Today’s guest post is from the fine folks at Examine.com, the internet’s leading authority for information on supplements and nutritional concepts. They’re a completely unbiased site that doesn’t sell any supplements themselves, but they do have some incredibly useful resources, like their supplement reference guide, and they’ve also just released a handy series of resources on supplement stacks.
A stack is essentially when you take multiple supplements with the purpose of producing a specific benefit, like taking creatine, protein, and branch-chain amino acids to help with muscle growth. Sometimes these stacks measure up through scientific scrutiny, and sometimes they fall flat. Other times, they can showcase some dangerous results, like combining thyroid medication and a fat burning supplement.
Anyways, I’ll let them take it from here. They’ve always produced killer posts for me, and this is no exception.
Let’s imagine a new study came out looking at creatine. A simple study really, they wanted to see how the dose of creatine interacted with the activity level of the subject. Their hypothesis is simple – people who are more active would benefit from more creatine supplementation than normal.
So they take two groups of people, one pretty much sedentary and given a light exercise plan. The other has competitive athletes. Divide each group into four doses of creatine (placebo, 2.5 grams, 5 grams, and 10 grams) to test the hypothesis, and compare results between the two groups after a few months.
Finally, let’s assume that in sedentary people all three doses performed equally while in the athletes there was a clear dose-dependent effect but 2.5 grams was not enough to be different from placebo. Such a result would be in line with the researcher’s initial hypothesis, and it seems to make a fair bit of sense if they conclude that “more creatine is needed if you have more activity, but this is not needed if you are not highly active”.
Then it hits the media and you get stuff like:
Naturally I threw in one blatant lie, but that’s how they get your attention.
The above situation was more of a reflection of how people who are not researchers distort information, but at times the researchers themselves are to ‘blame’. I put blame in quotations because they really aren’t doing anything wrong, but it is their actions that lead to confusion (well, that and people not considering their study in the context of the literature) rather than distortion from third parties.
Let’s say you have an antiinflammatory agent and it works great for joint pain, but damn is it expensive. The dosage used in the studies previously would cost a user upwards of $4.00 a day, so it really isn’t something you can recommend to some people who need it ($120.00 a month is out of the question for some people).
However, nobody has studied half the dose nor have they studied a quarter of the dose. What if you could actually quarter the dose and retain the same efficacy? $30.00 a month is a lot more reasonable than $120.00 a month, and even if it was 75% as effective it is still a good thing.
(Note: It is actually common for the very first study conducted with a supplement to optimize all conditions to sort of ‘force’ a positive result and this usually means high doses of pure supplements in the best possible research conditions. Future research gradually uses more lax criteria to see how broad the evidence can be applied to, then refines in on areas seen as most promising)
Now because life isn’t fair, let’s assume the study totally flops and it turns out you need the initial dose. Sucks I guess.
Regardless of how impartial reports try to be, if you only look at this study without looking at the body of evidence all you will see is failure when in reality they were just assessing the boundaries of efficacy. Nothing works “for everything at all times”, so when it is noted to work you will have to test how far you can take it before it stops working.
All possible misinterpretation could easily have been avoided when considering the body of evidence.
The media cares about one thing – getting your attention.
They are best used for things that do not require a ‘body of evidence’ to reflect on such as tips/tricks, advice, personal experiences, thoughts that could help the reader, input on current issues, etc. When timeliness is important, depicting the full picture is not a concern.
Of course, when the latest study hits, the response is typical:
It is in part because of the inherent “first come first serve” for traffic when it comes to new studies in the media that lead to this vicious cycle. It’s something that can be readily avoided if the articles reference databases or other compilations of evidence.
Benefits of databases and ‘position statements’
When referring to ‘position statements’ usually this is for organizations, such as the ISSN position stand on nutrient timing (as an example) or a position statement for treatment of knee and hip osteoarthritis from OARSI (Osteoarthritis Research Society International; Part 1 and Part 2) or, perhaps most famously, Cochrane collaborations. These are all characterized by:
Remember, scientific progress is slow and methodical. Which is why when we get our most popular questions (“What supplements should I take for _____?”), our answer isn’t based on just the latest research; it’s based on the full body.
Examine.com just released a series of stack guides to help you get the most scientifically supported and simple to use method of achieving your goals with proper supplementation, regardless of what you’re going for. They lay out what works, what doesn’t how to save money on your supplements, and how to get more targeted results, all in one handy resource. They have guides for goals like:
Plus a bunch of others
If you currently take supplements, this will be a very useful guide to help you know if what you’re using is helping you or hurting you. If you don’t take supplements because you’re confused about what works and what doesn’t, this takes all the guesswork out of it and lays out a plan that’s easy and specific to what you want.
The stack guides are on an introductory sale for a limited time, and you can get them individually or all at once. If you’re a trainer or health professional, I would recommend the total package as your clients and patients will benefit immensely from some recommendations. If you only want one or two, that’s cool as well.
Kamal Patel is the director of Examine.com. He has an MBA and an MPH (Master of Public Health) from Johns Hopkins University, and was pursuing his PhD in nutrition when he opted to go on hiatus to join Examine.com. He is dedicated in making scientific research in nutrition and supplementation accessible to everyone.