#400: Quack Asylum – Part 1: Malhotra & DiNicolantonio

Emulsifiers are a ubiquitous component of the modern food supply, found in everything from salad dressings and dairy products to pastries and sauces. Traditionally regarded as safe by regulatory agencies, emulsifiers play a vital role in enhancing the texture, stability, and shelf-life of countless processed foods. Yet, in recent years, emerging research has prompted a reevaluation of this assumption, raising intriguing questions about whether regular consumption of these additives might have previously overlooked health consequences. Recent epidemiological studies have suggested possible associations between higher emulsifier intake and chronic health issues. Concurrently, mechanistic research has provided some biological pathways through which emulsifiers could disrupt gut health. This episode aims to critically examine the scientific literature surrounding dietary emulsifiers, differentiating credible evidence from speculation, and outlining what can—and cannot—be concluded about their potential risks. Timestamps [01:18] Emulsifiers in food: definition, function, and common uses [05:15] Regulatory approval and traditional safety evaluations [09:32] Epidemiological studies on emulsifiers: nutriNet-santé cohort [14:55] Emulsifiers and cardiovascular disease risk [26:12] Emulsifiers and type 2 diabetes risk [30:01] Emulsifiers and cancer risk [35:05] Mechanistic insights: emulsifiers, gut health, and inflammatory bowel disease (IBD) [47:15] Practical recommendations and clinical implications Related Resources Subscribe to Sigma Nutrition Premium Go to episode page (with study links) Join the Sigma email newsletter for free Enroll in the next cohort of our Applied Nutrition Literacy course

Nutrition is increasingly being considered as a modifiable factor that may influence neurodevelopmental outcomes. While severe deficiencies in certain nutrients are known to have dramatic effects, there is growing interest in the potential impact of more subtle insufficiencies — particularly during critical windows such as pregnancy, infancy, and early childhood. In conditions like ADHD, dyslexia, and autism spectrum condition (ASC), questions have been raised around whether specific nutrients may play a role in cognitive performance, attention, or learning. Could low choline intake be a contributing factor to altered brain function? Are individuals with neurodevelopmental conditions more likely to have different nutrient needs or metabolic profiles? And how might practical dietary strategies fit into a broader management approach? In this episode, Dr. Emma Derbyshire discusses the evidence on choline and other brain-related nutrients in the context of neurodiversity. Timestamps [02:02] Guest background [05:38] Choline: what it is and why it matters [07:26] Research challenges: measuring choline and study design issues [10:49] Maternal intake: choline’s role in fetal brain development [14:24] Choline & neurodevelopmental disorders (ADHD, ASC, dyslexia) [17:14] The choline gap: intake vs. requirements [23:05] Supplementation: adequacy vs. excess and safety concerns [25:05] Food sources: choline in the diet & intake planning [30:14] Nutrition as a tool in ADHD and dyslexia management [38:45] Other key nutrients (omega-3s, iron, iodine, magnesium, water) Related Resources Go to episode page Join the Sigma email newsletter for free Subscribe to Sigma Nutrition Premium Enroll in the next cohort of our Applied Nutrition Literacy course Book: Nutrition for ADHD and Dyslexia: Unlocking the Potential for Learning and Wellbeing Dr. Derbyshire’s website: https://www.nutritional-insight.co.uk/

This is a segment from one of our Premium-exclusive AMA (ask me anything) episodes, where we answer questions submitted by Premium subscribers. To listen to the full episode, you’ll need to be a Premium subscriber and access the episode on the private Premium feed. Questions Answered in This Episode [02:00] Why does the Mediterranean diet emphasize monounsaturated fats over polyunsaturated fats when the latter seem more beneficial for heart health? [08:48] What dietary patterns or foods best support strength and recovery in premenopausal women, especially on a plant-based diet? [20:33] Are there specific foods or supplements that help regenerate or protect connective tissue in conditions like EDS? [28:39] What does the current evidence say about the keto diet during cancer treatment, and are there specific cancers where it might be beneficial? [43:31] What are the biochemical processes behind fat loss, including fat mobilization, transport, and any potential short-term cardiovascular risks? [59:48] What is the most effective system for organizing, structuring, and retrieving accumulated knowledge over time? [1:10:37] Do you agree with Dr. Tom Dayspring that a significant percentage of people are hyper-absorbers of dietary cholesterol, making food cholesterol impactful for them? [1:14:35] Is consuming 2g of protein per pound of body weight safe if calorie intake is high and well-balanced? Links Subscribe to Sigma Nutrition Premium Go to sigmanutrition.com

