[Examine Newsletter] September 2024 Updates

See what’s new at Examine over the past month!  ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏ ͏­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­ [Examine]( [View in browser](=) Hello {NAME}! Here’s your recap of Examine’s September 2024 updates. Are you going to FNCE 2024? The Examine team will be at the Food & Nutrition Conference & Expo (FNCE) in Minneapolis from Oct 5-8, 2024! Say hi at booth #616. Reply to this email if you’ll be attending and would like to meet up at the event. --------------------------------------------------------------- 📅 Top 5 Study Summaries for September September 5, 2024 Every month, we summarize 150+ recent studies for our [Examine+ Members](. You can read five of last month’s most favorited Study Summaries for free by clicking the links below. The Study Summaries marked with are Editor’s Picks, which provide more details about the study, mention related studies, and include helpful graphics. Want more evidence-based nutrition information? We post interesting tidbits on social media every day. Find us at our verified accounts on: - [Instagram](=) - [LinkedIn]( - [WhatsApp]() - [Facebook]() - [YouTube]() [Protein timing for muscle growth: Exploring the postworkout “anabolic window”]( In this randomized controlled trial in resistance-trained men who were consuming high-protein diets, the timing of protein intake around resistance exercise did not affect gains in muscle mass or strength. [Cocoa consumption can improve markers of cardiometabolic risk]() In this meta-analysis of randomized controlled trials, supplementation with cocoa improved several parameters related to cardiometabolic risk, including blood pressure, LDL cholesterol, and triglycerides. [Can cognitive decline be reversed?](=) In this randomized controlled trial in older adults with mild cognitive impairment or early Alzheimer’s disease, a multicomponent lifestyle intervention involving dietary changes, supplements, exercise, stress management, and social support was beneficial for cognitive function. [Saffron may be as effective as antidepressants for reducing depression and anxiety]() In this meta-analysis of randomized controlled trials, supplementation with saffron was as effective as (and safer than) antidepressants for reducing symptoms of anxiety and symptoms of depression. However, all trials were conducted in Iran, so the findings may be limited by factors unique to the Iranian population. [Does exercise burn fewer calories than expected?]( In this secondary analysis of a clinical trial, an exercise intervention caused participants to burn more calories throughout the day, but this effect was small or nonexistent in about half of the participants. You can also check out the [most-favorited summaries from previous months]().🔥 --------------------------------------------------------------- So, did you find something of interest? If not, please reply to this email to let me know which topics you’d like us to tackle. And if you’re ready to stay on top of the latest research, you can [try out Examine+ for free for 7 days](. --------------------------------------------------------------- The most effective health hack is … September 12, 2024 I’ll tell you what I personally think the answer is ten sentences down. But first, read the intro for some important context: What’s a health hack? Let’s define a “health hack” as a simple change that can significantly improve the health of most people, while being relatively low cost and easy to adhere to. Out of thousands of possible health hacks, most don’t fit the above criteria. For example: - Drink lemon water in the morning: See detailed explanation [here](). - [Avoid blue light before bed](=): Adherence is tough. It’s mighty tempting to be on your phone late or binge one more episode. - Any diet: No healthy diet is easy-peasy for most people to adhere to in the modern world of unlimited hyperpalatable food availability. - Supplement protocols: Supplement efficacy is a crapshoot. Costs add up over time, and people often forget to take them. The Oscar for Best Health Hack goes to … … the acclaimed half-Chinese half-French actor, Stan Ng-Desque!! (Most often professionally credited as Standing Desk.) [Pan to George Clooney clapping heartily, then pan to Stan’s acceptance speech.] I’d like to thank the Academy. But more importantly, I’d like to thank my homies Nikola Tesla and Thomas Edison, for advancing our understanding of electricity. You see, standing desks were used throughout antiquity in the form of lecterns or manually adjusted desks, but only when electronic height controls became cheaper in recent decades did standing desks become really popular. I’d also like to thank the DIY community. They’ve suggested cheap or free ways to try a standing setup if you’re not sure about buying a premade standing desk yet. Finally, none of this would be possible without the legions of ergonomists who pushed for standing desks at large companies. Their efforts accelerated public awareness and product development by desk companies. For years, ergonomists have preached a message of prevention and variation: prevent overuse and imbalance injuries by varying your position throughout the workday. Don’t stand all day, don’t sit all day, and take microbreaks if you can. And that’s where the magic of electronic controls comes in: switch positions with a tap of a button and unlock potential benefits. Mixing in some standing throughout your day may [help prevent cardiovascular disease](), plus burn an additional [50-60 calories a day](). Before the announcer forces me off the stage, I want to give a shout out to my favorite health website, Examine. They don’t sell standing desks or any physical product. They just want you to funnel your effort and money toward things that are most likely to help your health, based on the latest evidence and critical thinking. --------------------------------------------------------------- Thanks for the ringing endorsement Mr. Ng-Desque! You sure seem like a stand-up guy! I do want to add a little note to what he said though. Not everyone can or should stand for longer periods. Talk to your healthcare providers to get personalized advice. Some people can’t stand most of the time or at all, and some people use a wheelchair some or most of the time. Adjustable desks could still be helpful in these cases, for example as a way to make wheelchairs fit better with desks. Again, talk to your healthcare provider. --------------------------------------------------------------- I know this email format was a little silly. Don’t hesitate to reply back to let me know if you liked or hated it. Format aside, I earnestly think many of you without standing desks could benefit health-wise by getting one or trying a free or cheap temporary setup. Think about how much time you spend sitting in a static and possibly hunched position, every single day for years, then think about whether your body is likely to respond well to that as you age. Billions of dollars are spent on supplement and diet trials. Our [fish oil database]( alone has 148 trials so far. If I were pulling all the strings, even though it might not be great for Examine’s revenue, I’d move a big part of that money towards investigating cheap and free things like DIY standing desks that (I’d guess) are waaaaaaaay more likely to have body-wide health benefits. I’ve mentioned in the past that I grew up in a family hovering slightly above the poverty line. So studies on free and cheap interventions in populations who really need them appeal to me more than studies helping biohackers figure out how to optimize even further, even if those are interesting too! If this email spurs you to mix in more standing and you end up benefiting, do consider replying to me with your story. Sixteen years of joint issues from [Ehlers-Danlos syndrome]( led me to try various work station adaptations, like tented or fully split keyboards, vertical mice, touchscreens, voice dictation, and so on. I love hearing about how alterations help others, and it makes me feel like we’re all in this together. 