| March 9, 2017

Health & Fitness, Health & Sports, Nutrition, Podcast

Podcast #285: The Real Science of Nutrition and Supplements

If you work out regularly, you probably take some sort of supplement, be it whey protein or creatine or a pre-workout energy drink. But do the supplements you’re taking actually work?

My guest today on the show has spent his career studying the effects of what we put into our body and is the director of the online encyclopedia of supplements and nutrition called Examine.com. His name is Kamal Patel. He’s a researcher with an MPH and MBA from Johns Hopkins University and is working on his PhD in nutrition. Today on the show, Kamal and I discuss why there’s so much confusion when it comes to supplements and nutrition. For example, he explains why one study can say cholesterol is bad for you, while another one says it’s vital for health. Kamal then breaks down how to read scientific studies on nutrition so you can make informed decisions about your diet instead of relying on clickbait headlines published by pseudo-journalists. We then get into which supplements actually work and which ones are a waste of money. Kamal also shares his insights on the growing field of nootropics and if there really are supplements that will make you smarter.

Show Highlights

  • Kamal’s background and why he decided to run examine.com
  • Why does the public get so much contradictory information regarding nutrition and health?
  • Why nutrition is more complex to study and understand than it might seem
  • How to read a research study paper — the mindset to have and things to look for
  • Why abstracts of research papers can lead you astray
  • The types of research papers to read — randomized controlled trials vs. umbrella reviews
  • Why you should pay special attention to the group of people being studied
  • Can you make strength gains while cutting bulk?
  • Why healthy, athletic people should be especially wary of nutrition and health studies
  • The importance of finding out who is funding a study
  • How to approach studies done on animals, and transferring those findings to humans
  • The biggest nutrition and supplement myths
  • Kamal’s thoughts on the Paleo diet
  • The real keys to losing weight when it comes to diet and nutrition, and the importance of sustainability
  • The right way to gain weight if you’re trying to bulk up
  • Why there are so many supplements, and some background on the industry
  • Quack Miranda warnings on supplement bottles
  • Why Kamal doesn’t take supplements every day
  • The supplements people regularly take that aren’t doing anything
  • Are there any supplements that actually work?
  • Is there any credence to the efficacy of nootropics? Or is it all flim-flam?

Resources/People/Articles Mentioned in Podcast

Whenever I have a question about a supplement, Examine.com is the first place I go to. Head over there and search their detailed and easy-to-read analyses of studies on supplements and nutrition. It will save yourself a ton of money on supplements that aren’t really doing anything for you.

Connect With Kamal Patel and Examine.com

Examine.com

Examine.com on Twitter

Examine.com on Facebook

Kamal Patel on Facebook

Listen to the Podcast! (And don’t forget to leave us a review!)

available-on-itunes

available-on-stitcher

soundcloud-logo

pocketcasts

google-play-podcast

Listen to the episode on a separate page.

Download this episode.

Subscribe to the podcast in the media player of your choice.

Podcast Sponsors

Squarespace. Start your free trial today, at Squarespace.com and enter offer code MANLINESS to get 10% off your first purchase, plus a free domain.

Casper Mattress. Get $50 toward any mattress purchase by visiting www.casper.com/MANLINESS and using offer code MANLINESS.

2017 Toyota Highlander. Navigate to your nearest Toyota dealer or toyota.com to see why there’s always more to discover. Drivers are responsible for their own safe driving.

Take a survey! If you have an extra minute, please go to surveypod.net to take a very short anonymous survey about today’s episode. It would be a big help to the show, and I’d appreciate it.

And thanks to Creative Audio Lab in Tulsa, OK for editing our podcast!

Recorded on ClearCast.io.

Read the Transcript

Brett McKay: Welcome to another addition of the Art of Manliness podcast. If you work out regularly, you probably take some sort of supplement, via whey protein, or creatine, or some sort of pre-workout, but do the supplements you’re taking actually work? My guest today on the show has spent his career studying the effects of what we put in our body, and is the director of the online encyclopedia of supplements and nutrition called Examine.com. His name is Kamal Patel. He’s a researcher with an MPH and MBA from John Hopkins University, and is working on his PhD in nutrition.

Today on the show, Kamal and I discuss why there is so much confusion when it comes to supplements and nutrition. For example, he explains why one study can say cholesterol is bad for you while another one says it’s vital for health. Then, Kamal breaks down how to read scientific studies on nutrition so you can make informed decisions about your diet, instead of relying on click bait headlines published by pseudo-journalists. We then get into which supplements actually work, and which ones are a waste of money. Then, Kamal also shares his insights on the growing field of nootropics, and if there really are supplements that will make you smarter. If you’ve been overwhelmed by the science of supplements and nutrition, this podcast will give you several tools to make better, more informed choices. After the show is over, check out our show notes at aom.is/examine.

All right, Kamal Patel, welcome to the show.

Kamal Patel: It’s my pleasure.

Brett McKay: You started a website and own a website called examine.com that basically just simplifies and really digs in to the research out there about nutrition, supplements, et cetera, because it’s super confusing to analyze these studies, figure out what they actually are saying so you can make good decisions. It’s one of my go-to sources whenever I am thinking about, “Should I try this supplement? Does it actually do anything, or am I just peeing it away whenever I take it?” Before we get in talking about examine.com, can you tell us a little bit about your background and why you decided to start examine.com?

Kamal Patel: I first became interested in nutrition sometime in the late 90s. It was when I was in college and I was really skinny. Basically I wanted to get bigger. The first person I ever talked to about weightlifting happened to be a power lifter who lived in the dorm in the room next to me. He told me straightaway that the most important thing was to learn how to cook, and to learn some basics about nutrition, and not worry so much about micromanaging what you do at the gym. I went straight to the literature right away, which I was lucky to do rather than going through what people usually go through. Then, I gained some weight and I became sort of a wannabe power lifter myself. Then, a few years later, I guess 10-15 years later, I got more interested in the health aspects because like a lot of people, I had some injuries, had a few surgeries, and I stopped lifting weights so much.

Then, when you get older, your friends and family have health issues, and you become more interested in what it takes to feel better rather than only looking better. I started working at a research institution that was doing the systematic review for the 2010 vitamin D guidelines for the Institute of Medicine. I ended up reading a bunch of vitamin D studies and getting familiar with how governments make guidelines for different nutrients. Then, right around that point, examine.com had been founded two or three months prior sort of as an off-shoot from a discussion on Reddit, when a couple of people were talking about how there wasn’t a resource that was independent and did sort of systematic reviews for the public.

They needed somebody to run the website, and I was around, and I had a medicine background, so I came on. A few years later I think we’re most likely the biggest source of nutrition research on the web.

