Sigma Nutrition Radio
The podcast for lovers of nutrition science! Listen to detailed discussions with researchers and leading experts about the science of nutrition, dietetics and health.
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#599: Does Unprocessed Red Meat Increase Diabetes Risk? – Gil Carvalho, PhD MD & Mario Kratz, PhD
03/24/2026
#599: Does Unprocessed Red Meat Increase Diabetes Risk? – Gil Carvalho, PhD MD & Mario Kratz, PhD
This episode examines whether unprocessed red meat has a causal role in (1) type 2 diabetes risk and intermediate measures of glucose intolerance (insulin resistance, beta cell dysfunction, glycemic markers) and (2) cardiovascular disease (CVD) risk. While there is commonly observed risk signal from observational cohorts, there exist short-term randomized controlled trials (RCTs) that show largely null effects on glucose homeostasis. This had led to differing opinions and interpretations of the evidence base. Some feel that in the context of an otherwise healthy diet, there isn’t much to suggest concern about consuming unprocessed red meat. While others are of the view that there does exist a risk and that limiting or even avoiding consumption is prudent. The crucial concept of replacement effects is discussed. Increasing red meat intake always means decreasing something else or increasing total energy intake. Therefore, interpreting evidence requires specifying the comparator food(s), the background dietary pattern, the dose, the cut (lean vs fatty), and how the meat is prepared. To discuss their interpretations of this contentious evidence base, Dr. Mario Kratz and Dr. Gil Carvalho join the podcast to go through the studies most directly related to these questions. Timestamps [06:20] Red meat’s impact is debated [10:54] Mechanisms linking meat to diabetes [15:31] Cohort evidence on diabetes risk [24:43] Differences between cohorts and threshold effects [33:13] RCT evidence and substitution trials [45:49] Why comparator foods matter [50:43] RCT examples and mixed results [01:00:30] Is there cardiovascular risk beyond saturated fat? [01:08:10] Epidemiology patterns and dose thresholds [01:11:36] Personal recommendations and risk tolerance [01:16:19] Key ideas Related Resources (study links, guest bios, additional resources) Join the for free Subscribe to Enroll in the next cohort of our course Mario’s YouTube channel: Gil’s YouTube channel:
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#598: How Do Exercise & Diet Interact to Improve Glycaemic Control? – Jenna Gillen, PhD
03/17/2026
#598: How Do Exercise & Diet Interact to Improve Glycaemic Control? – Jenna Gillen, PhD
This episode examines how exercise and nutrition interact to influence glycaemic control, with particular focus on the postprandial period (i.e., the hours after eating) and on “time-efficient” exercise strategies such as low-volume interval training. Dr. Jenna Gillen outlines the physiological basis for why muscle contraction can acutely reduce post-meal glucose excursions, why repeated sessions can accumulate into longer-term improvements in insulin sensitivity, and why the nutrition context (pre- and post-exercise feeding, carbohydrate availability, and energy balance) can meaningfully alter observed outcomes. A key translational thread is that many clinically relevant improvements may come from small, feasible doses of activity; especially post-meal walking and brief “exercise snacks” used to interrupt sedentary time. However, the discussion considers who these interventions matter for most (and least). Postprandial glucose rises are normal in healthy individuals, whereas reducing exaggerated excursions is most relevant for those with insulin resistance, prediabetes, or type 2 diabetes (T2D). Dr. Jenna Gillen is an Assistant Professor of Exercise Physiology in the Faculty of Kinesiology & Physical Education at the University of Toronto. Timestamps [02:42] Dr. Gillen’s research focus [04:11] Understanding glycemic control [10:07] Fasted vs. fed state exercise [11:10] Post-meal exercise benefits [20:10] Low volume interval training [26:27] Interval training and blood glucose [31:29] Energy balance and insulin sensitivity [36:32] Exercise and nutrition interactions [40:11] Practical exercise recommendations [43:56] Key ideas segment (Premium-only) Links (with links to papers) Join the for free Subscribe to Enroll in the next cohort of our course See
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#597: Behavioral Psychology in Diet & Health Counselling – David Creel, PhD, RD
03/10/2026
#597: Behavioral Psychology in Diet & Health Counselling – David Creel, PhD, RD
In clinical practice effective nutrition, exercise, and obesity care is rarely about identifying the single “best” plan on paper. Instead, sustainable change depends on behavioral psychology: understanding the person’s context, motivation, barriers, and patterns, then co-designing practical steps that can actually be implemented in real life. David Creel PhD, RD is a clinical psychologist and registered dietitian working in weight management at the Cleveland Clinic. Dr. Creel discusses how clinicians can bridge the gap between “optimal recommendations” and what is most likely to create actual behaviour change. This includes a combination of using collaborative communication, self-monitoring, skill-building, relapse prevention planning, and a multidisciplinary framework. Behavioral and psychological factors shape food choices, physical activity, and adherence far more than knowing the newest guideline. In addition, the modern obesity treatment landscape (including GLP-1 receptor agonists) increases the need for structured behavior-change support: people may experience new hope and new fear (especially fear of weight regain), and the key clinical question becomes how to use these tools to build durable habits and reduce relapse risk over the long term. Timestamps [03:09] Start of interview [05:31] Challenges in nutrition and exercise recommendations [11:01] Behavior change in real-world practice [16:32] Self-monitoring and its importance [23:48] Non-scale victories and positive body image [25:58] Focusing on body capabilities over aesthetics [27:20] Integrating activity into lifestyle [30:30] Exercise snacking and practical tips [33:36] Impact of GLP-1 receptor agonists [38:24] Addressing fear of weight regain [41:24] Effective multidisciplinary obesity treatment Related Resources Join the for free Subscribe to Enroll in the next cohort of our course LinkedIn: X/Twitter:
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#596: Why Do Omega-3 Trials Show Mixed Results?
03/03/2026
#596: Why Do Omega-3 Trials Show Mixed Results?