The intersection of nutrition, dermatology, and skin health is an area of growing interest, yet one that remains riddled with misinformation and oversimplified claims. The influence of dietary patterns, specific nutrients, and lifestyle factors on conditions such as acne, eczema, psoriasis, and skin aging has been widely debated, with varying levels of evidence supporting different interventions. While some nutritional strategies may play a role in optimizing skin health, the challenge lies in distinguishing practical, evidence-based approaches from overstated or anecdotal claims. A significant issue in this space is the naturalistic fallacy—the belief that diet alone can replace medical treatments, or that conventional dermatological interventions should be avoided in favor of “natural” approaches. This has led to widespread vilification of certain foods, such as dairy, gluten, and sugar, despite a lack of strong supporting data. Similarly, supplements and probiotics are often promoted with broad claims, while their actual efficacy is highly context-dependent—varying based on individual nutrient status, disease severity, and baseline dietary intake. In this episode, Dr. Thivi Maruthappu, a consultant dermatologist and researcher in nutritional dermatology, joins Danny Lennon to explore the current state of evidence in this field. Guest Information Dr Thivi Maruthappu MA PhD FRCP ANutr is a consultant dermatologist, nutritionist and leading researcher. As the UK’s first and only dual-qualified dermatologist and nutritionist, her pioneering expertise bridges the gap between diet and skin health. Dr Thivi continues to work in the NHS and has her own practice based at London’s renowned Cleveland Clinic. Dr Thivi studied Medicine at Oxford University and completed Dermatology training in London. She undertook a PhD to understand the links between our skin and internal health and this research featured in top tier scientific journals. She is one of a handful of dermatologists to have completed training in severe eczema and psoriasis during a fellowship at St John’s Institute of Dermatology, London and achieved a Certificate in Nutrition Science from Stanford Medical School, USA. Timestamps [02:52] Start of interview [03:37] Dr. Maruthappu’s background and expertise [05:57] Sunscreen and skin health: myths and facts [12:15] Effective skincare ingredients [16:07] The role of nutrition in skin health [20:25] Dairy and skin conditions [24:10] Collagen supplements: do they work? [27:45] Probiotics for skin health [31:35] Research outcomes and challenges [35:20] Practical applications in clinical practice [43:05] Key ideas segment (premium-only) Related Resources Join the Sigma email newsletter for free Subscribe to Sigma Nutrition Premium Enroll in the next cohort of our Applied Nutrition Literacy course Dr. Maruthappu’s website

Discussions around ultra-processed foods (UPFs) and their role in public health have gained significant traction in recent years. While some advocate for categorizing and regulating these foods due to their potential negative health effects, others argue that such classifications can oversimplify the issue and detract from more actionable dietary changes. In this episode, Dr. Duane Mellor, a registered dietitian and researcher, joins us to explore the complexities of the UPF debate. Rather than dismissing the concept outright, Dr. Mellor emphasizes the importance of nuanced discussion, bridging the gap between research findings and practical, evidence-based dietary guidance. Throughout this conversation, we unpack the broader implications of ultra-processed foods in the food system, consider how added fat, salt, and sugar contribute to public health challenges, and explore realistic approaches for dietary improvements. Guest Information Dr. Duane Mellor, PhD is a registered dietitian, academic researcher and science communicator. Dr. Mellor is currently working in clinical dietetics, working to support people, families and carers living with diabetes. Previously Dr. Mellor worked in medical education at Aston University, holding the position of Associate Dean for Public Engagement in the College of Health and Life Sciences. After initially working in the areas of clinical trials, Dr. Mellor’s other research interests focused on improving nutrition and health by working with communities to celebrate their heritage through food and help tackle barriers resulting from societal inequalities. Timestamps [03:02] Interview start [06:39] Understanding the NOVA classification [09:53] Potential pitfalls and policy implications [14:52] Food science and technology perspectives [20:47] Challenges in food classification [26:13] Health equity and policy considerations [42:31] Communication and public perception [50:30] Final thoughts and advice [51:15] Key ideas segment (Premium-only) Related Resources Join the Sigma email newsletter for free Subscribe to Sigma Nutrition Premium Enroll in the next cohort of our Applied Nutrition Literacy course Paper: Mellor, 2024 – The role of food science and technology in navigating the health issues of ultra-processed foods Go to sigmanutrition.com