Brett McKay: Yeah you are. Pretty much anything and everything you can think of when it comes to nutrition, you can search for it and you’ll find this just wonderful breakdown of the research that’s out there. Let’s talk about, you know, there’s so much confusion out there about studies related to nutrition and health. If you’re listening to the popular media, watching TV, or reading the blogs, it always seems like there’s a study coming out saying, “X is bad for you.” Then, a year later it’s saying, “Well, X is actually good for you.” What’s going on there? Why does it seem there’s so much contradictory information out there about nutrition?

Kamal Patel: This is a really good question, and it could probably be a podcast by itself. What a lot of people don’t understand is that when you’re doing research, and then when you’re synthesizing that research into reviews and meta analysis, it’s a lot different than what you see in the media. It’s not because the media is biased, although they sometimes are, and it’s not because journalists are ignorant. Often, nowadays, either they learn stuff themselves or they have some science background. Rather, the reason why half the studies seem to conflict is that the scientific method, you know, that’s been carried on since Newton and before him involves making observations, doing tests, and then reiterating the process until you learn the truth. Nutrition is a lot more complex than a lot of topics because there’s a lot of things we don’t understand about the body. We don’t understand quite how the brain interacts with the gut. We don’t understand quite what makes some people gain muscle and some people don’t.

There’s just so many things that are unknown, and then when you do a clinical trial, when you do a controlled study, you’re purposefully holding as many factors controlled as you can so that you can study one particular thing, which is like vitamin D in people with diabetes. When you control for all those things, it’s good, because then you can focus in on one factor and see if it works or not, but it’s also bad because it doesn’t apply as well to real life. Then, when you do another study in a slightly different set of people, and then you use a slightly different intervention, and then you introduce some other methodological differences, and statistical differences as well, then you end up with different results. That’s not to mention there’s also ways that the research process is kind of flawed, because most studies that are published end up being studies that show some difference between placebo and intervention.

If you do a study and there’s no difference, you’re less likely to get it published in a good journal. When you take into account all these things, then things end up looking really confusing because, let’s say saturated fat, for example. Saturated fat was demonized for decades, and then slowly it’s been not as demonized, but then kind of it’s tipping the other way, so some people end up eating sticks of butter, or basically only meat because they want to only get saturated fat. That’s not so great, because everything in moderation is also really not good advice. Take that in moderation as well. When you don’t look at both sides of an issue, so the benefits and drawbacks of saturated fat, then you end up missing out that there are some safe and optimal doses for different nutrients. There’s always going to be studies that say that something is good for you, followed up by studies that say it’s bad for you. You really have to go look at the actual paper to see in what aspect it’s good for you or bad for you, and in which sorts of people it’s good and bad.

Brett McKay: Right, and I feel like also too in the popular media, and not necessarily like science writers, journalists, but you know, bloggers, et cetera, they’ll just look at the conclusion of a study and say, “Well yeah, it says it has beneficial aspects.” Again, they don’t take into account other factors. They’ll see that conclusion and just write this broad, making this broad, sweeping claim that, “Oh yeah, you need to do this because this one study said that it can have beneficial factors.” But they didn’t take into account the control or how narrow-refined the experiment was.

Kamal Patel: Yeah, I can’t blame people for doing that. Before I went to school for nutrition, I used to do the same thing. I would find an article on Pom Med and say, “Oh you know, this isn’t true because studies show that if you take BCAAs then it does this.” Then, there’s two levels of misinformation. One is that when you read the abstract, there’s usually not a standard of scientific integrity for the abstract. They don’t have to say what the major limitations for the study are in the abstract. They only get into that in the discussion, and often times they even miss some of the ones they don’t want to say. Then, the second thing is there is all kinds of pitfalls with the abstract. Let’s say you compare vitamin D to a placebo for muscle gain. Then, in the abstract you read that vitamin D increased muscle gain, as verified by a [inaudible 00:09:45] after eight weeks, and then you show somebody the study and you say, “Hey, vitamin D helps muscle gain.”

That all is technically true, but if you read the actual paper, sometimes what happens is, “Vitamin D increased muscle gain by like 2%.” Then, “Placebo increased muscle gain by 1%.” So, “Vitamin D significantly increased muscle-gain from the eight-week period back to baseline compared to itself.” But compared to placebo, it didn’t significantly increase muscle-gain, because they both did. The whole purpose of a placebo-controlled trial is to compare against placebo. Even 60 years after evidence-based medicine really started getting going, there are still studies with abstracts that only talk about the intervention, not comparison to placebo. That’s the kind of thing that we look at. We try to make sure that people aren’t duped by abstracts and by articles about the abstracts.

Brett McKay: Right. I feel like yeah, the abstract can really lead you astray. A lot of times, that’s all you have access to if you’re just a layman. You can just see the abstract, you can’t actually access the research unless you have to pay for it. You read the abstract and you’re like, “Oh. That says that, I’m going to go with that.”

Kamal Patel: Yep.

Brett McKay: Yeah. Let’s say if someone wants to take a look at these studies and actually examine them themselves, is there sort of a mindset or things that people should look for as they’re reading the studies so they’re not led astray by the abstract or a conclusion in the study?

Kamal Patel: Yeah. We have a short kind of study guide about studies on our website. Just to paraphrase some of the most important parts, most people who will look at a study kind of understand what significant means. It basically means that if you find that, let’s say, vitamin D, if you find that there is a significant difference between vitamin D and placebo, that means that there is a low-chance that the results of the study were random, just due to chance, and there is a higher probability that that difference between vitamin D and placebo is real. Now, the thing is, that’s usually about as deep as people get, but what’s really important to know is that the significance is not the most important part of the study. What’s really important is how sure are we of the results. That’s not just to do with significance. That’s to do with a bunch of other parts of the study.

There’s all of these study quality metrics that, like the Cochrane Collaboration, which synthesizes studies, and some other organizations use. When I used to work at that research center, some of the important things we would look at were not just what the result is. Vitamin D increased muscle gain by 2%, but rather what the confidence interval is. How confident are we and what are the upper and lower bounds of how confident we are. A confidence interval for that might say, “This study showed that vitamin D increased muscle gain by 2%, but the upper and lower bounds is, it could go up to 4% or it could go down to minus-1%.” You might think that if the lower bound is minus-1%, which means vitamin D could actually decrease muscle gain by 1%, what does that actually mean?

What it usually means is that the study was in a small enough sample of people that we’re not very confident of the results. If you did that study in 5,000 people, rather than 30, then you would end up with a much narrower confidence interval, and you would basically be much more confident in your result. Other than the significance and the numbers themselves, there’s a bunch of other things to look at. When you do a study the so-called gold-standard is a randomized control trial. Nowadays, people think in terms of meta analysis and systematic reviews of studies. There was a review about two years ago on vitamin D that was called an umbrella review, which is basically a meta analysis of meta analysis. There have been so many studies on vitamin D now, and then meta analysis looking at one specific topic, like the 20 different studies of vitamin D on blood pressure all get pooled together and looked at quantitatively, and that’s meta analysis.

