Links: Go to episode page (with resources) Subscribe to Sigma Nutrition Premium Receive our free weekly emails Introduction: Discordance between low-density lipoprotein particle (LDL-p) and low-density lipoprotein cholesterol (LDL-C) occurs when the levels of these two biomarkers do not match up as expected. Discordance between Apolipoprotein B (ApoB) and low-density lipoprotein cholesterol (LDL-C) is similar, except rather than counting just LDL particles, ApoB is a measure of the numbers of lipoproteins that have an ApoB attached. Discordance between ApoB and LDL-C can lead to either an underestimate or overestimate of ASCVD risk. And therefore there may be important implications for someone who does have discordance. Additionally, it is such cases that suggest that a measurement of ApoB may provide additional information beyond traditional lipid measures in assessing a person’s cardiovascular risk. Recent work from researchers at Liverpool John Moores University has investigated whether discordance is associated with certain dietary patterns. In this episode, one of the researchers involved, Dr. Ian Davies, is on the podcast to discuss this work in addition to wider questions in the diet-lipids-CVD field that remain to be answered.

Links: Go to episode page (w/ resources) Subscribe to PREMIUM Receive Danny's free weekly email Description: Fructose is a type of sugar that is commonly found in fruits, vegetables, and many processed foods. In recent years, there has been a lot of discussion and debate about the impact of fructose on health, with some claiming that it is a major contributor to obesity, diabetes, and other chronic diseases. However, these claims are often at odds with what the scientific literature actually says. One of the most common claims about fructose is that it is inherently “bad” for health, and that consuming too much of it can lead to a wide range of health problems. This idea has been popularized in many popular diet and health books, and has led to a widespread fear of fructose among the general public. However, many of these claims are based on outdated or oversimplified research, and do not reflect the complex reality of how fructose interacts with the human body. Another common claim about fructose is that it is uniquely responsible for the current obesity epidemic, and that reducing fructose intake is the key to weight loss and better health. While it is true that excessive consumption of sugary foods and beverages can contribute to weight gain and other health problems, the idea that fructose is uniquely responsible for these issues is not supported by the scientific evidence. In fact, many studies have found that total sugar intake, rather than fructose specifically, is the most important factor in the development of obesity and related health problems. In this episode we discuss the unique aspects of fructose metabolism, why some studies appear to show unique harm of fructose, and the implications of this for dietary choices. Go to episode page

Links: Go to episode page Subscribe to Premium Sign-up for our free weekly email: The Sigma Synopsis Description: The idea of food addiction has gained a lot of attention in recent years, as obesity rates continue to rise around the world. Many people struggle with overeating and find it difficult to resist certain foods, leading to a cycle of guilt and shame. The concept of food addiction suggests that there may be a biological explanation for this behavior, and that certain foods may be especially “rewarding” to the brain, leading to a kind of addiction. To help look at the evidence in this area, our guest in this episode is Dr. Charlotte Hardman, who is a leading researcher in the field of appetite and obesity. Dr. Hardman’s research focuses on the psychological and biological processes that contribute to overeating and obesity. She is particularly interested in the concept of “food addiction,” which suggests that certain foods may be addictive and lead to compulsive overeating, similar to substance addiction. In this podcast, we will explore the latest research on food addiction with Dr. Hardman. We will delve into the evidence for and against the idea of food addiction, as well as discuss the potential implications for public health and policy. Join us as we explore this fascinating topic and learn more about the complex relationship between food and the brain.

Questions Answered in this AMA [00:03:01] Mechanisms that keeps weight stable over time? [00:11:52] Semaglutide: Game-changer? Weight regain? [00:30:42] How to further lower LDL-C? Can I avoid statins? [00:43:52] Glyphosate: A cause for concern in food? [00:48:30] High caffeine intake is making me sweat more. What’s going on? [00:55:16] Should I avoid non-organic meat? [01:00:08] Is there evidence on iron and zinc co-ingestion for anemia of prematurity? [01:03:09] “Carni-nutrients”: Can vegan diets cause brain issues due to lower choline, creatine and taurine? [01:12:10] Are energy drinks bad for us? [01:17:43] What are some resources for doctors and patients that simply explain obesity & treatments? This is an episode exclusive to Premium subscribers. To listen to the full episode you’ll need to subscribe. However, you can listen to a preview here.  

Links: Go to episode page (with links & resources) Subscribe to Sigma Nutrition Premium Receive our free weekly email, The Sigma Synopsis About This Episode: Often claims are made recommending that people should aim to keep peaks in blood glucose low in terms of both magnitude and frequency. And while many claims about blood glucose “spikes” are incorrect or purposefully exaggerated to grab attention, there are some reasonable and interesting hypotheses put forward in relation to blood glucose variability and excursions. For example, interesting questions have been raised in relation to the impact of blood glucose excursions in seemingly normoglycemic and/or healthy people. In this episode, we look at three specific elements of this: average blood glucose, glucose variability, and glucose peaks. All in the context of people without prediabetes or type diabetes, who have typical blood glucose measures in the ‘normal’ range. Specifically, we look at three hypothesized recommendations made elsewhere: “The lower you average blood glucose (HbA1C) is better, even if already in normal range” “The more you can minimize glucose variability, the better.” “Minimizing the number of glucose “peaks” is important, even if they don’t meet the threshold for hyperglycemia” Can normoglycemic people benefit from further reducing these measures? Let’s take a look…

