Tag Archive for: research

Nutrition Research: Incomplete

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In July and August, I wrote about recently published studies on multivitamins and mortality and fish oil and atrial fibrillation. My criticism of those observational studies was because the analyses of the data were incomplete, in my opinion. Here’s how the study we just finished on quercetin and irritable bowel did the correct analysis.

Researchers focused on the subjects with an irritable bowel condition and examined a single nutrient. They already knew that increased fruit and vegetable intake benefitted people with irritable bowels; they specifically examined the quercetin content of those vegetables and fruit to see if subjects who ate those foods needed fewer enterotomies and had lower mortality. They did. This is the way nutrition research should be done.

That’s exactly what they did not do in the multivitamin and fish oil studies. It isn’t like they didn’t have the data; one of the studies used the exact same database of subjects with the nutrition data already collected. They could have analyzed by nutrient, whether it was a macronutrient such as protein, carbohydrate, and fat; by the source of the protein, fat, and carbohydrate intake; or by specific nutrients such as calcium, beta-carotene, or type of fish oil. I could go on, but the point is they could have done more. But as I suggested, when physicians and statisticians are the only experts used—without nutritionists and dieticians—they apparently didn’t know the correct questions to ask.

As a result, we’re now stuck with physicians and other healthcare professionals questioning the use of multivitamins and fish oil. Experience tells me that will be hanging over our heads for years.

During the conclusion and recommendation section of every study, they always finish the observational studies with something like “This study doesn’t provide cause and effect; we need randomized controlled trials to test these findings.” I submit we need more thoughtful analysis of the data used in these studies. The way I see it, those studies were disasters, and there are more to come in the near future. Next week we’ll look at a study that condemns green tea extract and turmeric.

What are you prepared to do today?

        Dr. Chet

One Decision, Lasting Impact

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I love behind-the-scenes shows: how do things work? That probably explains why I like to dig into health studies the way I do. My latest fascination is with a show on the National Geographic channel called Disaster Autopsy. Several scientists examine man-made disasters to find out what went wrong. Most of the time, it comes from a single decision or single event that was unforeseen but made a lasting impact. The disaster didn’t happen right away; in some cases, it was decades later.

Does this apply to our body as well? You may think I’m talking about a single decision you made related to health—one decision made years earlier, that could seal your fate. Health is not quite that simple with multiple variables that interact. Still, after reading the Memo of the lifestyle factors that influence a healthy brain, have you made any changes?

The science of health can do the same thing: have an impact that lasts. The next three Memos are related to the choices that researchers can make by looking at the data in depth instead of superficially; they can impact health recommendations for decades. At the same time, we’ll find out the benefits of a phytonutrient called quercetin.

What are you prepared to do today?

        Dr. Chet

Why I Hate Cilantro

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The All of Us genetic testing results I told you about Tuesday included four more genes; by examining the results, these genes explain a lot about my personal tastes. These are not world-changing genetic analyses such as risk for cardiovascular disease or celiac disease, but they’re nevertheless interesting. Here’s what else I found out about myself from the results.

Bitter

Remember, there are five tastes: bitter, salty, sour, sweet, and umami. Evidently not everyone tastes foods the same way; I didn’t know that there are at least 25 different types of bitter receptors. I have a gene that allows me to taste flavors that are considered bitter. There are at least 550 foods identified as bitter; some I naturally like such as coffee. We can adapt to tastes regardless of our genes, so you may develop an appreciation of bitter foods if you don’t like them now.

Earwax

I have a normal gene that allows me to produce wet earwax as opposed to dry, flaky earwax. In the analysis I received, there’s a long explanation about earwax and what it does. One function of earwax is to keep the ear drum dry when water enters the ear canal; it made me wonder if that’s why some people are more prone to “swimmer’s ear” than others.

Lactose Intolerance

There’s a gene that, depending on its location on your DNA, will allow you to produce more lactase, the enzyme that breaks down the milk sugar lactose. If the gene is in a different position, you may lose your ability to produce enough lactase, and thus you become lactose intolerant. Mine is evidently in a good position because I digest dairy products just fine.

Cilantro

I have the “I hate cilantro” gene. Actually, that’s an overstatement. If you have the gene mutation, you have a slight chance of disliking it, somewhere between 3% and 21%. To me (and Paula), it strongly tastes like soap instead of the refreshing citrus flavor most people experience.

Those were the genetic results I’ve gotten so far—nothing earth shattering but interesting nonetheless. It explains a lot, including that in spite of your genes, you can overcome some of your genetic tendencies and learn to love cilantro.

Consider joining the All of Us Research Program. You’ll be contributing a lot and you just might learn some interesting things about your genes as well. Check it out at https://www.joinallofus.org//#.

