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    Fitness & Nutrition

    Sigma Nutrition Radio

    Discussions about the science of nutrition, dietetics and health. The podcast that educates through nuanced conversations, exploring evidence and cultivating critical thinking. Hosted by Danny Lennon.

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    Copyright: © Sigma Nutrition

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    Latest Episodes:
    #500 – The Big Unanswered Questions in Nutrition Science Oct 31, 2023
    Show notes

    Links:

    • Subscribe to PREMIUM to get study notes to this episode
    • Go to episode page to see background detail & links
    • See our recommended resources for further learning
    Previous episodes referenced:
    • SNP17: Is Personalized Nutrition Superior to General Nutrition Advice?
    • 414: Will Machine Learning Overtake Traditional Nutrition Research Methods?
    • 469: Chrononutrition – New Findings & Updated Views
    About This Episode: To mark the 500th episode of the podcast, Danny and Alan take a look at some of the current outstanding questions in nutrition science, what areas have largely been resolved, and how their own thinking has evolved and changed over time. This brings them into areas such as personalized nutrition, ultra-processed foods, time-restricted eating, salt & health, and the difference between being "evidence-based" and "reference-based". We Discuss:
    • Outstanding questions in nutrition science
      • Personalized nutrition
      • Ultra-prosessed foods (UPFs)
      • Diet-Microbiome-Health
      • Omega-3 Fatty Acids
    • Largely resolved questions
      • Sodium & CVD risk
      • TRE/TRF
      • Macronutrient breakdown & weight loss
    • Evolution in our thinking
      • Epistemology at the forefront
      • "Reference-based" to evidence-based
      • Reading research: understanding "highest quality evidence"

    #499: How Sensory Cues Impact Food Choice & Behavior – Prof. Ciarán Forde Oct 24, 2023
    Show notes

    Links:

    • Subscribe to PREMIUM
    • Go to episode page (with further reading links)
    • Receive our weekly emails

    About This Episode:

    Sensory cues, comprising taste, smell, texture, and appearance, serve as the initial drivers that influence our food preferences and liking for particular items. These sensory cues can be both inherent, such as the natural sweetness of fruit, and learned, as in the association between a particular aroma and a favorite dish.

    One crucial aspect of this research is delving into how sensory properties of food, like texture and taste, contribute to our choices and consumption patterns. Food texture, for example, plays a key role in determining how quickly we consume a meal, with softer textures often being associated with faster eating rates.

    Sensory intensity and palatability are also central themes in this research. Moreover, research into dietary fat reveals intriguing phenomena like "fat blindness," where the ability to discriminate different levels of fat diminishes as taste intensity increases. Understanding these relationships can help shed light on factors contributing to overeating and potential avenues for behavior modification.

    To give us a better insight into this field of research, Professor in Sensory Science and Eating Behavior at Wageningen University, Prof. Ciarán Forde, is on the podcast to discuss these ideas.


    The PREDIMED Trial – Controversy, Criticisms, & Lessons Learned (SNP 22) Oct 17, 2023
    Show notes

    Links:

    • Subscribe to PREMIUM
    • Go to episode page
    • Learn more about the podcast
    • Sigma's recommended resources

    About This Episode:

    PREDIMED (Prevención con Dieta Mediterránea) is a landmark clinical trial conducted in Spain.

    The study made a huge splash due to the rarity in nutrition of having large RCTs with hard endpoints. In addition, it had results of a large magnitude; showing a 30% reduction in cardiovascular events.

    But the study did face criticisms and controversies over methodological issues, including randomization procedures at certain centers, ultimately leading to a retraction of the original paper and a re-analysis.

    Participants in the PREDIMED trial were randomly assigned to one of three groups:

    • A Mediterranean diet supplemented with extra-virgin olive oil.
    • A Mediterranean diet supplemented with mixed nuts (walnuts, almonds, and hazelnuts).
    • A control group following a low-fat diet.

    Despite the issues it still ends up being an incredibly useful source of data.

    In this episode we discuss the findings from PREDIMED, some of the potential limitations, and where it sits among the wider Mediterranean Diet literature.

    Note: This is a Premium-exclusive episode, so in order to listen to the full episode you'll need to subscribe to Sigma Nutrition Premium.


    #498: The PROPEL Trial & Weight Loss Interventions in Primary Care – John Apolzan, PhD Oct 10, 2023
    Show notes

    Links:

    • Subscribe to PREMIUM
    • Go to episode page (with linked studies)
    • Receive the weekly Sigma email newsletter
    • Recommended resources

    About this Episode:

    The PROPEL (Promoting Successful Weight Loss in Primary Care in Louisiana) trial was a cluster-randomized weight loss trial, specifically tailored to address the pressing health concerns of an underserved population in Louisiana, where obesity rates have reached alarming levels.

