Critically Evaluating Literature

I know that we all know that we can't take blogs at face value sometimes, and that they might misrepresent literature. We almost all know that we should look to medical journals and science, but what about when you get to the medical journals? How should you evaluate things at that point? 

I like to tell all of my clients this when they ask about a medication or a supplement or a new diet fad or a new technology- Everything goes back to the literature for the most part. The reason that you think that this is good or bad technology or a good or bad food is due to whatever some study said at some point. Have you been able to find that study first? If you haven't, that's fine, but is it possible that wherever this is coming from even if it's widely accepted by society is something that was funded by the very people who are trying to make money off of it. 

For example, the idea of "chemical imbalance" came from a marketing campaign done by Paxil. That doesn't mean that there aren't neurotransmitter shifts that occur and that Paxil might be one that will help you with that, but now that term is used by EVERYONE to state that mental illness is a real disease (which it is), and it was started by a marketing campaign. How bizarre right? I think so. 

The other thing that I always say is that if you are implementing this into your life, what is the reason for it? What areas do you think that it will help you? If it's the ketogenic diet or the plant based diet, how specifically will those diets help you? When you think about these specific diets, are you thinking about nutrition as a whole? Have you tried something similar in the past and failed? Is this too extreme for your life? What percentage points is this going to help you in a) living longer b) whatever goal that you have for yourself? If in theory, that percentage point of using the supplement that costs $60/month is only going to change something by 2%, then is it really worth the cost? 

If you are saying that diet coke is worse than regular coke, isn't that like comparing apples to oranges? Are you saying that aspartame is worse for you than sugar? And at what endpoint? Are we talking death? Cancer? Obesity? See what I mean? 

There's so many things to consider, and so when you are thinking of making some big diet haul, it's important to take a step back and say "Is this really going to make a difference? Is this something that I can realistically do? Is this data just a marketing campaign and what experts are recommending this? What are their credentials?" 

Here is an image of the different types of studies that are done in clinical trials, and I think it's really well done and it actually is referencing sports supplements so it's perfect for this article. I got this from: 

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The bottom is basically this blog post (ha). The second to the top is "Controlled trials" and the most reputable within that within looking at a trial is a randomized controlled trial. So for example, here is a RCT (randomized controlled trial) on the consumption of yogurt and liver disease: https://academic.oup.com/jn/advance-article-abstract/doi/10.1093/jn/nxy088/5040615?redirectedFrom=fulltext

The point of these trials is that they remove bias as best as possible and when it's "double blind", that means that both sides were blinded to what the studies objective was. 

At the very tip top of that graph, you'll see meta analysis. This is where they take a group of alllll the trials that have been done on a topic and can give a more collective consensus on what is actually happening or what we can definitely say that the literature states. 

Here is a great example! Apparently walnuts are very favorable on your lipid values! This study looked at 27 different studies together. That's a meta analysis.

https://academic.oup.com/ajcn/advance-article-abstract/doi/10.1093/ajcn/nqy091/5042152?redirectedFrom=fulltext

At the very bottom, you'll see it says "anecdote". Refeeds are more of an anecdotal science as of right now. There are a few studies showing the increase in leptin after a period of calorie deficit which we can deduce means that leptin is increased with a calculated increase in carbohydrate intake, however there are not studies to prove this. Therefore, the science is weak on that, but this study basically is anecdotal evidence from bodybuilders of 10 +/- 3 years in the industry so they have observed that it works well. I have seen in my coaching that it works really well, and I've noticed in myself that it works. So, just because there is not science there (reverse dieting) does not mean that it can't be beneficial both psychologically and physically and metabolically if you observe that to be true in your life :) 

The field of science is very nuanced and full of shotty data driven by money and greed and everyone wanting their paper to be the one that's published to get ahead in the rat race of life, so I just wanted to hopefully shed some light on how to look at them! :) 

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