What are you prepared to do today?

        Dr. Chet

All of Us: Genetic Results

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Almost two years ago, I wrote about the All of Us Research Program. Their goal was to get 1,000,000 partners who would be subjects in the largest study ever done within the U.S. I decided to participate fully and that means answering questionnaires as well as giving blood samples and other basic health information. I’ve gotten some results but this past week, I finally got some of the analysis of my DNA and genetics.

Paula likes to call me a pure-bred: all of my ancestors were Polish (with the exception of one maternal great-grandfather), while her ancestors came from all over Europe. While I was curious what the ancestry portion of the DNA test would reveal, there wasn’t much doubt. The All of Us program goes through great pains to explain why some people might want to know their ancestry while others might not. I would describe it as fairly rigorous just to make sure that you really, really wanted to know the outcome.

My DNA confirmed that there was a 79% chance that I was from Eastern Europe, specifically Poland or the Ukraine. The rest of the probability was northern or western European. No great surprises there. They also tested for four other genes, and I’ll talk about those on Saturday.

They’re still looking for participants. I would urge you to go to https://allofus.nih.gov/ and be part of something greater than yourself. You might also find out why you love cilantro or think it tastes like soap.

Super Bowl Webinar Replay

If you missed out on the webinar, you can still watch it in its entirety by purchasing the replay. It was the kick-off event for longer term focus on helping you become the best version of yourself. Aging with a Vengeance is just the beginning; you’ll see more as the year goes on.

What are you prepared to do today?

        Dr. Chet

Citations Are Important

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When I wrote the first Memo on citrus fruit last week, I omitted part of the date from the citation found at the bottom of every Memo that cites a study or publication. Only a single person noticed. As I wrote in response, sometimes you look at something so many times you don’t see what’s wrong. She noticed because she typically looks up research and wanted to see if it was something she had read before.

From the time I was in graduate school, I’ve always tried to get citations right, especially those that refer to scientific journals. I’ve been on too many frustrating walks through the stacks in research libraries to cause that kind of grief for someone else.

Today you can search databases of journals quite easily. That is, unless you’re given an incomplete citation or worse, just the name and the year—and the year is wrong. I’ll try to make sure I triple-check them from now on. But please, once in a while, look up the research paper or book and take a look at the research paper yourself. You might find you enjoy it.

What are you prepared to do today?

        Dr. Chet

All Research Matters

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As we enter the final holiday of summer, I want to challenge you to listen to a podcast over this long weekend. Before I get to the details about the podcast, I want to tell you why research matters.

I spend a considerable amount of time examining nutrition research. If you read what I write, you know I’ve criticized who nutrition research is done by as well as how nutrition research is done. That doesn’t mean that the research is not worthwhile. The interpretation of what any given study means can be debated and methodologies can always be better. It doesn’t mean that the research isn’t important; if nothing else, it can show how not to do something.

Take a different topic such as climate change or vaccinations. These topics are a great way to start an argument because people have strong opinions on them. Pick either side and you can find research to support your position. Again, that’s due to the interpretation of research on highly complicated topics, but it doesn’t mean that the research shouldn’t have been done in the first place. It absolutely has to take place.

We seem to be entering an era where government-sponsored research is being attacked, and that will be harmful to us in ways we can’t imagine. Think about it. Do you want research funded only by the sugar industry to set dietary guidelines? How about climate research funded only by the gas and oil industry or energy research funded only by the windmill industry? That’s where basic science research is critical to bring balance to the equation. No research should be avoided because it offends one industry or another.

Now to the podcast: listen to Malcolm Gladwell’s podcast called Revisionist History on your favorite podcast platform. The episode is titled The Obscure Virus Club. It’s the story of a small number of scientists who persisted for decades in researching obscure viruses and whose findings were ignored for way too long; I’ll tell you that Paula was in tears as she figured out the life-or-death consequences of those delays. Think of the implications if even more research were unfunded and unpublished. Just because it’s a holiday weekend doesn’t mean our brains shouldn’t be engaged. Send me your thoughts after you listen to it.

What are you prepared to do today?

        Dr. Chet

Research: http://revisionisthistory.com/episodes/40-the-obscure-virus-club

Something Greater than Yourself

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Who’s going to analyze all of this data when data collection is complete? A better question might be who couldn’t analyze this data. The answer: anyone who has a good research question and agrees to abide by the guidelines of data usage can run an analysis. That could even be you. That’s correct; if you have a question and the ability to analyze the data, you could do it.

The goal is personalized medicine, and not just a pitch by a practice that’s talking about typical healthcare. The goal is to be able to identify the subgroups that will respond best to preventive health practices or to specific disease treatments. In that way, a profile of the best techniques based on genetics, environment, and lifestyle can be developed.