    The core of the intervention comprises a pragmatic, high-intensity lifestyle-based obesity treatment program, thoughtfully designed to be integrated within primary care settings. Over a 24-month duration, this multi-component weight loss program is delivered by skilled health coaches who are embedded in primary care clinics, with the aim of instigating substantial and sustainable weight loss outcomes.

    In this study, 803 participants were enrolled, of whom 67% identified as Black and 84% as female, thereby ensuring a diverse representation. The research design randomized 18 clinics, allocating them equally into two groups: usual care and an Intensive Lifestyle Intervention (ILI). The usual care group continued to receive their customary primary care, serving as the benchmark against which the ILI's efficacy will be measured.

    In this episode we have the opportunity to delve deeper into the intricacies of the PROPEL trial and gain insights from one of its lead researchers, Dr. John Apolzan of the Pennington Biomedical Research Center.


    #497: Are Food Frequency Questionnaires Reliable? Oct 03, 2023
    Show notes

    Links:

    • Go to episode page
    • Subscribe to PREMIUM
    • Recommended resources
    • Receive Sigma's free email newsletter
    • Learn more about the podcast

    About This Episode:

    Food frequency questionnaires (FFQs) have been widely employed in nutrition research to assess dietary intake patterns among study participants. However, debates surrounding the reliability of FFQs have persisted both inside and outside the academic community.

    These debates primarily revolve around issues related to measurement error, recall bias, and the appropriateness of FFQs for diverse populations.

    One prominent concern is the potential for measurement error in FFQs. These questionnaires rely on self-reported data from participants, which can introduce inaccuracies due to memory limitations and social desirability bias. Participants may not accurately recall their food consumption frequencies and portion sizes, leading to imprecise estimates of nutrient intake.

    Recall bias is another critical issue in the reliability debate. Participants may selectively remember or misreport the consumption of certain foods or nutrients, leading to an overestimation or underestimation of actual dietary intake.

    Two concepts are crucial to understand: validity and reproducibility. FFQs are validated by cross-referencing the FFQ data with other dietary assessment tools (or other methods). It's also important to consider if an FFQ gives reproducible results when used on multiple occasions.

    When we ask "are FFQs reliable?", we must first understand the conceptual exposure of interest: average intake over time. Second, we must consider what nutrients we are looking at. And third, in what population.

    In this episode, Danny & Alan discuss the reliability of FFQs and how to have a deeper, more accurate understanding of their use. They take a look at valid critcisms of FFQs, as well as some of the more ill-informed criticisms.


    SNP21: Sick Individuals and Sick Populations Sep 26, 2023
    Show notes

    Links:

    • Subscribe to Premium
    • Sigma recommended resources
    • Learn more about the podcast

    About this episode:

    In 1985 a paper titled "Sick Individuals and Sick Populations" was published in the International Journal of Epidemiology.

    The paper, authored by eminent epidemiologist Geoffrey Rose, can be considered as seminal and important because it brilliantly raised the concept of the "prevention paradox" and challenged traditional approaches to public health and preventive medicine.

    The paper's insights have had a lasting impact on how we understand and approach population health interventions. And it raised many contentious public health issues, which are still debated and relevant today.

    The ideas have very important implications for how we can tackle diet-related diseases in meaningful ways.

    In this episode, Danny and Alan discuss the central themes of the paper, why they are so crucial to understand, and what this means for our understanding of diet and chronic disease prevention.


    #496: ATBC Cancer Prevention Study – Crucial Lessons Sep 19, 2023
    Show notes

    Links:

    • Go to episode page
    • Subscribe to PREMIUM
    • Get our free weekly emails
    • Learn more about Sigma Nutrition Radio

    About This Episode:

    The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study (ATBC) stands as a seminal and pioneering research endeavor within the domain of epidemiology and cancer prevention. Conducted in Finland, the study aimed to examine the potential protective effects of alpha-tocopherol (vitamin E) and beta-carotene supplementation against the occurrence of various cancer types, particularly lung cancer, among male smokers. Initiated in the early 1980s, the study's comprehensive design, rigorous methodology, and its focus on a specific high-risk population have contributed significantly to the understanding of the interplay between dietary antioxidants and cancer risk.

    The ATBC study was founded on a growing body of evidence suggesting the potential role of antioxidants in mitigating the deleterious effects of oxidative stress and free radical damage, which are recognized as contributors to carcinogenesis. The selection of male smokers as the study cohort was strategically significant, given the heightened susceptibility of this group to lung cancer and other malignancies due to the synergistic action of smoking and oxidative stress. The study's rigorous double-blind, placebo-controlled design ensured a high degree of scientific rigor, minimizing biases and confounding factors that might influence the outcomes.

