Functional Medicine Bitesized
Functional Medicine Bitesized
Supplements - Do We Need Them?
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Can we meet all of our nutritional requirements through diet alone? Should we be using supplements? What is the difference between standard nutrient reference values and optimal nutrient reference values? How do we distinguish between a good quality and a not so good quality product/company?
All these questions and more will be addressed in our latest podcast episode in which Pete discusses the in's and out's of nutrient availability in the diet with Ben Brown, Director of the Nutritional Medicine Institute and Editor of the Nutritional Medicine Journal.
Click here to see my supplement recommendations.
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Welcome to functional medicine bite sized the podcast where Pete chats to experts in the field of functional medicine and health, giving you the listener, pearls of wisdom to apply on a daily basis.
Peter Williams:Hey, everyone, and welcome to new podcasts. Welcome, Ben.
Ben Brown:Good, thanks. Yeah, good. Thanks for having me.
Peter Williams:As you know, I like to interview people who I've known for a very long time. And it's funny because we actually did this podcast about five months ago. And I sort of messed the technical side up a bit. I'm chuffed that you're going to do it again, Pal. But I can always remember Ben. Ben, was ah, he was actually was at a presentation that Jeff bland was on and we're talking could have been 20 years ago. I think Ben must have been about 12 when he got up and spoke at it, because I remember sat at the back going, who the hell is this kid? But I obviously knew that this kid would be pretty special if he was number one hanging about with Jeff and number two, um was speaking at the conference. So I think there's always been some degree of slight jealousy there, Ben, but good on you mate. You've been a good egg since since then. So mate, as you say, we've known each other for a very long time. You've been associated with quite a lot of companies and around nutrition in particular. And you're currently the director of the Nutritional Medicine Institute. Yeah. And you guys have brought out a pretty good journal, haven't you? If I if I remember, right Yeah.
Ben Brown:Yeah. Yeah. We also run, we run a conferences and a journal.
Peter Williams:Yeah. And you're currently the educational head for the UK and Europe with regards to Pure Encapsulations.(Correct) And just for everyone who knows, obviously, because we're going to be talking about the podcast today is why supplement, and I think, importantly, you know, giving you the opportunity to get a better understanding of what makes a good supplement, because I think this is an incredibly important topic. And of course, Pure Encapsulations is one of the companies that we regularly use, and very simply because they're good quality and what and we're gonna go through all of that with Ben today. So fella, you know, thanks so much for doing it again. I know your time is short. So let's jump in pal. (Yeah)Why do we need to supplement? I think that's probably a good, good way to start. Let's talk about the health of food. Let's talk about the health of the planet. Let's talk about the health of the soils. I'll leave you to wax lyrical for as long as you want on that.
Ben Brown:Yeah, I mean, it's it's a, it's a sort of classic question for anyone involved in functional medicine and nutrition in general is like, why supplement? And what's the reason and the way I see it is there a different sort of overarching reasons, without getting too lost in details, the first one is, you've touched on, which is the quality of our foods changed. And, and that's a fact, you know, in the last in particularly the last couple of 100 years, even if you're eating healthfully, and this is important, the mineral and vitamin content of the food that we are eating has changed significantly. And the main reason for that you also touched on this, the soil and the use of modern cultivars and farming methods and so on. The other thing is, of course, the industrialization of the food supply. So even if you are eating scrupulously, all the time, there's still a good chance that you're going to have discretions where you eat, you know, highly processed, refined, industrialised foods. And at the other end of the spectrum, some people can only eat that because of budget or financial constraints or whatever. And that, you know, is an obvious reason for nutritional gaps so that, you know, the foods one thing and then I think something that's really important, and this is particularly relevant to the practice of functional medicine is that nutrients are also used as treatments, basically, they used as interventions to optimise function and health in a way that isn't just about correcting a sort of obvious deficiency, that's actually using them almost pharmacologically to to improve physical function. And I think that's a really important distinction that not a lot of people in the general public hear a lot is, you know, it's more like, oh, you might have some nutrient gaps, you should fill them with a multivitamin, but we're, we're often dealing with something very different in clinical practice, we're actually harnessing the pharmacological effect of these to to improve function safely. And, and then, of course, you know, beyond those things, there are just reasons for increased metabolic demand. And this is a this is not a deficiency per se. It's actually a unique requirement for an individual that is different to a dietary deficiency. It's related to their physiological demand, and there are a lot of different things that can affect that, genetics, pharmaceutical drug use disease states, age, sex, and so on. And this is a really important underlying concept of personalised and functional medicine is that we're all different. We all have different demands. And an important thing about this is it's not just that, oh, you know, this person needs vitamin C, whereas this person doesn't. We can be very specific and identify people that, you know, in fact, it's been said like this that that some people have dependencies on supplementation, because you can't achieve the levels that are required to optimise function with diet alone. And this is not a new idea. This has been going on since about 80 years, this concept of individual by, you know, biochemical individuality, and personalised nutrition and personalised medicine. And, you know, those three tiers for me are probably the, the overarching reasons, supplements are so useful.