Now there are so many of those meta analysis that someone went and looked at all those meta analysis and they said, “This shows that there’s actually not as much certainty about vitamin D benefits as we might have thought, so we might want to be careful about recommending it.” There’s all kinds of pros and cons to that. In my opinion, when you get so far away from the data itself, doing a review of reviews, then you lose some of the forest for the trees. Vitamin D is a hormone precursor, and it makes sense. The mechanistics make sense for a bunch of different outcomes. I think it doesn’t really matter sometimes what all the studies say, but rather what the best studies say combined with whether it makes sense or not. There’s a lot of things to look at for the average person looking at a study. Really you just have to read up and practice looking at studies and find out more and more.

Brett McKay: Yeah. One thing that I’ve learned over the years writing content for The Art of Manliness based on scientific research is also looked at what’s the group that they’re studying. For example, testosterone. Like increasing your testosterone. One study can say, “Well, if you do this one intervention, it’s shown an increase in testosterone levels.” You have to look at who are they studying. Often times these great increase in testosterone levels were done on people who had just severely low testosterone, older men, men with diabetes, men who had some kind of health problem. It didn’t cover relatively healthy guys who were wanting to increase their testosterone. You could do those interventions, you probably wouldn’t see much of an increase. That’s one thing I’ve had to like catch myself as I was looking, it’s like, “Who is actually being studied on this.” Because this control group, or the study group can have fantastic results, but for a regular, relatively healthy guy, you’re probably not going to see the same thing.

Kamal Patel: Yeah, it’s funny you should mention that, because I just answered a question on our Facebook page. Somebody asked about this article we posted. The study we posted showed that if you doubled your protein intake during a heavy calorie deficit, you could lose a lot of fat and gain some muscle at the same time. Historically, people have thought you have to go on bulking and cutting cycles, because you can’t really do both at the same time. If you’re in a calorie deficit, you’re not going to gain muscle, if you’re in an excess of calories you’re not going to lose fat.

Then, people started periodizing their carbs around workouts or, you know, other types of almost intermittent fasting type things, and then they found that you maybe could. This study had showed a pretty significant lean-mass increase after cutting calories by 40%. We made sure to say that this was an overweight man. Then somebody asked, “Why do they keep doing these studies? There’s all these studies done on overweight men showing that you can do things such as gain muscle on a heavy calorie deficit, can you explain why that even happens? Why are there all these studies out there?” People lose sight of the fact that studies aren’t done for healthy, lean, athletic people.

The problem in America, or the problem in Australia, or basically any country nowadays that’s losing the economy billions of dollars and causing a lot of distress is not that people with 4-packs are not able to get 6-packs. It’s that people who are overweight are getting pre-diabetes and diabetes a lot earlier than usual. People basically have whacked hormones a lot earlier than usual. The problem is with sick people and with two-thirds of people being overweight or obese, you’re going to end up with NIH funding on those people. That doesn’t mean that you can’t rely on those studies for people who aren’t sick or overweight or obese. It just means that there is a decent chance that it might not apply the further you’re away from that.

If you’re a competition-ready bodybuilder, you’re not going to go on a 40% calorie deficit and gain muscle, because your body would not survive if you kept doing that. For somebody who is a little bit overweight or even normal weight, you could gain some muscle on a 40% calorie deficit, but you really do have to look at the population in-hand, and you have to look at who the study is funded by. There has been all kinds of studies we’ve looked at where, for example, when you look at fructose research, fruit sugar, and also sugar in high-fructose corn syrup, and you look at beverages that contain sugar in general, when you look at randomized trails on them, most likely if a trial is funded by the sugar industry, then that trial will show no difference between water and sugared beverages. If you look at NIH funded research, it’s more likely to show that beverages with sugar are harmful.

That applies to a bunch of things, including supplement companies and the dairy industry, and stuff like that. It’s not that dairy is bad. It’s not that meat is bad. It’s not that sugar is bad. It’s just that you can’t be fully sure that the research you’re reading hasn’t been influenced in some way.

Brett McKay: How should people approach studies done on animals? A lot of the research on supplements, or in regards to testosterone, it’s done on mice. That’s the experiment group. Should you take that with a grain of salt, or is there anything you can actually gleam from animal studies and transfer that to human health.

Kamal Patel: Yeah, it should be a grain of salt, or more, but not totally disregarded. The reason animals are used is because you can control factors in animals a lot better. Animals have shorter life-spans and it’s cheaper and easier than using humans. Even a study of, let’s say, 30 people, if you control their diet, meaning you, as the primary investigator, provides their food for them, then you have to make sure to follow up to make sure they’re eating it, and then they have to have site visits. Over the course of months, that adds up to a ton of money, and usually those kind of studies cost at least $1 or $2 million. If you do a study in mice or rats, it’s a lot cheaper. We do share a lot of physiology with rodents and with other animals, but there’s a lot of downside.

Even for very basic things, rodents and other mammals are different than humans. As one example, vitamin C is one of the most studied supplements because it’s one of our major exogenous antioxidants. The antioxidants we make in our body are things like glutathione. Vitamin C is important. If you don’t get enough of it, which can sometimes happen on a low-card diet if you don’t pay attention to what you’re eating or supplementing, then you could sort of develop low-level symptoms of not healing well, and not performing well at the gym, and a bunch of other things.

Humans cannot synthesize vitamin C, but almost every other animal can. In that very basic way, we’re different than rodents and other animals. At some point, about two million years ago, we developed a genetic mutation so that we wouldn’t produce vitamin C. We don’t know exactly why. It could have provided a survival advantage in some way, plus maybe we were eating more fruit around then or something. For various reasons, we don’t produce vitamin C and every other animal does. Vitamin C is a major antioxidant that’s water soluble. That’s just one easily identifiable between us and rodents. There’s all kinds of other differences. Metabolism rates are different, ways to deal with stress are different. The organs are the same, but often hormonal communication is different, so yeah. You have to be very wary of when there is a rodent study done on testosterone applying that to humans.

Even, for example, like phytoestrogen studies. We don’t know exactly which dietary phytoestrogens are important and not important for humans to watch out for. That applies to men or women. For men trying to increase their testosterone, or to prevent a decline, we don’t know how much soy it takes. We don’t know how much of other plants it takes to disrupt our testosterone production because of constituents in them, because animal studies often don’t translate to humans. Actually, the best way we know that is not through supplements, but through cancer drugs. Something like 70% of cancer drugs that work in rodents end up not working in humans for a wide variety of reasons. Then, on the flip-side, a lot of drugs that don’t show side-effects in rodents end up showing side-effects in humans. You can never be sure. It’s mostly like observational, cohort, epidemiological evidence. Humans can be used to generate hypotheses. In my view, rodent evidence should be used to generate hypotheses, not to directly apply it to somebody’s life.