Omega-3 fatty acids (particularly EPA and DHA) have a long history in nutrition and cardiovascular medicine, yet the clinical trial literature is often perceived as inconsistent. This episode examines why some randomized trials show clear benefit while others show null or mixed findings, and how differences in trial design, dose, population risk, and outcome selection can materially change what we observe. A key theme is separating (1) the persistent cultural narratives around omega-3s (including origin stories that do not hold up well to modern evidence) from (2) the more precise, mechanistic and clinical questions about where supplemental EPA/DHA may reduce cardiovascular risk. The discussion focuses heavily on understanding heterogeneity: why “omega-3 supplementation” is not a single, uniform exposure, and why subgroup patterns (e.g., secondary prevention, higher baseline triglycerides, and higher doses) may explain much of the apparent conflict in the evidence. Note: This discussion is taken from a previous episode of the podcast. The audio has been remastered and improved, and now study notes and full transcript are available. Timestamps [04:10] Omega-3 historical context and Inuit studies [08:38] Mechanisms of omega-3 benefits [12:49] VITAL and ASCEND trials analysis [23:41] GISSI-Prevenzione trial insights [26:44] REDUCE-IT trial and residual risk [32:19] Significance of baseline triglycerides [37:57] 2018 Cochrane review [46:02] Hu et al. meta-analysis [01:00:27] Practical takeaways for omega-3 supplementation [01:03:55] Key ideas segment (premium subscribers only) Related Resources (with links to mentioned studies) Join the for free Subscribe to Enroll in the next cohort of our course Alan Flanagan’s
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#595: Neuroplasticity and Reducing Risk of Cognitive Impairment – Dr. Majid Fotuhi
02/24/2026
#595: Neuroplasticity and Reducing Risk of Cognitive Impairment – Dr. Majid Fotuhi
Conversations about brain health have been dominated by a competing mix of fatalism and over-promising, with aging framed as inevitable decline and “brain optimisation” sold through weak evidence. So how should we think about cognition across the lifespan? In this episode, we explore the idea that neuroplasticity does not disappear in adulthood, but instead continues to respond, for better or worse, to repeated behaviours and exposures. Much of what is labelled age-related cognitive decline may in fact reflect an accumulation of modifiable risk factors. We also dig into how to critically evaluate brain-health claims and how lifestyle pillars such as exercise, sleep, diet, stress reduction and cognitive training fit into a coherent framework. The discussion extends to emerging multimodal intervention programs, their promising signals and their clear limitations, and to a broader, multifactorial view of Alzheimer’s disease that moves beyond a narrow amyloid-centric model. Finally, we examine the role of genetics, including ApoE4, and why genetic risk does not equate to biological destiny, even later in life. Dr. Majid Fotuhi is a neurologist and an adjunct professor at the Johns Hopkins Mind/Brain Institute. He earned his medical degree from Harvard Medical School and completed a Ph.D. in neuroscience at Johns Hopkins University. That was followed by internship and neurology residency at Johns Hopkins Hospital. Timestamps [03:41] Understanding neuroplasticity [05:22] Risk factors for cognitive decline [07:07] Evidence-based interventions for brain health [09:37] The five pillars of brain health [10:42] Dr. Fotuhi’s multimodal program [19:09] Measuring cognitive function [24:43] The role of amyloid and tau in Alzheimer’s [27:53] Genetics and lifestyle in brain health [30:03] Debunking myths and overhyped claims [36:08] Key ideas segment (premium subscribers only) Related Resources (with links to studies mentioned) Join the for free Subscribe to Enroll in the next cohort of our course Dr. Fotuhi’s book:
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How Much Dietary Fiber Do We Need to be Healthy? (SNP48)
02/17/2026
How Much Dietary Fiber Do We Need to be Healthy? (SNP48)
This is a Premium-exclusive episode of the podcast. To listen to the full episode you need to be subscribed to . This episode examines dietary fiber through the lens of a practical, clinically relevant question: if higher fiber intakes are consistently associated with reduced chronic disease risk, what intake level should we be aiming for to meaningfully improve health outcomes? The discussion deliberately spans from common online claims that fiber is “not essential” (and therefore unnecessary), through to mechanistic reasoning and the highest-quality evidence we have for hard outcomes and accepted intermediate cardiometabolic endpoints. Across the episode, we’ll hear from six expert perspectives to integrate epidemiology, controlled feeding studies, and clinical guideline contexts. We will consider how the dose–response patterns, fiber type/source, individual tolerance, and the limitations of nutrition trials all influence what can be recommended with confidence. Timestamps [03:51] Addressing the claim “fiber is not an essential nutrient” [11:23] Carbohydrate quality and fiber [17:16] Dietary recommendations for fiber [20:01] Portfolio diet and cardiovascular health [26:48] Comparing fiber sources [36:07] Epidemiological evidence on fiber [41:57] Understanding fiber intake and coronary heart disease [43:23] Fiber intake and colorectal cancer [54:06] Diet swap study: south african vs. african american diets [01:01:47] High fiber diets and diabetes [01:16:18] Challenges in fiber intake and IBS [01:21:45] Concluding thoughts on fiber intake Related Resources Subscribe to Go to (with links to mentioned studies) Join the for free Enroll in the next cohort of our course
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#594: Can Muscle Still Adapt Positively When Training Under Low Energy Availability? – Jose Areta, PhD
02/10/2026
#594: Can Muscle Still Adapt Positively When Training Under Low Energy Availability? – Jose Areta, PhD
Dr. José Areta and colleagues recently carried out a human intervention study examining how a pronounced, short-term energy deficit interacts with an aerobic training stimulus to shape endocrine, metabolic, and skeletal muscle proteomic adaptations. The core premise is that “low energy availability” is often discussed in a largely unidirectional risk framework, yet human physiology evolved under intermittent energy scarcity, and therefore adaptive responses may be more nuanced than “energy deficit equals impaired adaptation.” The study used tightly controlled diet and exercise, repeated muscle biopsies, and dynamic proteomic profiling to quantify both abundance and synthesis rates of hundreds of individual muscle proteins. This enables a more granular view of “muscle quality” and phenotype than traditional bulk muscle protein synthesis measures. The findings were incredibly interesting and could have implications for how we view the impact of energy deficits and exercise response. We discuss the implications for athletes who routinely encounter transient within-day or multi-day energy deficits, for weight loss contexts, and for broader questions around healthspan and ageing biology. Timestamps [02:27] Guest introduction [03:28] Research background and study design [12:18] Study findings: weight loss and endocrine responses [15:47] Muscle adaptations and proteomic analysis [21:47] Interpreting the results: evolutionary and practical implications [26:57] Mitochondrial proteins and muscle adaptation [28:44] Energy deficit as a stressor [34:26] Case study: female tour de france athlete [40:20] Implications for clinical populations [41:44] Future research directions [46:48] Key ideas segment (Premium subcribers only) Related Resources Go to (with links to studies) Join the for free Subscribe to Enroll in the next cohort of our course X:
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#593: Can We Define Hyper-Palatable Foods? And Is Processing Actually the Problem? – Tera Fazzino, PhD
02/03/2026
#593: Can We Define Hyper-Palatable Foods? And Is Processing Actually the Problem? – Tera Fazzino, PhD
While the term “hyperpalatable” has been used frequently for considerable time to refer to foods that are so appealing and tasty that they drive overeating, this term hasn’t been well-defined nor has there been a universal standard for what it means. One researcher who set out to create an objective definition for hyper-palatable foods (HPFs) is Dr. Tera Fazzino. Using specific defined thresholds of sugar, fat and salt combinations, Dr. Fazzino and colleagues have looked at the impact of consumption of these HPFs. In this episode, we delve into defining HPFs and their nutrient profiles, whether they have addictive-like properties, how HPFs differ from (and overlap with) ultra-processed foods (UPFs), the mechanisms by which these foods drive overconsumption, and the broader public health implications. Tera Fazzino, PhD, is an associate professor of psychology at the University of Kansas. Her research focuses on addiction, obesity, and eating-related behaviors. Timestamps [03:39] Interview begins [05:05] Attempting to define hyper palatability [10:03] Nutrient combinations in hyper palatable foods [14:54] Prevalence of hyper palatable foods [17:43] Debate on ultra processed foods [30:02] Mechanisms behind hyper palatability [35:06] Addiction theory and hyper-palatable foods [43:38] Early exposure and long-term effects [50:53] Key ideas recap Related Resources Go to (with links to studies mentioned) Join the for free Subscribe to Enroll in the next cohort of our course
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#592: How Much Protein is Actually Healthy? – Eric Helms, PhD & Matt Nagra, ND
01/27/2026
#592: How Much Protein is Actually Healthy? – Eric Helms, PhD & Matt Nagra, ND
In this episode, the discussion turns to a deceptively simple question that sits at the centre of countless nutrition debates: how much protein do we actually need? On one side, there are confident claims that very high protein intakes are not just beneficial but essential for maximising strength, performance, and muscle mass. On the other, equally strong assertions that the current RDA is entirely sufficient for most people, and that going beyond it is unnecessary or even harmful. Dr. Eric Helms and Dr. Matthew Nagra work through what the evidence actually tells us when we step away from slogans and thresholds. What does 0.8 g/kg represent, and just as importantly, what does it not? At what point do higher intakes stop meaningfully improving muscle-related outcomes? And where do concerns about kidney function, longevity, and chronic disease fit when we look at long-term data rather than isolated mechanisms? Rather than treating protein as a single number to defend or dismiss, this conversation places intake in context: training status, ageing, health outcomes, source and optimising for specific goals. Timestamps [05:19] Discussion starts [07:18] Setting the scene: protein intake and health [09:38] Health outcomes and protein intake [10:27] Mechanistic measures vs. longitudinal outcomes [15:47] The RDA: purpose and limitations [19:19] Higher protein recommendations: where do they come from? [21:48] Protein intake for athletes and general population [27:25] Dose response and optimal protein intake [44:59] Statistical errors in Morton meta-analysis [46:07] Comparing meta-analyses: Morton, Tagawa, and Nunez [56:23] Mechanistic claims and protein intake [59:49] Nitrogen balance and protein requirements [01:11:55] Protein sources and health outcomes [01:18:13] Summarizing optimal protein intake [01:24:31] Key ideas segment (premium subscribers only) Related Resources (with linked studies & resources) Join the for free Subscribe to Enroll in the next cohort of our course Dr. Helms: Instagram: Dr. Nagra: Instagram:
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#591: Maintaining Functional Capacity with Age – Brendan Egan, PhD
01/20/2026
#591: Maintaining Functional Capacity with Age – Brendan Egan, PhD
Maintaining the ability to carry out everyday tasks and live independently is often described as a cornerstone of healthy ageing. But what actually happens to muscle strength, power, and functional ability as we get older? And how inevitable is their decline? At what point do changes in muscle function really begin to matter for day-to-day life? Is loss of strength an unavoidable consequence of ageing itself, or does it reflect something more modifiable? If declines are not fixed, what kinds of training or lifestyle interventions genuinely make a difference, and how strong is the evidence behind them? In this episode, exercise physiologist Dr Brendan Egan examines these questions through the lens of both epidemiological data and controlled training studies in older adults. What do we learn from short-term resistance training interventions lasting just a few months? Do the gains persist once supervised training ends? And what does this tell us about the practical challenges of maintaining functional capacity over the long term? The conversation also explores the idea of “use it or lose it” in muscle function, the role of resistance training in extending healthspan, and how exercise programmes can be designed to support independence later in life. Ultimately, the episode asks a simple but crucial question: what does the evidence actually say about staying strong, capable, and functionally independent as we age? Dr. Brendan Egan is an Associate Professor of Sport and Exercise Physiology the School of Health and Human Performance at Dublin City University. Currently, he is Associate Dean for Research in the Faculty of Science and Health. Timestamps [03:49] Understanding functional capacity [05:56] The importance of muscle strength and mass [14:09] Epidemiology and strength training [25:07] Concurrent training in older adults study [31:05] Barriers to strength training in older adults [34:18] Misconceptions about older adults and exercise [39:13] Exercise snacking and SBAE [51:04] Key ideas segment (Premium-only) Links & Resources (with links to studies) Join the for free Subscribe to Enroll in the next cohort of our course
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#590: Is the Nutrient Density of Crops Declining? – Edward Joy, PhD
01/13/2026
#590: Is the Nutrient Density of Crops Declining? – Edward Joy, PhD