Peter Williams:Yeah, I would probably take it a couple of 1000 years back, because I can, I can still bring out some quotes and Hippocrates, which had just still the most personalised and beautiful individualised quotes about what any one human needs at any one time, and look mate that absolutely resonate with me and my journey on the genetics of vitamin D and my own results, you know, and that turned up when we're actually turned up in lockdown, because I don't know about you, but in lockdown, I mean, we almost lost the business and there was nothing else to do because we were locked down except hang out in the garden, it was really lovely summer. And so I just basically was in the garden training and doing the garden. Basically, every day, I was brown has a button, by the end of the end of the summer, got to take my vit D levels, and they were unusually low, I think I was at 79 nanimols. And I just like this doesn't make any sense. And we went on to find that I probably got G I've got gene variations all the way through how we metabolise cholesterol right through it sort of the inactive aspect of it, being developed on the skin, and then it's transport to the liver, and then transport out to the cells at every step of that I don't do that well at all. So there's a classic example of personalization as opposed to in general population. And we see that all the time. And I'm a massive fan, we've been using genetics for 15 years, and there's no doubt if you have some degree of understanding of it, it just opens up a whole new world as far as personalization, which I think is what you were trying to say because they're in particular, I think about there are B vitamins and there are B vitamins, for instance, and some need to be in a certain specialised form for them to work for certain individuals. Can you just sort of give us it, I mean, maybe you can throw some numbers over your head, but worldwide, some of the losses that we're seeing in in the soil, whether it's suboptimal levels or deficiencies that we're seeing in, you know, in basic minerals, and vitamins, you know, whether you could run any of those off your head, just to give us an idea of how prevalent it is,
Ben Brown:yeah, it's, it's not something I can, I can give you exact statistics on off off the top of my head, but it is quite significant. So there was actually one of the best papers that was published in this area, I'll just see if I can dig up. No, I can't dig up a reference at the moment. But that only came out a couple of years ago. And what they were doing was analysing the mineral and vitamin content of food in the UK over the last 70 years. And, you know, don't quote me on statistics, because 90% of them are made up. But this was like, you know, around the 30 to 40% Mark declines in nutrients over that period of time. And that's a, that's a pretty huge hike. And that's really just talking about, you know, the food, the industrialization of farming basically was the main impact on that there's also our changing global environment. So the increase in carbon dioxide in the air is actually affecting nutrient levels as well. They're going down as global warming goes up, or climate change, whatever you want to call it. But the big shift also is not just you know, recent farming methods, it's also this dramatic shift that happened about seven to 10,000 years ago, we went from hunter gatherers to Agrarian/agricultural type societies and, and so on. So you know, that one is much harder to put a finger on but some research groups have attended it and it looks like huge variations compared to what we're eating today in terms of basic things like minerals and fibre. Like one example of fibre, I can recall so there was some weird studies that were done by an anthropologist looking at the fibre content of like fossilised human poo, right, which is apparently a good way to I'm not an anthropologist, so I don't I don't know this but what they did is determined the average fibre intake based on what they were measuring in the samples you know, and estimates of dietary intake at the time of the foods they were eating and the fibre intake and this will just knock anyone who knows what the RDA of fibre is, will fall off their seat but they're fibre their intake was upwards of like 80 to 150 grammes a day possibly, now if I tried to eat that I just walk around bloated and and it just, it's almost impossible to do with a modern digestive system, I think. But our ancestors were like eating a lot. And the average today I think is about 18 grammes, the average person is eating, if you're really healthy, 24? You know, it's, that's five times less.