Brett McKay: They could read the studies on their own with some of those guidelines, and again, we’ll put a link to the site where you have that study guide people can follow so they can do their own research, but they can also go to examine.com, where this stuff has been synthesized for you. In your work with examine.com, what are the biggest nutrition myths, or supplement myths that you see being pushed over and over again? You keep getting questions asked about it. Are there any like that?

Kamal Patel: Yeah, so most of the most important myths are blank is bad. Carbs are bad, fat is bad, meat is bad, you know, I’d say those are the three main ones. Addressing them in order, carbs are obviously not bad. It’s almost painfully obvious, because observationally, some of the longest lived cultures in the world eat a lot of carbs. Our bodies do not run badly on carbs. There’s no inherent reason why you would develop blood-sugar disregulation and diabetes from eating carbs. Diabetes can be a conglomeration of different things, such as eating an unhealthy diet that includes a lot of carbs, but carbs are not evil.

Similarly, fat is not evil. There’s pros and cons of each. The body develops adipose tissue in order to efficiently store extra calories. If we couldn’t efficiently store extra calories, then we would die. There would be too much tri-glyceride in our blood. Our pancreas would end up getting overwhelmed. It’s good to be able to dispose of calories and adipose tissue. If you don’t, you end up with things like diabetes and disregulation of hormones. The excess calories can be from fat or from sugar. Fat is very easy to over consume, as is processed sugar.

Things that contain carbs that are not processed are not easy to overeat. You can’t actually eat that much fruit if it’s not processed, for example. If you tried to eat like 10 bananas, or 15 apples or something, you have to really slog your way through that. Those contain all carbs no fat. It’s really the water and the fiber that provides some satiety. Similarly, fat is not bad, which I’m sure 99.9% of your podcast audience knows, but fat is also not inherently good. Isolated fat does usually not contain many nutrients. It’s easy to over consume fat.

I worked for a bit at an obesity clinic in Boston. When working with patients, this isn’t like random internet reading and seeing what works for you, when working with large swathes of patients, there’s a lot of people who are overweight or obese who have certain foods that they can’t get enough of, and they like binge-eat at night. Peanut butter, chocolate, things with a lot of fat contain a lot of calories and a small amount of matter. Then, there’s other things like it’s possible if you eat a junk food diet that also contains a lot of fat, then there could be some issues for your gut. That doesn’t mean that sugar is clear to that either, but there’s just pros and cons of both.

Then, meat is bad or meat is good is also not true. There’s some reasons why meat could potentially not be optimal, certain types of meat in large doses, mostly processed meats. That could be because of carcinogens in meat that’s either cooked very well, almost burnt, or meat that’s been preserved, or even eating a ton of meat that’s not been preserved for certain people could have issues, like iron overload in people who have some susceptibility to that. I’ve often wondered for myself, there’s a lot of things we don’t know about the gut. There is certain people who might have genetic differences in the way that they handle iron or handle other things from meat. There are bacteria that, for example, could consume protein and amino acids.

There’s just a lot of things we don’t know, so I think having a diet that’s almost only meat and no carbohydrate, that could potentially have long-term effects for certain people. I think a safe diet is just a normal diet. It’s anything that has a lot of food that looks like plants or animals, whether it’s beef, or chicken, or fish. Normal lettuce, or kale, or quinoa, or whatever. As long as you’re eating mostly normal food, then it usually works out. Any time you completely eliminate something and you force your friends and family too as well, then I’d say that’s the biggest and most harmful myth.

Brett McKay: You’re not a fan of like the paleo diet or stuff like that?

Kamal Patel: Funnily enough I kind of came through the paleo-sphere. I helped organize one of the first two or three paleo conferences, but what always got to me was that there’s a lot of people who speak at those who are well-versed and who are professors in different areas, and you know, it’s a very interesting topic to see how connected our diet is or should be to what people ate either 10,000 years ago, 5,000 years ago, or 100 years ago, but I think when people first get into the paleo-diet, then they look at it in terms of specific rules. “I have to eat meats, fruits, and vegetables, and I can’t eat other stuff. I can’t eat any added sugar. I can’t eat legumes. I can’t eat potatoes or white rice.” There aren’t a lot of good reasons why white rice would be harmful if you eat it in normal amounts. People in Japan eat a moderate to low amount of white rice almost every day, or in certain Asian countries. Those are some of the longest living cultures in the world.

White potatoes, when paleo sort of first got popular got demonized for a couple of reasons. One is that they contain a decent amount of carbohydrate, which is actually somewhat of misconstruing the nutrition facts, because if you eat a whole potato, it’s got something like 25 grams of carbohydrate, but if you eat a whole potato, you’re going to get fairly full, because it has a lot of water and fiber as well. For some reason, some people are okay with sweet potatoes but not white potatoes, even though they both contain a similar amount of micro-nutrients. There’s a lot of reasons why those black and white rules don’t really pertain, but there are reasons why a paleo-template works well for a lot of people. I just think it’s good to always take a step back and look in terms of, “Why am I implementing these rules?” Instead of just, “What makes me feel good or feel bad?”

Brett McKay: If someone’s listening and say they want to lose weight, what’s the key to that? Is there like a macro-makeup they should shoot for? A calorie count they should shoot for? Any insight there?

Kamal Patel: Yeah, so I always advise two different paths. There was a time when I worked with a physician here in San Francisco who did a quantified self-tracking system with his patients. Half of the patients were people with metabolic disorders or could develop them, and half the patients were former addicts, either drug addicts, smokers, or people who are addicted to food. What I would say is, after a session or two, you would try to get to know the person and see what their MO was, how they acted. It was somebody who did really well when they find out something, they have to learn everything about it. When they work, then they work very specifically with specific habits. Like they wouldn’t do good with working at home unless they used time-boxing, like a Pomodoro-type thing where you work in 25 minutes and take 5 minutes off.

For those types of people, fitting their diet into a calorie count is often a really great idea. You give them 2,000, or 2,500, or 1,800 calories a day, and you say, “Eat whatever you want, but make sure to not fill it with junk food. Have a mix of things.” Then they often lose weight reliably and quickly. Then, on the flip-side, there’s people who would never do that kind of thing. They work when they want to work. They work while they watch TV. They work all weekend and then do a Netflix binge Monday, Tuesday, Wednesday. For those people I’d say, look at general principles. What are the types of things that you eat too much of that you know aren’t healthy?