Nutrient density refers to the concentration of vitamins and minerals in crops relative to their yield. There are widespread claims that today’s fruits, vegetables, and grains contain fewer micronutrients than in decades past, often linked to modern farming practices or soil degradation. This issue is important because if staple crops become less nutritious, it could silently undermine dietary quality and contribute to micronutrient deficiencies (“hidden hunger”) in populations. Dr. Edward Joy is uniquely qualified to address this topic. As a senior research fellow in food systems and nutrition at Rothamsted Research and an associate professor at the London School of Hygiene & Tropical Medicine, his work centers on the intersection of agriculture and nutrition. In this conversation, Dr. Joy draws on evidence from agronomy and public health to clarify whether the nutrient content of crops has indeed declined, what factors might be responsible (from soil health to plant breeding and climate change), and what we can do to improve the situation. The discussion emphasizes an evidence-based perspective on soil nutrients, crop varieties, and interventions, cutting through myths to identify real concerns and practical solutions. Timestamps [00:55] Interview [04:49] Understanding nutrient density and soil health [10:25] Historical evidence and crop experiments [20:39] Impact of climate change on crop nutrition [24:05] Potential solutions and future research [30:34] Translating research to human health Related Resources Go to Join the for free Subscribe to Enroll in the next cohort of our course X/Twitter:
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Does Processing Really Make Food Unhealthy? (SNP47)
01/06/2026
Does Processing Really Make Food Unhealthy? (SNP47)
This is a Premium-exclusive episode of the podcast. To listen to the full episode you need to be subscribed to . Recently we (Danny Lennon & Alan Flanagan) were invited to ‘Processing the Evidence’, a “behind closed doors” workshop to discuss the latest scientific evidence on the role of processed foods in human health. The event was organized by Professors Ciarán Forde and Vincenzo Fogliano of Wageningen University in the Netherlands. The workshop attendees included a range of prominent researchers across a range of domains related to food processing, nutrition science, and public health. The sessions included open discussions on current evidence, knowledge gaps and challenges within the UPF debate. There were several structured sessions looking at different sub-topics, such as: Emulsifier-gut interactions Ultra-processing and its effect on food matrix and bioavailability Food liking and hedonic overeating UPFs: Interpreting nutritional epidemiology and RCTs New trial data: the PROMENADE trial, the RESTRUCTURE Trial, etc. In this episode, Alan and Danny review some of the key talking points and their takeaways from this event. Timestamps [00:31] Event overview: processing the evidence [04:44] Conference insights with Dr. Alan Flanagan [07:52] Hypotheses on ultra processed foods [11:53] Microbiome and additives panel [21:51] Food science and technology panel [33:21] Behavioral aspects of food consumption [38:10] Nutritional epidemiology session [47:19] Discussion on dietary pattern classification [50:19] The role of ultra-processed foods in public health policy [54:18] Clinical and metabolic data on processed foods [01:00:55] Critique of the NOVA classification system [01:08:03] Concluding thoughts on ultra-processed foods [01:23:12] Key ideas and methodological standpoints Related Resources Subscribe to Go to Join the for free Enroll in the next cohort of our course
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#589: Causal Inference in Nutrition Science – Daniel Ibsen, PhD
12/30/2025
#589: Causal Inference in Nutrition Science – Daniel Ibsen, PhD
This episode explores how asking better questions and using stronger methods can resolve much of the confusion in nutrition science. Dr. Daniel Ibsen discusses why nutrition research often produces conflicting results and how careful methodological thinking can clarify true diet-disease relationships. Nutrition science has unique challenges – diets are complex, people self-report their food intake imperfectly, and we can’t easily run long-term diet experiments on people. Dr. Ibsen explains how embracing concepts like food substitution analysis, the “target trial” framework, and objective dietary assessment can strengthen evidence. The episode centers on methodological insights that make nutrition research more reliable and actionable. Key themes include defining dietary comparisons explicitly (the “compared to what?” question), considering people’s starting diets, and using causal inference techniques to design better studies. Daniel B. Ibsen is an epidemiologist and nutritional scientist whose work bridges rigorous causal inference methods with real-world diet and cardiometabolic disease research. He is an Associate Professor at Aarhus University, Denmark. Timestamps [00:13] Introduction to the topic [03:23] Interview start [08:02] The importance of asking the right questions in nutrition science [22:18] Understanding causal inference in nutrition [28:58] Challenges and approaches in nutrition epidemiology [32:07] Mimicking dietary interventions in studies [32:55] Target trial framework [39:52] Objective vs. subjective dietary assessment [47:01] Why causal effects of ultra-processed foods cannot be identified Links/Resources: Go to (with links to mentioned studies) Join the for free Subscribe to Enroll in the next cohort of our course
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#588: Menstrual Cycle “Syncing”: Do the Claims Hold Up to Evidence? – Expert Panel
12/23/2025
#588: Menstrual Cycle “Syncing”: Do the Claims Hold Up to Evidence? – Expert Panel
How much do hormonal fluctuations really influence performance and recovery? Should women be adjusting their training and nutrition based on the menstrual cycle? And do female athletes need different protein strategies or recovery protocols than men? These are questions that have fuelled countless online claims, from rigid “cycle syncing” programmes to supposedly gender-specific nutrition rules. But how much of that is actually grounded in evidence? In this episode, the conversation tackles those debates head-on, exploring what we truly know about female physiology, adaptation, and recovery, and where confident narratives outpace the science. You’ll hear from four leading experts: Professors Kirsty Elliot-Sale, Stu Phillips, Shona Halson, and Dr. Eric Helms, as they unpack the data on menstrual-cycle variation, autoregulation, and the real determinants of muscle growth and recovery in women. These discussions were originally recorded live as part of “The Inside Advantage” event hosted by Optimum Nutrition at the McLaren F1 Performance Centre in the UK, where Danny Lennon moderated the session. Timestamps [02:07] Introducing the topics of discussion [07:46] Understanding the menstrual cycle [09:22] Recovery and hormonal impact [10:23] Where did “cycle syncing” claims originate? [15:01] Indirect effects of hormones on performance [17:28] Sleep and menstrual cycle [18:46] Training adaptations and hormonal differences [26:29] Do we have research on female athletes? [29:20] Muscle building: are there sex differences? [34:01] Do hormones influence training? [45:08] Key ideas segment (Premium-only) Related Resources Go to (includes study links, guest bios, & more) Join the for free Subscribe to Watch: Previous episodes with these guests: #'s 452, 280, 192, 454