Peter Williams:What's quite interesting about that is that, you know, I still look at some of the fundamentals. And it's always like, comes full circle sometimes. But I'm just still again, in that area where the appreciation of what fibre brings to human health is just enormous. So I'm I'm pretty high fibre at the moment. But what's quite interesting, I think there is a, as you're saying, there's a limit of what any one individual can take. I mean, the amount that's coming out me at the moment is unbelievable, but what's quite interesting about that, is that I don't seem to be able to keep the weight on with with a high fibre diet as well. I mean, I seem to it seems to lean me up really well. So really interesting. I'm a massive, you know, again, it's one of those key players, I think, in basic diets that, you know, the fibre needs to be probably higher than you getting at the moment for most people. So that I suppose that leads to that classic question doesn't it is that you should be able to get everything out of your food. I wonder what you think about that, because I can remember, Tim Spector, Professor Tim Spector, saying you should be able to get everything out your food. And, you know, I just got went back to him on that and said, Look, I would love to believe that this is the case. But, you know, we've been in private practice for 20 years, and we've never seen it, we've never seen anyone need that. In fact, even the best ones we've ever seen, then we're talking about people where money's not an object, they've got chefs at home, the quality of the food that they're putting in is unbelievably brilliant. And yet, still, we're seeing suboptimal nutrients across the board. So I find it difficult to believe that that is the case. I don't know what you think about that.
Ben Brown:Yeah, I think, um, you know, Tim's a great scientist, but I think his views on nutrition are really wrong in a lot of areas. And I think that probably comes from, you know, and I'll be bold enough to say this, but it probably comes from Him not having a formal background in nutrition. He's an epidemiologist and geneticists to my knowledge. But he's written a popular book on nutrition. And one of the premises of that popular book, although I've never read it from what I understand is that it's a bit like that it's a bit like that all diets are wrong and nutritional supplements are a waste of time. And I did speak with him once at a conference, and I got the gist of it from his talk is that he's using meta analytic data that is so flawed to sort of pick a fight with supplements has been useless. And, yeah, we could just talk for hours about how wrong that approach is, and how outdated it is but you know, fair enough. Everyone needs to sell books. Yeah.
Peter Williams:I think there's a I think there's a really good argument here. And isn't it? Because I suppose that the first the first way to start is that, you know, I think we're alll food first, aren't we? Yeah. So I think you know, there is, I suppose if your diet is crap, then you know, sorting out that sorting out your diet would always be the first way to go. And that's always the way we work in practice that said, though, Ben, you know, if your diet is crap, and you've got some symptoms, or disorders or diseases that are a consequence of that, and trying to sort your diet out over time is going to take a long time, then therapeutic nutrient supplementation is absolutely the way we would go with certain patients, because you know, I think, again, is it there's a nuanced art of, well, how we're going to jump in with this patient. And, you know, I can say, from, as you say, from being in over 20 years of practice that I don't understand why people would say that I sometimes feel about well, maybe they're not in clinical practice, because it doesn't make any sense to me that I think that doesn't make any sense to me. When you start to really personalise people's approaches, it makes even more sense. Because, because most people don't tend to have optimal levels. But, but I suppose the other argument in that maybe, is that a lot of supplementation is pretty poor quality. I think that's one of the key things we want to get over today. So I mean, shall we talk about there are certain places where you could go to get supplements, supplements that are cheap, and actually the ones you have, not only are cheap, and don't do the job that you need them to do, they can actually be quite damaging to an individual. So you know, I think there's the good, bad and ugly with regards to the supplementation industry. And I think sort of, you know, the man and woman on the street can be can be out of pocket, and potentially damaged by the rubbish that's out there. So can we get a we get to sort of an idea of all of that, and just what actually goes in to making a quality supplementation? Like, you know, like Pure Encapsulations is would make?
Ben Brown:Yeah, yeah, absolutely. So you're, firstly, I'll say that, in general, supplements are incredibly safe, like, although, you know, you've set the scene for things, you know, potentially caning containing rubbish, or being potentially harmful or so on that, that in general, across the board, you know, very, very safe thing to be utilising in practice or yourself, but you raise a very good point, and that is, is that there are huge variations in in quality, essentially. And, and also, I would add to that, in the quality of practices by the companies producing the materials, you know, sometimes it's not just the product that you need to be mindful of in terms of, you know, quality, it's also the brand that's selling it and what they're saying and the reliability of that information, and so on. Because there is a, I think, like any product, it's not a problem unique to food supplements, it's, you know, there's, there's often layers of absolute marketing. So, but, you know, the, the way to cut through that is, is look for good brands that are cautious about what they say, and put a lot more care into the kinds of products they're producing Now, speaking specifically to the United Kingdom, because there are different rules in different countries and so on. But there are basic quality standards that are required in the United Kingdom here for food supplements. So generally speaking, across the board, you'll find decent, you know, products in the market. However, there are important sort of levels of quality assurance beyond the basic minimum requirements that brands can take to make sure that you're getting a much better quality and more reliable product in terms of what it says it's it is on the tin. And also
Peter Williams:It's the Ronseal advert isn't it, it does exactly what it says on the tin. Yeah, give us an idea of what that would be maybe like a certain certification for people to look for, or is there anything on there where, as you say, you can go in and get a better idea that it really is what it says on the tin? Because that's a massive issue right across the board.