    One of the primary reasons for the study's seminal status is its contribution to the understanding of the complex relationship between antioxidants and cancer risk. While the study did not find a significant reduction in lung cancer incidence among the intervention group receiving alpha-tocopherol and beta-carotene supplements, its findings spurred critical discussions within the scientific community. The neutral or inconclusive results underscored the intricate nature of carcinogenesis and highlighted the limitations of simplistic cause-and-effect interpretations in the context of cancer prevention. Moreover, the ATBC study contributed to a shift in research paradigms, prompting scientists to explore broader dietary and lifestyle factors that influence cancer risk beyond single-nutrient interventions.

    In this episode we discuss the three most important publications from the study, with a specific look at what crucial lessons they teach us about the nuances, challenges, and unique aspects of nutrition as a scientific field.


    #495: Circadian Clocks in Muscle & Exercise as a Time Cue – Prof. Karyn Esser Sep 12, 2023
    Show notes

    Links:

    • Episode page with extra resources
    • Subscribe to PREMIUM
    • Receive our free weekly emails
    • Learn more about Sigma Nutrition Radio

    About this Episode:

    The field of circadian biology has long been associated with regulating diurnal physiological processes, notably the sleep-wake cycle. However, recent advances have unveiled a broader role for circadian clocks across various tissues, including skeletal muscle.

    Within this context, the investigation of circadian clocks within the skeletal muscle milieu has emerged as a frontier of scientific inquiry. These intrinsic timekeeping mechanisms exhibit multifaceted regulatory capacities beyond mere temporal synchronization.

    This episode delves into the implications of "circadian clocks" operating within skeletal muscle tissue, with the esteemed Prof. Karyn Esser as this week's guest. Her pioneering work has been instrumental in understanding the interplay between circadian rhythmicity and muscular physiology.


    #494: Multiple Risk Factor Intervention Trial Sep 05, 2023
    Show notes

    Links:

    • Go to episode page (with study links & resources)
    • Subscribe to PREMIUM
    • Receive our weekly newsletter
    • More episodes on cholesterol & heart disease

    About This Episode:

    The Multiple Risk Factor Intervention Trial (MRFIT) was a groundbreaking clinical trial conducted in the 1970s and 1980s. Its main objective was to investigate the relationship between various risk factors and the incidence of heart disease.

    The study aimed to determine whether modifying risk factors, such as high blood pressure, high cholesterol levels, and smoking, could lead to a reduction in cardiovascular events.

    The trial spanned several years, with participants being followed up for a period of approximately six years to assess the incidence of cardiovascular events and mortality. The primary outcome measures included coronary heart disease (CHD) mortality and overall mortality.

    The MRFIT trial yielded several important findings that have significantly influenced our understanding of cardiovascular health and prevention strategies.

    In this episode we take a look at why this is such seminal research, as well as the contribution of one of the greatest researchers ever in the field, Jeramiah Stamler.


    #493: The Keys Equation – How Dietary Fats Impact Blood Cholesterol Aug 29, 2023
    Show notes

    Links:

    • Go to episode page (with resources for this episode)
    • Subscribe to PREMIUM
    • Join the Sigma email newsletter
    • Learn more about Sigma Nutrition Radio

    About this Episode:

    One of the most important and influential papers in nutrition science is one by Ancel Keys and his colleagues that was published in The Lancet in 1957. This seminal paper examined the relationship between dietary fat intake and serum cholesterol levels. The researchers investigated how different types of fats in the diet affected cholesterol levels in a series of their previous tightly-controlled dietary experiments..

    Those studies involved feeding the participants various diets with different compositions of fats. The researchers analyzed the participants' blood samples to measure changes in serum cholesterol levels in response to dietary changes.

    The most important aspect of this paper is the presentation of the 'Keys Equation'; a predictive equation for the impacts of saturated, monounsaturated, and polyunsaturated fats, and dietary cholesterol, on blood cholesterol levels.

    Crucially, the Keys Equation identifies the importance of the ratio of polyunsaturated to saturated fats in the diet; known as the 'P:S ratio'. It showed that the P:S ratio is the most important dietary factor impacting blood cholesterol levels. And specifically that saturated fats increase total and LDL cholesterol twice as much as polyunsaturated fats lower them.

    The findings of this study were significant in highlighting the potential impact of dietary fat subtypes on serum cholesterol levels and heart disease risk. It contributed to the growing body of evidence supporting the hypothesis that high serum cholesterol levels, particularly due to a diet rich in saturated fats, were associated with an increased risk of cardiovascular diseases.

    In this episode, as part of our new series taking an in-depth look at seminal nutrition studies, we go through this influential paper from Keys, Anderson and Grande.


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