Links: Episode page (with more links) Subscribe to Premium Introduction Depression is a common disorder and is a leading cause of disability worldwide. Depression results from a complex interaction of social, psychological, and biological factors. Diet has been one area that has been suggested in playing a role; from potential for exacerbating symptoms to being a treatment. And while some associations have been noted, many claims far exceed what (little) evidence exists. Online it is common to see people claiming certain diets can treat depression or that certain foods will improve outcomes. However, does the evidence match such claims? In trials that have been published on diet-depression, there has been considerable media attention and fanfare around some results. For example, the SMILES trial published out of Australia. However, some have raised considerable concerns about the interpretation of such findings. In this episode, clinical psychologist Dr. Nicole Lippman-Barile is on the podcast to discuss what we currently know about diet and depression, what issues exist with current studies, and why many nutrition-mental health studies are being incorrently interpreted.

Links: Subscribe to Premium Go to this episode's page (with links) Live event: London - March 18th Receive 'Sigma Synopsis' emails Description: When thinking about the effect of eating or not eating a certain food or nutrient, we can’t consider this in isolation. Meaning, we need to evaluate the impact within the context of what such an inclusion/exclusion does to an individual’s overall diet pattern. Thinking about this concept, the phrase “compared to what?” has been colloquially used. And while this is an important idea, there has been some misapplication of this principle. In nutrition science, this is related to the concept of food or nutrient “substitution”. And this concept is crucial to understanding the issues that can arise in nutrition studies, particularly when it comes to single food analyses in nutritional epidemiology. This concept of substitution is quite intuitive in controlled feeding studies. However, it is not as obvious when considering nutrition epidemiology studies. As noted by Ibsen & Dahm (2022): “Whereas studying the effects of eating one food instead of another is typically explicit in interventional study designs, it is often implicit and sometimes hidden in analyses of observational studies.” However, in nutrition epidemiology substitution is still happening, but it typically emerges as a consequence of adjustment models. In nutritional epidemiology, it is essential to adjust for confounders. E.g., one vital adjustment is often for total calorie intake. However, when our exposure is a specific food/nutrient, we must think about confounding by other foods. So knowing what, and how, a study is adjusting for variables helps us interpret it better. In this episode, Dr. Alan Flanagan and Danny Lennon discuss these crucial ideas of food substitution, adjustment models, and “compared to what?”. Go to this episode's page (with links)

Links: Episode page Subscribe to Premium Live Event: London, UK Receive the Sigma Synopsis emails    About This Episode: Does sodium lead to calcium losses? Do high-salt diets harm bone health? At what thresholds could there be an impact? Does any of this change our recommendations around salt/sodium intake? Thanks to Sigma Nutrition Premium subscriber Kate Wall for submitting a question in the member’s area that inspired this episode. Kate asks: “Salt can impact calcium excretion in the urine and it is said that a high salt diet can increase risk of osteoporosis as it draws calcium from the bone and excretes it. How much of an impact does dietary salt intake actually have on bone health and how high would salt intake have to be for this to be a concern? Obviously high salt intakes are not something to aim for in general, but just wondered if this was a mechanism that could remove meaningful amounts of calcium in a way that I should be advising around this in those that we work with as nutritional professionals. Thanks!” So in this episode, Danny and Alan look at some of the evidence in this area to see if there are impacts that have pragmatic implications for nutrition and medical professionals, as well as health-concious people.

Links: Subscribe to Premium Episode page   Description: Nutritionists, dietitians and other health & fitness professionals face many challenges when attempting to help their clients and in understanding what approaches are best in a given situations. There are often discussions around improving client adherence to dietary recommendations. However, sometimes we need to think deeper about this topic. Is there really just a tool to fix this? Or could the problem be the recommendations themselves? Similarly, while quantifying dietary intake in terms of calorie and macronutrient amounts can be useful in some cases, it’s clear that this isn’t the best approach in many cases. So for coaches aiming to help athletes or those with body composition goals, how do we use “non-tracking” approaches effectively? This episode brings you a roundtable discusssion between three accomplised and insightful nutrition professionals; Dr. Eric Helms, Dr. Zoya Huschtscha, and Mackenzie Baker. In the episode we discuss the above-mentioned topics and more.

Links: Episode page Subscribe to Premium Live event in London, UK Description: Meal timing has been a popular, and at times controversial, topic of interest in nutrition. Despite much speculation over the years as to potential advantages to specific meal timing or meal frequencies, for many outcomes there seems to be little pragmatically meaningful difference. For example, when accounting for calorie and macronutrient intake, there is little to no effect of meal timing on body composition, blood pressure, and energy expenditure. However, just because there is little evidence for the importance of meal timing in relation to those outcomes, this should not be interpreted to mean there is no impact of meal timing on all health outcomes. One area where meal timing may be an important factor is in relation to glucose tolerance and glycaemic control. For example, it has been consistently shown that eating at ‘biological night’ leads to worse postprandial glucose responses. And this could be particularly important for those with insulin resistance, pre-diabetes or type 2 diabetes. Some of the most influential work in this area has been done by Marta Garaulet’s lab at the University of Murcia. One of the central aspects they have published on has been the interaction between food timing and melatonin levels, and how this in turn affects glucose tolerance and cardiometabolic markers. In this episode, Danny and Alan discuss the topic of meal timing and glucose tolerance, using a recent study from Garaulet et al. to highlight some important concepts.