It could be obvious things like chips, or cookies, or something, or it could be something more insidious, like I said before, peanut butter. Some people just eat a bunch of things that are healthy, but they eat too much of them. Like noodles can be very healthy, but some people just eat a ton of that, and then they get overweight over time just by eating a little too many calories every week over the course of years. For those people I’d say write down two or three things that seem to be important and then tick that off every day. Like, “Today I did not binge on blank.” Or, “Today I only ate from, 12:00 p.m. to 8:00 p.m. and I didn’t late-night binge.”

If you do that for a week, and then you get used to it and you keep doing that, then you’ll lose weight. There’s actually a third group, which I’d say is in the minority and be careful with this, and I kind of fall into this. People who do well with extremes. I like reading everything about stuff that I want to know about, kind of like the second group, and that’s sort of why I’m at Examine. When I did my first ketogenic diet I think it was 1997, I was just learning about nutrition. I read Lyle McDonald’s Ketogenic Diet, and I was like, “I want to use this in my cutting cycle.” I did it, and I did it successfully. Then I was like, “Oh you know, next time I want to do an even more extreme version.” I did a protein-sparing modified fast, so I ate something like 700 calories a day. It was a slightly modified protein-sparing modified fast. I cut really well, and I got the leanest I’ve ever been, but I would not recommend that to 99.999% of people, because the major thing you want to do is make something sustainable.

For myself, I knew that I could sustainably experiment with diets. For most people, the sustainability is not with experimentation, it’s with being healthy and losing weight. Making sure that you don’t collapse on the street because you didn’t eat enough of a certain nutrient. I’d say find where you are amongst those groups and go from there. Either calorie counting or focusing on two or three major rules.

Brett McKay: I like how you take into account behavior, because that’s the thing I think people overlook often times, and they try to work against their natural inclinations, and that’s where they end up with that frustration where a diet fails.

Kamal Patel: Mm-hmm (affirmative).

Brett McKay: We talked about losing weight, what if you want to gain weight? Any insight there from your research?

Kamal Patel: Yeah, so there’s ways to tweak weight-gain, but the principles have almost always been the same. What I find interesting is almost any country that you look at, the sort of old-time strongmen, whether it was Western Europe and the strongman-slash-wrestler type person or India, the people who would do feats of strength, and then it’s sort of the same in East Asia and other parts of the world. People would eat similar diets. No matter what the amount of meat was, people would often eat large amounts of whole foods basically. Like in India there was somebody who would eat a lot of the, in our weird Indian language, I don’t know how you would say it in English or Hindi, but the sort of wraps made out of either graham flour, or wheat flour, or whatever flour, and potatoes, and milk, and lentils. Just eat a lot of that, and eat consistently. In Western Europe, often times people would eat a lot of potatoes and meat and milk. In East Asia, there would be a lot of rice and meat or wheat and meat, depending on what region of East Asia you’re in.

It was always mostly the same. Getting in a lot of calories, getting a minimum of protein, and eating a lot consistently. Then, if the person wanted to concentrate on physique, they would do a cutting cycle. Nowadays, since we know a bit more, basically what we’ve done is improved the cutting cycle a bit, and then less so improved the bulking part. If you already know a lot about nutrition, then you probably know that one of the conceptually easiest ways to do the bulking is sort of the Martin Berkhan Intermittent Fasting type thing. That’s because if you’re bulking free-style then … I remember when I was I trying to get ready for my first physique competition, which never happened.

I bulked without thinking twice about things and just ate a lot of everything. I ended up getting a DXA scan three times that year, and I got to my highest body-fat percentage ever. I was strangely proud of that, and then I ended up cutting really hard, but the harder you bulk, the harder you have to cut. Sometimes you bulk so hard that you’ll never get back down to a six-pack. What we know now is that eating at all times of the day is probably not a great thing, not just for bulking but for health in general. This is where sort of the paleo-template helps. If you think in terms of food availability, unless you were rich, a few hundred years ago you would not eat all the time.

I remember when I first got on this paleo forum a few years ago, Paleo Hacks, which I think is mostly defunct now. A lot of paleo people got mad at me because I would ask questions like, “If you eat three eggs every morning the rest of your life, is that Paleo?” Because would paleo man have found three eggs every morning every day for his whole life? If he found a stash of eggs, would he share that with his family or with his village? Would there be times when because of animal migration there wouldn’t be a lot of eggs? That wasn’t a comment about micro-nutrients or health, it was rather, “Is this natural?” I don’t think it’s unhealthy to eat three eggs every day, but I do think that if you’re thinking in terms of a template, a natural template, it’s not really a natural thing to even eat the same thing every day, usually.

People would often eat different things. You would have to try to actively find food, and when you actively try to find food, you have to experiment with different foods and look in different places. Anyway, back to your original question of bulking. When you’re trying to gain muscle, a myth is that you have to overdose on protein. You don’t. Protein is most important when you’re cutting, because when you’re cutting, then your body is trying to, you know, what you’re trying to do is not eat your own muscle, eat your own protein. That’s when you have to eat a lot of protein. When you’re bulking, then you have an excess of carbs, usually, so you don’t have to eat as much protein. Then, also when you’re bulking, what you have to make sure to do is to not overtrain.

This is kind of … There is a wrinkle in this advice. For people who are experienced athletes, then often you try to train as much as you can given how much you fuel your body. That’s great, but for people who are getting into first gaining muscle, I think that’s the wrong way to go about things, because when you’re gaining muscle, the first thing to watch out for is not hurting yourself. If you train as much as fueling will let you, then often times your ligaments and tendons will be the bottleneck, the thing that can not handle what the muscle is doing, and then you get hurt. It’s a lot harder to come back from being hurt than it is to incrementally gain muscle. When you’re bulking, make sure to sustainably bulk. Don’t overdose on protein just because you heard other people say that. Make sure to get enough calories every day.

Brett McKay: It sounds like you kind of alluded to with that paleo stuff that maybe an intermittent fast and then eat most of your calories later in the day might be a good idea?

Kamal Patel: There’s a few different ways to look at that. When I’ve worked with clients, there’s some people who, you know, there’s, people listening to the podcast, there’s a sort of archetype I’ve seen, which is people between 30 and 50 years old, men between 30 and 50 years old who are not as athletic as they were before, and have an office job, and are trying to figure out how long to keep their office job, and might even be trying to figure out a way to work at home, or to work partially from home. In that case, I’d say the most important thing is to figure out when you’re working out during your work schedule, and then also when you go to bed and when you wake up.