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#587: How Should Nutrition Be Taught in Medical Training? – Akash Patel
12/16/2025
#587: How Should Nutrition Be Taught in Medical Training? – Akash Patel
This episode centers on the critical gap in nutrition education within medical training and efforts to bridge it. Guest Akash Patel, a medical student who led a pilot nutrition curriculum, discusses why doctors receive little formal training in nutrition despite poor diet being a major driver of disease. With diet-related conditions (obesity, diabetes, cardiovascular disease, etc.) contributing heavily to morbidity and healthcare costs, the conversation highlights a pivotal push to better equip physicians in nutritional knowledge and counseling. Patel’s work comes at a turning point: there are now calls for standardized nutrition competencies in medical education (e.g., a recent JAMA consensus) and a growing recognition that improving doctors’ nutrition literacy could enhance patient care and public trust. But at the same time, medical programs already have a huge workload and little space is available for appropriate training. Others state that nutrition shouldn’t fall within the remit of doctors. So how do we reconcile all this? While this episode focuses on the United States context, the concepts apply to other countries, as it outlines both the challenges and the emerging solutions for closing the nutrition training gap in medicine. Timestamps [03:21] Akash Patel’s background and interests [05:22] Current state of nutrition education in medical schools [07:55] Akash’s pilot program and initial findings [13:37] Challenges and considerations for curriculum integration [15:11] Effective curriculum design for nutrition education [23:38] Debating the role of nutrition education in medical training [29:00] Practical scenarios and the role of doctors [33:58] Advice for implementing nutrition education initiatives [38:15] Future directions in nutrition and medicine [43:07] Key ideas segment Links & Resources (with studies listed & linked) Join the for free Subscribe to Enroll in the next cohort of our course Instagram: @withakashpatel @dannylennon_sigma @sigmanutrition
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#586: The Manufactured Collapse of Expertise
12/09/2025
#586: The Manufactured Collapse of Expertise
Never before has there been greater access to information about nutrition and health. But never before has there been such a low barrier to being seen as an “expert”. There are large numbers of people getting information from, and basing their health decisions on, people who don’t have direct expertise in the field in which they are talking about. Moreover, some promote the lack of domain expertise as a feature, not a bug. They claim that those that were conventionally seen as domain experts are either brainwashed, lazy in their thinking, or outright corrupt. And the solution is instead to look to those with a fresh perspective that can illuminate us on the “truth”. In this episode, Alan and Danny discuss this “death of domain expertise”, how it plays out online, and its ramifications for people’s ability to get good information. Note: This episode was originally published as an exclusive episode for subscribers. If you wish to get more Premium-only episode or read study notes to our episodes, you can subscribe to . Timestamps [03:21] The manufactured collapse of expertise [09:58] Understanding domain specific expertise [15:10] Cross domain expertise and its limits [33:07] The illusion of learning from popular podcasts [38:26] The problem with self-proclaimed experts [46:11] The challenge of identifying true expertise [50:39] The impact of institutional distrust [56:30] Navigating the information landscape Links Go to Join the for free Subscribe to Alan Flanagan’s Enroll in the next cohort of our course Mentioned books & studies:
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SNP46: Reviewing Six Key Insights from the Year’s Conversations
12/02/2025
SNP46: Reviewing Six Key Insights from the Year’s Conversations
This is a Premium-exclusive episode of the podcast. To listen to the full episode you need to be subscribed to . Each year, the conversations on Sigma Nutrition Radio aim to examine the ideas that shape how we understand nutrition, health, and human behavior. This episode brings together the key insights from those discussions, revisiting the most important themes, emerging evidence, and shifts in understanding from the past year. Across topics such as dietary guidelines, ultra-processed foods, sleep, metabolism, environmental exposures, and the psychology of eating, this review distills what the science actually shows and what remains uncertain. Whether you have followed throughout the year or are tuning in for the first time, this episode provides a concise synthesis of what truly mattered and what these ideas imply for how we interpret nutrition science moving forward. Timestamps [02:23] Christopher Gardner, PhD – How dietary guidelines are shaped, misused, and what the evidence really supports. [13:10] Marie-Pierre St-Onge, PhD – The bidirectional relationship between sleep quality, circadian timing, and diet. [20:03] Duane Mellor, PhD – Rethinking ultra-processed foods: mechanisms, misconceptions, and policy realism. [29:26] Samuel Dicken, PhD – The UPDATE trial and what nutrient-matched processing tells us about satiety and intake. [35:37] Ian Mudway, PhD – Microplastics, pollution, and why evidence must outrun public fear. [43:46] Martin Caraher, PhD – The financialization of food systems and its impact on inequality and diet quality. Related Resources Go to Join the for free Subscribe to Enroll in the next cohort of our course
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#585: Why We Think Poorly: Reason, Emotion, and Evidence-Based Reasoning
11/25/2025
#585: Why We Think Poorly: Reason, Emotion, and Evidence-Based Reasoning
We take a look at critical thinking in science and healthcare, examining how we often fall prey to cognitive biases, emotional reasoning, and flawed thinking. Drawing from six different experts in their respective fields, the episode explores why we sometimes believe we are being rational when in fact our conclusions aren’t truly evidence-based. The discussion spans what genuine evidence-based practice means, how domain expertise matters, and how factors like identity, beliefs, and emotions can derail objective reasoning. Timestamps [02:56] Dr. David Nunan on evidence-based medicine [15:30] Dr. John Kiely on translating research into practice [26:10] Dr. Gil Carvallo on emotion and decision making [30:10] Dr. David Robert Grimes on webs of belief [37:18] Dr. Matthew Facciani identity and belief formation [42:31] Dr. Alan Flanagan on domain-specific expertise in nutrition science Related Resources Go to Join the for free Subscribe to Enroll in the next cohort of our course Alan Flanagan’s
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#584: EAT-Lancet: Does the Planetary Health Diet Improve Human Health?
11/18/2025
#584: EAT-Lancet: Does the Planetary Health Diet Improve Human Health?