In the realm of health psychology, our understanding of eating behaviors extends beyond mere physiological hunger cues. Research indicates that factors such as learned associations, cultural influences, and individual perceptions play pivotal roles in shaping our dietary choices. Recognizing this complexity is essential for developing effective dietary interventions that move beyond simplistic recommendations, acknowledging the intricate web of cognitive, emotional, and societal factors at play. A significant discussion within nutrition science centers on the regulation of eating patterns, particularly the balance between internal cues and external structures. While intuitive eating emphasizes responding to one’s internal hunger signals, studies suggest that these signals are often influenced by external factors such as distractions and learned behaviors. An alternative approach, known as “pinned eating,” proposes structuring meals around fixed times and contexts. In this episode Prof. Jane Ogden, Professor of Health Psychology at the University of Surrey, discusses these concepts and some of the research her group has carried out. Guest Information Professor Jane Ogden is a distinguished health psychologist at the University of Surrey, with over three decades of experience in researching eating behavior, weight management, and women’s health. She earned her PhD from the Institute of Psychiatry in London in 1990 and has since contributed extensively to the field through her research and publications. Throughout her career, Professor Ogden has authored several influential books, including “Health Psychology: A Textbook,” now in its seventh edition, and “Thinking Critically about Research.” Her work is widely recognized, leading to her receiving an honorary Doctor of Science from the University of Buckingham in 2022. Timestamps [02:01] Interview start [02:41] Understanding eating behaviors and influences [10:33] Integrating psychology into nutrition practice [13:58] Pinned Eating [16:46] Critique of Intuitive Eating [21:30] Eating behaviors and hunger as a perception [26:34] Taste preferences and acquisition in children [29:10] Cultural and contextual meanings of food [33:25] Disgust and food presentation [35:29] Health communication and obesity [44:28] Future research in health psychology [47:23] Key ideas segment (Premium-only) Links: Subscribe to Sigma Nutrition Premium Join the Sigma email newsletter for free Go to Sigma Nutrition website Enroll in the next cohort of our Applied Nutrition Literacy course Study: Ogden et al., 2020 – The impact of intuitive eating v. pinned eating on behavioural markers: a preliminary investigation

Sleep is one of the most critical yet often overlooked components of health, performance, and overall well-being. Poor sleep quality or insufficient sleep can disrupt circadian rhythms, impair glucose metabolism, and alter hunger signals, leading to increased food intake, reduced insulin sensitivity, and other undesirable outcomes. In this episode, we bring together expert discussions from some of the leading researchers in sleep science, to explore what defines high-quality sleep, the mechanisms behind sleep regulation, and the factors that influence sleep-wake cycles, from light exposure to psychological stress. Timestamps Note: Full episode only available on Sigma Nutrition Premium. [02:14] The importance of sleep duration and timing [05:32] Exploring sleep intensity and architecture [07:50] Defining good quality sleep [12:46] The two process model of sleep regulation [19:06] What is sleep? [24:47] Socioeconomic factors and sleep [34:30] The impact of blue light on sleep [47:10] Wake drive and sleep pressure [52:44] Stress, anxiety, and sleep [58:27] Common sleep disorders [01:06:26] Sleep and eating behavior Related Resources Join the Sigma email newsletter for free Subscribe to Sigma Nutrition Premium Enroll in the next cohort of our Applied Nutrition Literacy course Episodes referenced: 38: Dan Pardi, PhD 316: Michael Grandner, PhD 209: Amy Bender, PhD 433: Greg Potter, PhD 328: Meeta Singh, MD 536: Ian Dunican, PhD 61: Kirk Parsley, MD