If you work out during the workday, then I’d say that’s the most flexible, because then you allow enough fuel to work out, and then to refuel during lunch. Eat a big lunch, and then eat less as the day goes on. There are some circadian rhythm reasons why eating a really huge dinner might not be as good as eating a really huge lunch, but that really depends on the person. Some people are very sensitive to this. If you eat a big dinner and you don’t eat much during the day, then they could have worse sleep. Some people deal okay with that. Basically, the body responds well to seeing blue light during the day, eating a lot during the day, carbohydrates especially, and seeing people during the day. Whether it’s actual people, seeing pictures of people, the brain actually responds really well to seeing babies in terms of regulating your circadian rhythm. I’d say instead of periodizing your meals depending on when is exactly optimal according to studies, see what makes you feel the best and what works the best with your work schedule and then tweak it from there.

Brett McKay: Okay, so we’ve talked about nutrition, let’s talk about supplements. A lot of confusion out there. Can you tell us a little bit about the supplement industry and why there’s so much, like why there’s so many supplements in the first place claiming to do different things, and why some of these claims are just crazy and insane you’re like, “That can not be true.” Can you tell us a little bit about that?

Kamal Patel: The whole thing starts back in the early 90s. There was a time when the supplement industry could have been highly regulated, for better or for worse. You don’t want supplements to be so regulated that you can’t buy supplements, but you don’t want supplements to be so little regulated that you have the current situation where companies can basically make whatever claim they want. In the early 90s, there was a chance that supplements could have been extremely regulated. Then, a couple congressmen, who were basically in the pockets of the supplement industry, decided that this should not happen, and they should pass legislation to make sure it didn’t happen. These congressmen, one of whom was Orrin Hatch, so he was from Utah, and he was indirectly responsible for the well-being of some supplement companies that were centered in Utah. Him and another congressperson started this legislation DSHAE, the Dietary Supplement Health and Education Act.

Then, there was a lot of controversy about this act while it was being debated in congress. There was actually a video, if you’re on YouTube and you look up Mel Gibson Vitamin C, then you’ll see this ad from like ’93 or something that showed police sirens blaring and then they went to this house, and it’s sort of this guerrilla-style video that’s all shaky and you go in there, and somebody has a bottle of something, and it looks like a drug-bust. It turns it’s Mel Gibson. Mel Gibson says, “Hey, there’s no drugs here.” Or something like that. “It’s just vitamin C.” Then, the ad closes with this message, “Don’t let them take away our vitamin C.” Or something. It’s a straw man argument. Nobody was every going to take away your vitamin C, just like nobody is going to take away your guns. This was just a scare tactic from supplement companies to get away from the main issue, which is we needed at least a little bit more regulation.

What DSHAE ended up doing was two things. It made it so that the supplement manufacturer is the one who is responsible for supplement safety before a supplement goes on the market, and then the FDA is only, “Responsible after unsafe supplements have been found and there’s been enough public outcry.” There’s problems on both ends of that. The manufacturer never has enough money to do rigorous enough trials to show safety for a supplement, and then the FDA never has enough money to do post-market surveillance of a supplement. When you combine those things, it means that there’s basically a no-holds-barred Wild West, anything goes, and there’s not enough tracking to show that supplements that are unsafe are actually unsafe. Then, to compound that, there’s this warning. The so-called Quack-Miranda Warnings. The Miranda Warning is when you get arrested, you have the right not to say anything. It’s basically, now that you know, go ahead and say whatever you want.

The Quack-Miranda Warning is the thing that you find on every supplement bottle, that “This product is not intended to treat disease, or diagnose.” Even though the supplement bottle can basically say that it treats cardiovascular disease, or blood sugar, or testosterone, or anything. There is a lot of imbalance there. We get false information from the supplement label and from marketing, then from fancy looking bar graphs. Then we buy stuff, and then there’s Amazon reviews that are sometimes influenced by people who get the product for free from the supplement manufacturer, and then we use things. By that time it’s too late. If there’s one study that shows a lack of effect, it gets drowned out by a bunch of other studies that show there was some effect from a study design that was not optimal. There’s just a lot of things wrong, and it’s basically why we exist at examine.com.

Brett McKay: Right, and with that lack of regulation, it’s possible for a supplement company to say, “X is in this supplement.” But there’s actually not that supplement in that supplement, correct?

Kamal Patel: Yeah, so we covered one of those in our research digest a few months ago. A type of bacteria, pro-biotic, [inaudible 00:48:38] bacteria is one of the biggest types of probiotics, along with lacto species. For the first time, a research group looked at some of the available bifido bacteria containing bottles, and they found that out of 17 that were tested, only 1 actually contained the strains on the bottle. The rest either didn’t contain some of the strains, or it contained some extra strains. That’s not even talking about whether it met the label claims, like having 10 billion CFUs or having more or less. It’s a bit problem, not just for probiotics, but for everything else.

There’s a researcher, Peter Cowan, who lives in Boston and does a lot of research with Harvard Medical School and some other institutions looking at supplements and what’s in the bottle and what isn’t. Sometimes it’s not that important. Like, for some random nutrient that doesn’t have a lot of side-effects at high-dosages, that might not be important. For some herb, if you take a lot of that herb over time, then you could run into trouble, because anything that can have a positive effect often times can have a negative effect. Like, when you look at some registries, for example liver side-effects, often times the culprits are like, “Somebody took this random herb for six months and then their liver shut down, and it just kind of came out of nowhere.”

It’s because the liver has to detox. The reason why detox diets don’t work is that the liver is a really robust organ, it doesn’t need help. Actually, our body, our kidney’s and liver doesn’t really need help as long as you lead a normal, healthy diet. When you start introducing strange things into the body and you do it every day, that’s when the liver runs into problems, and that’s also when other organs can run into problems. Given that you don’t have to provide safety information, you yourself have to do the research. I never take a supplement every day if I can help it. I only take a supplement if it’s been extremely well-studied, or if I’m experimenting with it to see if it makes me feel better. I don’t take a bucket-list of supplements every day. I stopped that about ten years ago.

Before then, I would take everything that well-known websites said worked, and I would spend a lot of money every month. Then, I just sort of had a realization one day, I was like, “If it’s not making me feel better, and it’s not extensively shown to make people healthier, then why am I wasting my money on it?” People have to make sure that they’re not throwing their money away, and they’re not setting themselves up to go to the ICU and get in trouble when they’re in their 60s or something because their organs have been subject to weird herbs.

Brett McKay: Yeah, we actually had a guy on the podcast awhile back ago. He was a major league prospect and he was taking some muscle, some supplement, and he actually experienced liver failure, and it actually derailed his baseball career. Really, really sad. Are there supplements that people take regularly that actually aren’t doing anything for them?