How should we think about diets that claim to optimise both human and planetary health? Can a single “reference diet” really balance the complex trade-offs between nutrition adequacy, chronic disease prevention, and environmental sustainability? These questions have gained renewed attention with the release of the 2025 update to the EAT-Lancet Planetary Health Diet. The original 2019 report proposed a mostly plant-based dietary pattern designed to improve population health while staying within planetary boundaries. But since then, new data have emerged—on nutrient requirements, disease risk, and environmental modelling—that complicate many of the original assumptions. What does the updated evidence actually say about the health impacts of eating in line with this framework? How have the environmental projections changed? And what do these evolving targets mean for individuals, policymakers, and researchers trying to translate broad sustainability goals into practical dietary guidance? These are some of the questions explored in this episode of Sigma Nutrition, which examines the 2025 EAT-Lancet update, its scientific foundations, and what it reveals about the intersection of nutrition, health, and planetary sustainability. Timestamps [01:46] Focus on the 2025 EAT-Lancet report [02:27] Overview of the Planetary Health Diet [03:13] Comparing 2019 and 2025 reports [03:40] Dietary recommendations and nutrient targets [04:14] Health and environmental impacts [09:12] Scoring methods and dietary patterns [27:00] Mortality and chronic disease outcomes [40:01] Type 2 diabetes [44:13] Neuroimaging and cognitive outcomes [49:48] Conclusions and practical implications [58:55] Key ideas segment (Premium-only) Links & Resources Go to Join the for free Subscribe to Alan Flanagan’s Enroll in the next cohort of our course Report:
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#583: Ultra-Processed Foods & Fixing the Food Environment – Kevin Hall, PhD
11/11/2025
#583: Ultra-Processed Foods & Fixing the Food Environment – Kevin Hall, PhD
Ultra-processed foods have become central to the way we eat and to many of the challenges we face in public health nutrition. They dominate supermarket shelves, shape population diets, and often appear as the prime suspect in rising obesity and metabolic disease rates. But beyond the label itself, what exactly makes these foods problematic? Is it their nutrient composition, their texture and palatability, the rate at which we consume them, or the broader environments that make them so accessible and appealing? The debate around ultra-processed foods sits at the intersection of metabolic science, behaviour, and policy. It raises uncomfortable questions about how food systems evolved to prioritise convenience and profit, and what it might take to meaningfully change that trajectory. In this episode, Dr. Kevin Hall joins the podcast to examine the evidence from controlled feeding studies and population research, exploring what we really know about ultra-processed foods, overeating, and how we might begin to fix the food environment. Timestamps [04:24] Dr. Hall’s background and career [06:47] Ultra processed foods and health [15:10] Mechanisms behind ultra processed foods [27:00] Healthy ultra processed foods: a possibility? [30:43] Minimizing ultra processed foods in different cultures [33:03] Policy and regulation for better food quality [44:26] The importance of pilot studies in policy implementation [49:10] Future of food and sustainable diets [51:50] Key ideas segment (Premium-only) Links & Resources Go to Join the for free Subscribe to Enroll in the next cohort of our course X: Book: Previous episodes with Dr. Hall: #429, 376, 165, 88
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SNP45: Antioxidants – What You Need To Know
11/04/2025
SNP45: Antioxidants – What You Need To Know
This is a Premium-exclusive episode of the podcast. To listen to the full episode you need to be subscribed to . What exactly are “antioxidants,” and why do they get so much hype? We often hear that blueberries, dark chocolate, and red wine are healthy because they’re packed with antioxidants – but is the story really as simple as “more antioxidants = better health”? In this episode, Danny explores the true role of antioxidants in the body, challenging simplistic narratives. Are antioxidants magic molecules that single-handedly prevent aging and disease? Or is the reality more nuanced, with context and balance being key? We delve into these intriguing questions to clarify what antioxidants are, how they work, and what the current consensus tells us about using them for health. Antioxidants are frequently credited as the reason why colorful fruits and vegetables are beneficial. Yet, as past Sigma episodes on polyphenols have noted, the benefits of those plant foods aren’t primarily due to direct antioxidant effects. Here we untangle common misconceptions (e.g., “antioxidants = health, always”), distinguish between different types of antioxidants, and explain why simply taking high-dose antioxidant supplements isn’t a guarantee of protection – and in some cases might even backfire. By the end, health professionals and science-savvy listeners will understand the diverse roles of antioxidants, the importance of balance, and how to apply this knowledge in practice. Timestamps [01:27] Understanding antioxidants [04:19] The role of free radicals [08:43] Endogenous antioxidant systems [09:58] Dietary antioxidants [16:03] Polyphenols and their impact [24:28] Health benefits of polyphenols [27:39] Antioxidants in cognitive function [36:47] Practical takeaways on antioxidants Links & Resources: Subscribe to Go to the Join the for free Become a member of Alan Flanagan’s Enroll in the next cohort of our course See all our other Instagram: X:
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#582: GLP-1 Agonists: Side Effects, Management and Diet – Dr. Spencer Nadolsky
10/28/2025
#582: GLP-1 Agonists: Side Effects, Management and Diet – Dr. Spencer Nadolsky
GLP-1 receptor agonists have emerged as a groundbreaking tool in obesity treatment. In this episode, Dr. Spencer Nadolsky (an obesity specialist) explains how these medications are now yielding unprecedented weight loss outcomes in people with obesity. The discussion centers on GLP-1 agonist drugs like semaglutide and tirzepatide: how they work, how much weight loss they can produce, and why they represent a paradigm shift in obesity management. Importantly, the conversation addresses practical aspects of using these drugs, including managing their side effects and optimizing patients’ diet and lifestyle while on therapy. This topic is of great significance to nutrition science, clinical practice, and public health. Obesity is a chronic, relapsing condition that has proven difficult to treat with lifestyle changes alone. The advent of GLP-1 agonists offers new hope by inducing weight loss levels previously seen only with surgical interventions. Understanding these medications is crucial for healthcare professionals: it enables evidence-based prescribing, proper patient counseling on diet and side effects, and integration of medication with lifestyle interventions. Discussing safety and long-term use is vital, as millions more patients might use these drugs in coming years. From a public health perspective, GLP-1 agonists prompt debates about access and cost, given their high price and life-changing potential. Timestamps [03:25] Conversation with Dr. Spencer Nadolsky begins [05:24] Mechanism and types of GLP-1 medications [07:55] Efficacy and weight loss results [16:53] Common side effects and management [22:57] Muscle loss concerns and clinical insights [28:09] Addressing nutritional concerns with GLP-1 medications [29:38] Exploring potential benefits beyond weight loss [33:48] Marketing and misconceptions around GLP-1 [36:59] Public health and accessibility issues [43:25] Future research [46:16] Key ideas segment (Premium-only) Related Resources Go to Join the for free Subscribe to Enroll in the next cohort of our course Instagram: Related episodes:
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#581: What Is Successful Public Nutrition Policy? And Why Is It So Hard to Achieve? – Emily Callahan, RD, MPH
10/21/2025
#581: What Is Successful Public Nutrition Policy? And Why Is It So Hard to Achieve? – Emily Callahan, RD, MPH
Public nutrition policy plays a critical role in shaping population health through laws, guidelines, and programs that influence what people eat. In this episode, Emily Callahan, an expert in nutrition policy, talks about why public nutrition policies often fall short and what “success” looks like. They discuss how evidence-based nutrition interventions can stall due to political or practical barriers, and explore examples ranging from federal food assistance programs to sodium reduction initiatives. Crucially, they address how to evaluate if a policy has worked and highlight emerging strategies (like integrating “food as medicine” into healthcare) that offer hope for better outcomes. This conversation is highly relevant for researchers, clinicians, and nutrition professionals, as it underscores the importance of policy in addressing nutrition challenges at the population level and examines how to design effective, data-driven policies for public health impact. Timestamps [05:09] Understanding public health nutrition policy [08:44] Examples of public nutrition policies [21:27] Challenges in implementing nutrition policies [31:24] Evaluating the success of nutrition policies [34:58] Sustainability and political viability of health policies [38:07] Food Is Medicine: a promising policy target [44:50] Medically tailored meals: evidence and implementation [48:55] The MAHA commission report and its implications [56:42] Future directions in nutrition policy [01:04:49] Key ideas segment (premium-only) Related Resources Join the for free Subscribe to Go to Enroll in the next cohort of our course JAMA Commentary:
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#580: Sodium Bicarbonate for Sports Performance – Prof. Lewis Gough
10/14/2025
#580: Sodium Bicarbonate for Sports Performance – Prof. Lewis Gough
Sodium bicarbonate is one of the most consistently supported ergogenic aids in sports nutrition research, yet its underlying mechanisms and real-world applications remain widely misunderstood. More recent developments have focused on how to optimise both the timing and formulation of supplementation. The “individualised ingestion timing” approach has emerged as a practical strategy, recognising that the time-to-peak blood bicarbonate concentration varies considerably between individuals. Similarly, novel formulations are being explored to address issues with gastrointestinal distress and practicality of dosing. These include topical approaches such as sodium bicarbonate lotion, and commercial products like Maurten’s “Bicarb System.” In this episode, Prof. Lewis Gough joins to discuss the latest evidence on sodium bicarbonate and performance, its mechanisms, novel delivery systems, and the key directions for future research. Dr. Lewis Gough is a Professor of Nutrition and Physiology at Birmingham City University. He is globally recognized for his research on sodium bicarbonate supplementation in sport, and his work spans applied sport and exercise nutrition, exercise metabolism, acid–base balance, and fatigue. Timestamps [03:12] Professor Gough’s academic journey [06:29] Mechanisms of sodium bicarbonate and historical perspective on lactate [11:21] Sodium bicarbonate’s role in performance [22:45] Individual responses to sodium bicarbonate [26:53] Timing strategies for sodium bicarbonate [32:38] Individualized approach to sodium bicarbonate timing [36:47] Traditional vs. novel delivery methods [44:27] Practical recommendations for athletes [51:18] Future research directions [01:02:08] Key Ideas segment Resources Go to (w/ links to relevant studies) Subscribe to Join the for free Enroll in the next cohort of our course See all of Sigma's
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#579: Is Your Chronotype Hard-Wired or Modifiable? And What Does It Mean for Health?
10/07/2025
#579: Is Your Chronotype Hard-Wired or Modifiable? And What Does It Mean for Health?
In this episode, we explore the concept of chronotype, which reflects an individual’s biological circadian timing and how it manifests in preferred sleep–wake patterns. Understanding chronotype is important because it differs from simple diurnal preference, which may be shaped by lifestyle or psychological factors rather than biology. We examine how chronotype is measured, from gold-standard laboratory methods to validated questionnaires used in field studies. The discussion also highlights the importance of accounting for sleep debt when estimating true biological timing. Finally, we consider the limitations of consumer devices and the practical implications of assessing chronotype in real-world settings. Timestamps [02:02] Understanding chronotypes [06:26] Measuring chronotypes [15:12] Genetic and environmental influences on chronotypes [28:34] Health implications of chronotypes [52:21] Practical applications Related Resources Join the for free Subscribe to Become a member of Alan Flanagan’s Enroll in the next cohort of our course Related previous episodes: 495, 470, 469
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#578: Creatine For Brain Health: Overhyped Trend or Science-based Intervention? – Prof. Eric Rawson
09/30/2025
#578: Creatine For Brain Health: Overhyped Trend or Science-based Intervention? – Prof. Eric Rawson
Creatine is best known as a sports supplement for enhancing muscle strength and high-intensity performance. But could it also improve brain health and cognitive function? Or are such claims overhyped? If creatine can support brain health, it could have implications for aging, neurodegenerative diseases, concussion recovery, and mental fatigue. In this podcast episode, Professor Eric Rawson discusses what current science says about creatine’s effects on the brain, including memory, executive function, and protection against neurological stress. Professor Rawson provides context on how creatine works in the body, why the brain might benefit, and what evidence exists so far. Eric Rawson, PhD is Professor and Chair in the Department of Health, Nutrition & Exercise Science at Messiah University. For over twenty years, his research has centered on the interplay between nutrition and skeletal muscle, notably investigating how creatine supplementation affects both muscle and brain function. Timestamps [03:14] Understanding creatine: biochemistry and history [07:55] Creatine supplementation and muscle performance [09:35] Creatine and brain health: emerging research [14:03] Measuring brain creatine: challenges and techniques [19:58] Cognitive benefits of creatine supplementation [26:23] Evaluating the evidence: caution and promise [30:45] Mega dosing and brain health protocols [32:04] Creatine for brain health: context matters [38:54] Creatine for brain injury and aging [51:25] Key ideas segment (Premium-only) Related Resources Join the for free Subscribe to Enroll in the next cohort of our course (see Related Resources section)
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Is There a Limit to Energy Expenditure? And What Happens When We Push It? (SNP44)
09/23/2025
Is There a Limit to Energy Expenditure? And What Happens When We Push It? (SNP44)