There is research suggesting that industrialization has significantly altered the composition of our gut microbiota, with certain microbial species now absent in many industrialized populations. Given the known associations between gut microbiome diversity and health, researchers have begun investigating whether restoring lost microbial species and adopting dietary patterns similar to those of non-industrialized populations could lead to measurable health benefits. In a newly-published study, the investigators aimed to explore whether L. reuteri could be successfully reintroduced into the microbiome through the “Restore Diet” and whether such a shift would result in improvements in key cardiometabolic and inflammatory markers. One of the authors, Dr. Anissa Armet, is on the podcast to discuss this area and both the potential and limitations of microbiome restoration efforts. Timestamps [03:48] Interview start [08:45] Understanding gut microbiome restoration [11:44] Challenges in microbiome research [21:03] Study design and objectives [43:23] Key findings and results [47:46] Future research directions [01:04:04] Key ideas segment (premium-only) Links Join the Sigma email newsletter for free Subscribe to Sigma Nutrition Premium Enroll in the next cohort of our Applied Nutrition Literacy course Free Book: The NiMe Diet: Scientific Principles and Recipes Paper: Cardiometabolic benefits of a non-industrialized-type diet are linked to gut microbiome modulation Dr. Armet’s free, open-access High Protein Cookbook for Muscle Health During Cancer Treatment

Every five years, the U.S. Dietary Guidelines are updated based on the latest scientific evidence to help shape national nutrition recommendations. A panel of experts was assembled to review the existing research, evaluate new findings, and provide recommendations that will inform the next edition of the guidelines. One of the committee members involved in this process is Professor Christopher Gardner, a leading nutrition scientist at Stanford University, who joins us to share key insights from the committee’s work. In this discussion, Professor Gardner provides an inside look into how the committee evaluated dietary patterns, the role of plant-based proteins, and the ongoing debate surrounding ultra-processed foods. He explains the rigorous process of reviewing scientific literature, the challenges in translating research into policy, and the critical role of health equity in shaping the recommendations. By exploring these themes, this episode aims to provide clarity on the scientific foundation behind the upcoming dietary guidelines. Whether you’re a nutrition professional, researcher, or someone interested in how dietary recommendations are formed, this conversation sheds light on the key discussions shaping the future of nutrition policy. Timestamps [03:38] Interview begins [07:18] The rigorous process behind formulating dietary guidelines [12:10] Key questions addressed and major findings from the report [25:41] Identifying nutrients of concern and refining dietary patterns [33:39] The importance of health equity in dietary recommendations [36:04] Reassessing dairy’s role in different population groups [41:05] Shifting the focus towards plant-based protein sources [47:52] The debate on ultra-processed foods and public health implications [58:24] Key Ideas segment (Premium-only) Related Resources Enroll in the next cohort of our Applied Nutrition Literacy course Subscribe to Sigma Nutrition Premium Join the Sigma email newsletter for free Scientific Report of the 2025 Dietary Guidelines Advisory Committee Previous episode with Prof. Gardner: Episode 223

Understanding the complexities of diet-disease relationships requires a nuanced approach to nutritional science. Unlike other scientific disciplines, nutrition research often grapples with the inherent challenges of studying dietary patterns and nutrient intakes in free-living populations over long periods. The cumulative effects of dietary exposures, combined with the necessity to control for confounding factors such as total energy intake and population-specific dietary habits, highlight the need for rigorous study designs and careful interpretation of findings. Despite their utility, these methods are often misunderstood or misrepresented in public discourse. Addressing these misunderstandings requires a clear communication of key principles underpinning nutritional science, including the role of cumulative exposure, the importance of contextualizing absolute and relative risks, and the necessity of evaluating the long-term effects of dietary patterns. This episode aims to provide a comprehensive overview of these essential ideas, equipping readers with the tools to critically appraise the evidence and engage meaningfully with the ongoing conversation around nutrition research. Timestamps [03:26] Understanding nutrition science: core concepts [06:01] Standards of proof in nutrition research [19:39] Unique challenges in nutrition research [26:30] High vs. low exposure in nutrition studies [34:34] Challenges in nutrition randomized control trials [39:29] Understanding null by design in nutrition trials [41:58] The importance of temporal relationships in diet and disease [43:55] Relative risk vs. absolute risk [57:16] The role of substitution and adjustment in nutrition studies Related Resources Enroll in the next cohort of our Applied Nutrition Literacy course Join the Sigma email newsletter for free Subscribe to Sigma Nutrition Premium Episodes referenced: 531: Correlation, Causation & Cliché 478: Exposures in Nutrition – Why They’re Crucial to Understand 511: Null By Design – When “No Effect” Doesn’t Mean No Effect 378: Nutritional Epidemiology 472: Compared To What? – Understanding Food Substitution Analysis & Adjustment Models