Kamal Patel: Yeah, so the two categories that usually don’t do anything is testosterone boosters and fat burners. Testosterone boosters, you personally know a lot about that, and you know that ways to be healthy often boost testosterone without involving a supplement, but the long and short of it is that a testosterone booster can do one of two things to make it seem like it’s working. It can either boost libido, which you might think would also mean it’s boosting testosterone, but it isn’t, necessarily. The second thing is it can boost testosterone, maybe for two, or three, or four weeks and then go back to baseline or even lower. Usually testosterone-boosting supplements don’t boost testosterone. The intuitive way to think about this is that if there was a testosterone-booster that did reliably boost testosterone over the long-run, then why would the testosterone pharmaceuticals do well at all?

You have to go to the doctor, convince them basically to prescribe you testosterone if your testosterone isn’t extremely low, go pick up the medication instead of just ordering it on Amazon. It’s kind of like the argument people say, “There’s a cure for cancer, I’m sure of it. It’s just pharmaceutical companies are blocking it so they make a lot of money.” There’s a lot of things wrong with pharmaceutical companies, but that’s not one of them. There is no magic testosterone-boosting supplement. There are ones that could help things related to libido and stuff, but there isn’t one that super-reliably works.

With fat-burners, it’s basically that the body doesn’t like burning fat. Fat is a useful way to dispose of extra energy. It’s a way to feed your body during times of famine, even if that never happens in industrialized societies. To burn fat, you have to work hard at it. There are ways to somewhat support it sometimes, like green tea in some people, especially overweight and obese people could support it in a very minor extent. 99% of fat-burning supplements don’t work. Often times those are based on animal-studies or flawed human-studies.

Then, even some of the major supplements that people take, multi-vitamins, probiotics, fish-oil are often not working for them, even if they work for other people. Fish oil, for some people, could help. If you’re older. If you’ve had a heart attack. If you have some markers of intermediate cardiovascular risk, then it could help. For a healthy person, fish-oil often does not help. For somebody with major depressive disorder it could help. For somebody who is looking to just make gains at the gym and read some random study, it won’t help. A multivitamin for somebody who eats a really crappy diet could help, because they’re not getting a lot of nutrients anyways. For somebody who is eating a pretty good diet, it probably won’t help. For those high-dose multivitamins that come in either powder or a lot of pills that you have to take every day, I’d say skip those, because researchers find out new things basically every year about how high-levels of certain nutrients could be bad.

Folic acid was put in rich back into the diet so that pregnant women wouldn’t give birth to babies with neural tube defects, which is great, but folic acid in high levels is increasingly linked to cancer. Just because it’s a water soluble vitamin doesn’t mean it couldn’t have a negative effect. Then, those vitamins often don’t have optimal levels of minerals. I’d say minerals are more important than vitamins often in terms of things people are deficient in. If you take a multivitamin that has 50% of magnesium, but it’s in the magnesium-oxide form, then that’s not going to be absorbed really well. It’s absorbed at around 10%, whereas magnesium-chelates are much, much higher than that. Rather than taking a multivitamin, if you’re eating a decent diet, log your diet for a few days, let’s say two weekdays and one weekend day for two or three weeks. See what nutrients you’re low in, and then supplement with those or look at foods that have those and eat those. Don’t just take a multivitamin because it seems like a good idea.

Brett McKay: Are there supplements that work then? That studies have shown over and over again that they actually have a benefit without much downside?

Kamal Patel: Yeah. There’s some things that have no detriment, so any benefit is going to be good. Nitrates, this doesn’t mean nitrate-producing supplements like arginine and stuff like that. This means dietary nitrates, or if you need to get it through a supplement, it would be like a beet powder or something. Nitrates don’t have detriment, and that’s because nitrates basically increase nitric-oxide synthesis in our body, and that’s controlled enough that you can’t overdose on beets and kale and stuff. People used to think that when you ate leafy greens that it’s healthy because of fiber, or it’s healthy because of some phytochemicals, because it’s green, or it’s healthy because it decreases your calorie intake.

Those might all be true, but possibly one of the biggest parts of the reason leafy greens are good is because they increase nitrate levels and nitric-oxide levels in our body, and they do so with a long enough half-life that it’s healthy. When you take a supplement it might only increase nitric-oxide for an hour or something, but if you eat leafy greens twice during the day then that could increase nitric-oxide levels for a few hours during the day, and when you accumulate that over the course of a lifetime, that means that you might get that vasodilation in your blood vessels for long enough that that provides you some heart benefit. Then, it just so happens that nitrates can be helpful for exercise performance, and that’s for both short-term and for an endurance activity. Nitrates are pretty much a no-brainer.

A second pretty-much no-brainer is creatine. That’s because creatine has the most research out of any supplement that’s related to performance, and creatine has an increasing amount of research for cognitive enhancement. Really, there’s not that many others. Protein is a supplement that for certain people I’d say is a no-brainer. If you’re an older person, if you’re at-risk for falls, take protein, because when you fall and you break your hip, that’s the leading reason why older people get sick or die. One way to prevent the complications of that is getting a ton of protein. I’d say that those supplements are some of the only no-brainers. Everything else there is some degree of you have to think about it first.

Brett McKay: You’ve done a lot of research in vitamin D, and you hear in the media, “Vitamin D! Vitamin D!” It’s like the cure-all for everything. Depression, metabolic diseases, et cetera. Is that one of those sort of things that you have to put a little more thought into?

Kamal Patel: It is, and the only reason is this. In the general populace, I’d say, so this isn’t people who listen to the podcast. This is the general populace who thinks a few times a year about their health, but mostly reads articles on CNN or Huffington Post about some new supplement or diet. It’s not that those studies are bad, and it’s not that vitamin D doesn’t help X, Y, Z condition. It’s that you have to think about the nutrients that are missing from your life and from your diet. Vitamin D is not a dietary nutrient. It’s not that people 200 years ago and 10,000 years ago made sure to get cod liver so that they could get enough vitamin D. They didn’t eat fortified or enriched foods to get vitamin D. What they did is they were outside. Some people who listen to the podcast will live at a latitude where they get enough vitamin D outside. It’s actually not that hard if, basically, you’re white. Especially if you’re white enough to get a tan as soon as you spend half an hour in the sun.

Then, if you take vacations regularly in warm weather climates you can also get enough vitamin D, or if you take a multivitamin, you can often get enough vitamin D. Then, there’s two other groups of people. When I first got my vitamin D tested, I had taken a multivitamin almost every day for two or three years. My vitamin D ended up at around 18 or 19, which is fairly low for someone who has taken a multivitamin. Increasingly, what people are seeing is that there is not an extremely strong correlation between how much vitamin D you take in and what your levels are. It is a strong, but not extremely strong correlation, which means you can be like me and take it and still not have high levels.