The only disappointment I have is that they didn’t include the microbiome. That would require a stool sample and add a greater degree of complexity to a data collection procedure that’s already very complicated. Maybe they’ll add that in the future.

If you go to the All of Us website, you’ll be able to find the local healthcare system in your area that’s responsible for data collection. In Grand Rapids, it’s Spectrum Health. I did the surveys online and scheduled an appointment for the physical data collection; that was it. In our area, we get a $25 gift card to a large grocery store chain, so I’m planning to get the whole family involved; Riley’s off the hook because you must be 18 and able to give consent. Whether you’re healthy or not doesn’t play a part in it; in fact, the info from people with current health conditions may be even more important.

The Bottom Line

The opportunity to become a part of something significant doesn’t happen all the time and almost never in preventive healthcare. This is time to do something greater than yourself, I can’t tell you whether it will benefit you personally, but it will benefit humanity. Maybe, just maybe, it will benefit a friend or relative. Check it out and check in to All of Us.

What are you prepared to do today?

        Dr. Chet

Reference: https://allofus.nih.gov/

All of Us: The Details

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Before I go further, I want you to consider this. For every variable, there will be a million data points. Height: one million. Weight: one million. Hip circumference: one million. You get the idea—and this is the simple stuff. The blood work alone could have 100 variables. Then we get into the DNA. Every gene has to be mapped to examine specific areas of DNA to see similarities or differences between healthy people and those with diseases.

If you volunteer, you will be called a partner instead of a subject. You’ll be giving the study plenty of information, but the information doesn’t just go one way. In the future, when there’s something that can benefit your health, you may be given information critical to preventing or treating a disease. The data collection includes giving Informed Consent and HIPAA for electronic data collection. Then there are several surveys and perhaps more in the future. There will also be blood and urine specimens as well as some baseline anthropomorphic data.

One thing that’s on everyone’s mind is information security. The researchers go into great detail to protect your identity. Data will be posted only with a number instead of a name, and the highest level of encryption available today will be used to protect your identity. I take security seriously, and I’m comfortable with it.

Check out the link in the Reference to find out more, and if you choose, to get started now yourself.

What are you prepared to do today?

        Dr. Chet

Reference: https://allofus.nih.gov/

All of Us

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Would you like to be part of one of the largest studies ever attempted in the U.S.? I decided I would and I think you should as well.

The study is called All of Us, and it’s an attempt to gather health data from one million or more volunteers and then track them over many years. The purpose is to examine how genetics, environment, and lifestyle can impact health and disease. The goal is to provide a database that researchers can use to determine the factors that can impact the development of disease and eventually, the most effective treatment.

I think that’s the real goal. We have no idea what causes many diseases, whether it’s arthritis, cancer, auto-immune, or many others. The same holds true for treatments. Why does one treatment work well on one person and not at all on another? The genetics and environment as well as lifestyle may all have a role; with a database so extensive, just about every type of human subgroup will be represented.

What’s involved? I’ll tell you that on Thursday. If you want to read about all the details involved, check out the link in the References.

What are you prepared to do today?

        Dr. Chet

Reference: https://allofus.nih.gov/

The Bottom Line on Human Fat as Medicine

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The final question in our look at human fat is whether there are actual benefits to the use of human fat for human health. Human fat is primarily long-chain saturated fatty acids; we’re animals and that’s the type of fat animals make. There are some hormones present in fat tissue and probably other factors related to blood vessel growth, but there were no proven benefits for the use of human fat for anything related to human health 400 or 500 years ago.

Why not? Science had not yet begun to use research techniques to assess the benefits. I sometimes criticize randomized clinical trials and the way they’re conducted, but even with its faults, research is necessary to assess whether benefits exist for any chemical. At its core, that’s what human fat is: simply a chemical.

Could there be unknown benefits? We’ll most likely never know for two reasons. First, no Human Subjects Committee would approve the research for the use of human fat for research. The legal and scientific quandaries of using fat from some humans on other humans are mind-bending.

Second, even if some benefits could be proven, there’s the issue of collection. We do not dispose or treat corpses in the same way we did 500 years ago. Where would the human fat come from? Just the thought would be disturbing to many people.

The Bottom Line

The historical look at human fat as medicine illustrates why the scientific process is important and irreplaceable, flawed though it may be. It’s a slow process and can be frustrating, especially as it relates to nutrition. In today’s “get a product to market first” climate, we end up with too many nutritional products in a marketplace with little to no science behind them. That will be our topic for next week’s Memos.

What are you prepared to do today?

        Dr. Chet

Reference: Christopher Forth PhD. 2019. Fat: A Cultural History of the Stuff of Life.