Energy expenditure is one of the most fundamental yet often misunderstood aspects of human physiology. A central question is whether there is a ceiling to how many calories we can burn, and what happens when activity levels approach that limit. Grasping these dynamics is essential for health professionals and researchers, as energy balance directly influences body weight regulation, metabolic health, and athletic performance. Emerging research shows that our bodies regulate calorie burn not in a fixed manner, but through adaptation and compensation, revealing that the “calories in vs. calories out” model is far more dynamic than it may first appear. In this episode, we revisit key insights from experts such as Dr. Herman Pontzer, Dr. Brent Ruby, Dr. Mark Hopkins, Dr. Eric Trexler, and Dr. Chris Melby. These perspectives cover how the body adapts to different levels of physical activity, the metabolic adjustments during weight loss (often called adaptive thermogenesis), and the concept of energy flux in weight maintenance. Note: This episode is one of our Premium-exclusive episodes. To listen to the full episode, you’ll need to be a and access the episode on the private Premium feed. Otherwise, you can hear a preview of the episode on the public feed of the podcast. Timestamps [03:36] Contrained model of energy expendiure [12:33] What is the ceiling of human energy expenditure? [13:05] Reconciling energy intake and expenditure [13:32] Variability in metabolic rates [15:16] Adaptive thermogenesis and weight loss [18:37] Metabolic adaptation explained [31:51] Energy flux and weight maintenance Resources Go to Article: Included episodes: 208 – Herman Pontzer, PhD | Constrained Energy Expenditure Model & Evolutionary Biology of Energy Balance 124 – Brent Ruby, PhD | The Human Ceiling of Energy Expenditure 299 – Mark Hopkins, PhD | Compensatory Eating & Activity Energy Expenditure 377 – Herman Pontzer, PhD | Metabolism, Mitochondria & Measuring Energy Expenditure 484 – Eric Trexler, PhD | Is Metabolic Adaptation an Illusion? 318 – Chris Melby, DrPH | Impact of Energy Flux on Weight Management
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#577: Ultra-processed vs. Minimally Processed Diets: UPDATE Trial – Samuel Dicken, PhD
09/16/2025
#577: Ultra-processed vs. Minimally Processed Diets: UPDATE Trial – Samuel Dicken, PhD
Recently a new trial was published in Nature Medicine comparing the effect of ultra-processed versus minimally processed diets. Specifically, the UPDATE trial compared these two diets in the context of a healthy dietary pattern (in line with the UK’s EatWell Guide). This eight-week randomized, crossover trial generated a lot of discussion and was largely seen as being a really useful addition to the evidence base, and providing answers to some previously unexamined questions. In this episode the study’s lead author, Dr. Samuel Dicken, explains the background context for the UPDATE trial, provides an insight into its execution, and puts some of the results in context. There is also a discussion about the current state of evidence more broadly and the leading hypotheses around the mechanisms that drive the observations seen with consuming ultra-processed foods. This episode is particularly noteworthy because it provides fresh evidence on an important question: does following dietary guidelines with minimally processed foods confer extra benefits over following the same guidelines with ultra-processed foods? Timestamps [02:48] Interview with Dr. Samuel Dicken [03:08] Background and research interests of Dr. Samuel Dicken [04:31] Details of the update trial [09:48] Trial design and methodology [15:45] Results and findings of the update trial [18:46] Secondary outcomes and craving control [25:43] Hypotheses and mechanisms behind UPF effects [40:28] Policy implications and future research directions Related Resources Subscribe to Go to Join the for free Enroll in the next cohort of our course Study: LinkedIn: X:
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#576: The Social Psychology of Health Beliefs and Misinformation – Matthew Facciani, PhD
09/09/2025
#576: The Social Psychology of Health Beliefs and Misinformation – Matthew Facciani, PhD
In this episode, Dr. Matthew Facciani explores how social psychology influences health beliefs and the spread of misinformation. The conversation delves into why people adopt certain nutrition or health beliefs so strongly, how identity and group membership shape our interpretation of evidence, and what makes us susceptible to false or misleading health claims. Dr. Facciani’s interdisciplinary background (spanning neuroscience, psychology, and sociology) allows him to offer a unique evidence-informed perspective on these issues. The episode centers on understanding the social forces behind health-related attitudes and how we might improve communication and critical thinking in the face of rampant misinformation. This topic is highly relevant for health professionals and researchers because misinformation about nutrition, health, and medicine can lead to poor decisions, vaccine hesitancy, or harmful fad diets. By understanding the psychological drivers that cause people to cling to unscientific beliefs, practitioners can better address patients’ concerns and correct false claims. Matthew Facciani is a postdoctoral researcher at The University of Notre Dame in the Computer Science and Engineering Department. He is an interdisciplinary social scientist with a background in neuroscience and psychology and holds a PhD in sociology. His research focuses on media literacy, misinformation, social networks, political polarization, identities, and artificial intelligence. Timestamps [01:41] Interview start [06:57] The role of identities in belief formation [16:01] Health attitudes and political identities [25:28] Improving dialogue and addressing misinformation [31:59] Does fact-checking work? [35:41] Media literacy and pre-bunking [44:03] Optimism and pessimism for the future [52:28] Key ideas segment (premium-only) Related Resources Go to Join the for free Subscribe to Enroll in the next cohort of our course Matthew’s book: Matthew’s Recommended episode:
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#575: How Does Dairy Impact Cardiometabolic Health? – Prof. Jean-Philippe Drouin-Chartier
09/02/2025
#575: How Does Dairy Impact Cardiometabolic Health? – Prof. Jean-Philippe Drouin-Chartier
Dairy is often treated as a single food group, yet milk, yogurt, cheese, and butter can have very different effects on health. Some evidence links yogurt to favourable outcomes, while butter is known to raise LDL cholesterol. And then there’s the paradox of cheese: high in saturated fat, but not consistently associated with higher heart disease risk. These complexities raise the question of whether the “dairy matrix” (the combination of nutrients and food structure) explains why not all dairy acts the same. In this episode, Prof. Jean-Philippe Drouin-Chartier, a nutrition researcher and registered dietitian, is on the show to examine what recent trials and large population studies tell us about dairy foods and cardiometabolic health. The discussion covers blood lipids, blood pressure, glucose metabolism, and how guidelines should interpret this evolving evidence. Timestamps [02:18] Interview start [09:38] Dairy consumption and type 2 diabetes [16:06] Dairy and cardiovascular disease [21:42] Dairy, blood pressure, and hypertension [25:56] Dietary guidelines and dairy [43:30] Key ideas segment (Premium-only) Related Resources Subscribe to Join the for free Website: Enroll in the next cohort of our course Referenced studies
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