🙂 --------------------------------------------------------------- The subtle art of interpreting keto studies September 26, 2024 In 2002, Yahoo was still the most popular search engine. The first iPhone was five years away from being launched. 2002 was also the first time I read a few [keto]() studies and tried out the diet. At that time, there weren’t a ton of keto trials on topics outside of epilepsy. It didn’t take me long to realize that keto, like most diets, was neither “bad” nor “good”. Net benefit or harm is determined by a variety of factors that vary by person. Alas, dichotomous thinking about diets predominated then and continues to do so. I try to avoid those yearly “best and worst diets” lists put out by major media sources. They’re a great way to generate clicks without encouraging critical thinking. To complicate matters even further, diet trials tend to be much more difficult to interpret compared to supplement trials, due to the greater number of variables at play. Some wrinkles to be aware of regarding keto trials - Keto typically leads to several pounds of water weight loss due to [glycogen]() depletion. If that’s not accounted for, a trial’s body composition results could be misleading, since water loss isn’t fat loss. Most trials from the past few years account for this water loss, yet results are still commonly misinterpreted by media sources and the public. - Keto and [vegan](=) diets are two of the most common diets that exclude specific foods. They share a key characteristic: each reduces the number of calorie-dense and/or hyperpalatable food options you have. So then you have to figure out what portion of the benefits seen in the trial are due to the specific diet being tested, and what portion is due to weight loss from less availability of hyperpalatable food. For some people the benefits are mostly from the reduced calorie-dense options, and for others it’s mostly the specific food included or excluded in the diet. - One of the major downsides of these diets is lower long-term adherence. Trials can show that a diet with specific rules works in a semi-controlled setting for six months, but real life isn’t a trial where you’re under implicit pressure to adhere. Controlled settings measure efficacy, while real-world settings assess effectiveness. Some people will be able to stick to these diets indefinitely, probably because they don’t find the restrictions onerous at all, while others won’t. - Diets that exclude specific foods typically lack flexibility. Still, some people do best having a simple non-flexible rule to follow every day because if they incorporate flexibility, they tend to break instead of bend. Other people do better when they can be flexible about their diet. - Using a single result from a keto trial hides the important inter-individual variability in results. Here’s a graphic we made for a big [low-carb versus low-fat study](=) years ago. Some people lost tons of weight while others didn’t lose any, or gained some weight. Notice that the spread of results was remarkably similar between the low-carb and low-fat diets. And the most important wrinkle of them all? There’s no such thing as a placebo diet, so trialists have to pick a comparator diet that keto (or whatever diet of interest) is tested against. This has a huuuuuuuuuge impact on the study results! If you test keto versus a low-fat diet, vegan diet, [DASH diet](=), or some other diet, the results could easily go from significant to not significant (or vice versa). Testing more than two diets in a single trial tends to be prohibitively expensive, so it isn’t often done. Instead, the trialist has to carefully pick the comparator diet. Do you pick a “generally healthy” diet because it’s the most broadly applicable at a population level? Do you pick low-fat because it competes with low-carb at a macro level? Vegan because it’s kinda sorta the opposite diet? Mediterranean diets often do well in trials — although it’s debatable how authentically Mediterranean some of these diets are — so if the trialist is brave, they can pit keto against Mediterranean. A month or two ago, I saw that some keto dieters and academics on the web were excited about a trial comparing keto to a Mediterranean diet for psoriatic arthritis, with keto winning out. I filed this away in my brain with the mental tag, “exciting result!” I should have tagged it as “exciting result?” You see, I forgot to check this really cool website called Examine to see if they had covered it yet. Just last week, I ran across it on the site. It’s still a promising study, but I’m not sure if the people who previously shared the study read the full text. [Examine researchers noticed](): Some caution may be appropriate when interpreting these findings, due to the small sample size and relatively high dropout rate (39%). Also, outcomes were listed with incorrectly calculated percentages. Rather than calculate percent changes from baseline to the end of the diet period, the investigators calculated these percentages backwards (i.e., as if time went in reverse) and then reversed the direction of effect (e.g., from an increase to a decrease). This resulted in some percentage reductions being more than 100% (which is impossible). In addition, 2 of the authors were employed by Evivios Med., the company which provided the ketogenic snacks. The subtle art of keto research interpretation seems to have a prerequisite: you have to read the actual paper. Most people don’t have time or expertise to read tons of full text papers, and artificial intelligence summaries can’t catch things like the above. So don’t be like me. Before mentally filing a trial away as “exciting!” without adding in some qualifiers (and definitely before telling other people about an amazing study that came out), check to see if Examine covered it. If we didn’t, let us know and we may queue it up. --------------------------------------------------------------- Sincerely, Kamal Patel and Morgan Pfiffner Follow us on: [LinkedIn]( [Instagram](=) [Facebook]( [YouTube]() [WhatsApp]() [About Examine]( | [Careers]() | [Member’s Area]() [Unlock Examine+]( PO Box 592, Station-P, Toronto, Ontario M5S 2T1 [Switch to weekly emails](=) | [Opt out of all emails](