I took more and I ended up normalizing my vitamin D. When you get vitamin D through sun, I would say the correlation is quite a bit higher of your sun exposure and what your vitamin D levels end up being. Let’s say that because of where you live, you can not get enough vitamin D and you’re not good at regularly taking the supplement. Then, you do have to make sure to get tested for vitamin D, and your primary care provider should pay for it in most every case. If they don’t pay for it, then order the test yourself and get tested. If you end up in your teens, that’s bad. Make sure to take a vitamin D supplement of at least, let’s say, 1,000 IUs. If you’re somewhere in your 20s, then you might or might not need to supplement. People with darker skin think they have to supplement because the vitamin D council said you have to be above 30.

There’s some wrinkles in that story. People who, let’s say, there was a study in African-American adolescent girls that showed that most of the time when those girls are lower in vitamin D, it doesn’t actually do anything bad. Even though their intake might be low, and their vitamin D levels might be low in their serum, in their blood, they don’t have lower bone mineral density or risk of fracture. It varies a lot by genetics, and genetics doesn’t only depend on skin color. Genetics could be similar between a lily-white person and a darker person like myself. It’s just hard to know.

That’s why you have to get tested. You can’t rely on your skin color. You can’t rely on how much vitamin D you’re taking. You absolutely have to get tested. Once you do get tested, if you’re in your teens and you have some health issues, then take vitamin D every day for two or three months, then there’s a decent chance that you could show some actual benefit in terms of your cognition, how you feel, depression, your muscle gain or whatever, because vitamin D is not a nutrient like other nutrients. It’s a wide-reaching pre-hormone.

Brett McKay: Got you. Kamal, lately, in the past few years, nootropics have become hot. There’s just every, it seems like every single week there’s some nootropic company coming out. For those of you who aren’t familiar, nootropics are supplements that claim to be able to increase cognition, help you focus better, have better memory, it’s basically The Limitless, is that what that movie was called? Yeah, the pill you take and you just become like superhuman. Is there any credence to nootropics that these nootropic companies are making, or is it all just a bunch of flim-flam?

Kamal Patel: First, we should take a step back and look at what nootropics are. Nootropics do have an evidence-theoretical basis. Some types were and are used as medications in Europe. There are some that have been studied more than others. Originally there was a definition. Nootropics had to be something that had certain effects on the brain, in summary. It was only a loose definition, and it’s only gotten looser over time. The current definition is not that dissimilar to, “Does something in the brain, often with cognition.” I’d say the current definition is basically something that does something in the brain, often with cognition, doesn’t have many side-effects. Is not shown to be toxic in high amounts.” In that definition, a ton of things apply to nootropics, not just the historically defined ones, like the piracetam and other similarly named nootropics.

If we look at all of the cognitive enhancers in general, then it’s virtually impossible to have a go-to nootropic. Your go-to muscle-gain supplement might be creatine. Your go-to broad-reaching supplement for mood and other stuff might be vitamin D, your go-to for like weird conditions might be vitamin C. Quick reason why is that, like I said before, we have to consume our vitamin C, other animals can make theirs. When an animal that makes vitamin C is subject to a lot of physiological stress, they make a ton of vitamin C, like many, many grams. When humans are subject to a lot of stress, we eat less, or we eat a lot of junk food and we don’t get a lot of vitamin C, so counter-productive.

There hasn’t been a lot of studies on this, but most likely, when we’re under a lot of stress, we should get more vitamin C, because when you’re not under a lot of stress and you take in a lot of vitamin C, then you get diarrhea, but when you’re under a lot of stress and you take in a lot of vitamin C, you don’t get diarrhea. It’s because we use that vitamin C, instead of having it mess with our guts and getting pooped out, or peed out rather. Vitamin C is, along with vitamin D and creatine go-to supplements. There is no go-to nootropic. Even the most well-studied cognition enhancers work in far less than half of people. Often times, like you said before, the studies that are done are on people who have some cognitive deficits, are ill in some manner, are older.

I used to work with this research center on aging. Almost every study done on a supplement is done on older people when they show good results. The only sort of supplement that shows broadly good results in cognition amongst younger and older people is blueberry, and that’s not really classified as a supplement, even though you can take blueberry powder. I don’t think nootropics are bunk. You know, back in the day when I would experiment more, I would cap my own nootropics, you know, get a capping machine, buy the bulk powder, make my own. Because I’m crazy, I would even placebo control myself. I would take a batch, take another batch and make them sugar-powder in capsules, or multi-dextrine powder and then see after two or three years what the effect was and then unmask, un-blind myself.

Most non-crazy people won’t do that, but that’s really the only way to know if a hyped nootropic is doing anything, because you can take a supplement, and I’ve had a placebo effect myself, when I took a generic medication and only later found out that that generic medication is actually not as helpful as the normal medication. In 99% of cases, the generic does as well as the normal medication, but there can be very slight differences. The generic medication, the configuration of the molecules could make either greater side-effects or less efficacy of that medication. Only later did I find that I was probably overthinking things and thought that the medication provides some benefit, because the longer I took it there wasn’t any benefit anymore. I’d say nootropics are the last thing you should look at. Look at diet, look at sleep, look at stress first, and then look at nootropics.

Brett McKay: Okay. Great advice. Well, Kamal, we really dug deep in this podcast, but there’s so much more we could talk about. Where can people learn more about your work?

Kamal Patel: Go to examine.com, send us a message. I read every message. If you want to talk to me or look at stuff I personally post, I’m at Facebook.com/mirandajuly. Long and stupid story why that’s my Facebook address, but I love talking to people interested in nutrition and health and lifestyle. Send us random studies. We love it. We like looking at new things. We like looking at even case studies. We’re just a collection of people, like you guys, that like reading stuff. Talk to us and we’ll talk back.

Brett McKay: Awesome. Well, Kamal Patel, thank you so much for your time, it’s been a pleasure.

Kamal Patel: Yep, and have a good day.

Brett McKay: My guest today was Kamal Patel, he’s the head researcher at examine.com. If you want to find out about any sort of supplement that you have a question about, whether it’s effective or not, head over to examine.com. Search for it and you’re going to get a very detailed analysis in plain language that will tell you whether it works or not, all independently verified. They also have a lot of other great content just about nutrition and health in general, so check that out as well. Examine.com. Also, check out our show notes at aom.is/examine, where you’ll find links to resources where you can delve deeper into this topic.

Well that wraps up another addition of the Art of Manliness Podcast. For more manly tips and podcast, make sure to check out the Art of Manliness website at artofmaniliness.com, and if you could do me a favor, if you have an extra minute please go to surveypod.net and take a short survey about today’s episode. It would help the show out a lot and I appreciate it a lot. Again, surveypod.net for a quick survey to help the show. Until next time, this is Brett McKay telling you to stay manly.

Last updated: December 5, 2017

Continue the Conversation ...

Want to share your thoughts on this article? Send us a tweet or join the discussion on Facebook!