bit over 1 mg/dL for each kilogram of weight lost due to lifestyle changes.

The second article that especially caught my eye was a network meta-analysis of several non-drug interventions to reduce blood pressure. There, Tai Chi had the biggest effect, lowering systolic blood pressure by around 15 mmHg, with diastolic pressure not that far behind, beating out other interventions like the DASH diet! This may seem surprising until you consider the quality of the evidence: the authors assessed Tai Chi’s evidence base as very low quality, meaning that there’s a solid chance those numbers would be overturned by stronger evidence. Quantity isn’t everything; quality matters, too! Indeed, DASH wound up having a substantial effect on blood pressure and a strong evidence base.

Numbers aren’t everything, but if you’re interested in answering questions about how much weight to lose to reach a certain cholesterol level, or determining the best way to lower blood pressure, they certainly help a lot.

Gregory Lopez, MA, PharmD
Editor-in-chief, Nutrition Examination Research Digest

See other articles in Issue #74 (December 2020) of Study Deep Dives.