Ben Brown:Yeah, it is. And people don't realise this, including even practitioners that are using nutritional medicine, I think the actual level of you know, issues with quality is poorly understood. And there are a lot of problems with quality in terms of products not containing the level that it says on the label. They may be adulterated with contaminants, either intentionally or unintentionally, intentionally, in the case of there may be a substitution for something that's cheaper, for example, that shouldn't really be in there or in unintentionally, and that it might be might have things like pesticides, or herbicides, or heavy metals or so on. But without getting into all the details. From a consumer type perspective, there's a really simple question that you can ask a brand to make sure that there is some level of quality assurance beyond the basics. And that is, do you do third party testing? You know, so do you do independent testing to verify what's in your product? And can you show me those results? Actually, while I've got you on? And, and how often are you doing that is the next question. So I'm very biassed, because I'm a consultant for pure encapsulations. But I can tell you that part of the reason I'm a consultant for them is because I really like the quality and you know, the, the nature of the products as well which talk more about the, you know, more professional in terms of dose, and so on. But the qualities, it really is outstanding. So for example, what they do is they batch test every batch of finished products to make sure that it does have what it says, you know, according to the label, and also that there are no contaminants in there as well. And that also happens with the raw material before production as well. So there's this sort of tier of testing above standard, just to make sure that you're getting what
Peter Williams:And I think this is the thing, isn't it? Because you think you're getting. sometimes well, I would say a lot of the time you're going to end up spending, if you're going to buy quality supplementation, it's going to cost you and it's going to cost you for everything that we're talking about here. Can you give us an indication of maybe some of the contaminants that something like Pure Encaps would make sure that there are no contamination but maybe other slightly cheaper products can be cheaper because they've not they've not done that? What would we be looking at what would we you know, what would you be concerned with?
Ben Brown:Yeah, so it actually varies a little bit from product to product. So some products, you're looking for certain contaminants, whereas others that may not be an issue, so don't screw In for them, but across the board, generally, pure encapsulations are testing for over 70 pesticides in every product just to make sure there's no contamination. They're also checking for heavy metals. So several different toxic metals that can be present in the environment or the finished product or so on. And then things like potential allergens like gluten. So when pure encapsulations make a claim of being gluten free against the product, it's actually certified by a gluten free certification body. It's not just if we don't think there's any gluten in there, it's been routinely tested and certified to be gluten free. So these sorts of like layers of quality assurance of what's going into the product. And then there are more specific things. So with herbal products, there's sometimes a risk of adulteration. And what that means is that the raw material that's being produced wherever you know, it can be grown anywhere in the world, at some point that raw material may be contaminated with what they call adulterants to sort of artificially make it look better than it is, or even more active than it is like there are crazy examples of anti inflammatory herbs being spiked with anti inflammatory drugs, to make them work more, you know, potently and in a dietary supplement. So you need to be very mindful of this sort of stuff and routinely screened, you know, for these adulterants.
Peter Williams:I mean, for that for the man and woman on the street, it becomes almost becomes the dark web of supplementation, doesn't it? But it is a bit, it is a bit crazy when I mean, I can remember reports on a lot of the adaptogenic herbs coming in from China that were just full of heavy metals. And you just don't know you think you're buying, you think you're buying the quality product. But the reality is you're not. And I think that's where it becomes quite risky if you're buying stuff that seems quite cheap to buy.
Ben Brown:Yeah, absolutely. And I think that's a very good salient point for listeners is just be very careful if something looks very cheap. Cheap doesn't necessarily mean bad, but just be very cautious, especially online.
Peter Williams:Mate, so I think there's, if we could also talk about maybe some of the aspects that we've talked about, we've sort of covered that some manufacturing aspects, can you tell us about where we're starting to see actual brand made supplementation going, actually going into research, because I know pure Encaps are doing quite a few of that. And that's quite new, isn't it? There's not a lot of companies, there are a few. But there's not a lot of companies that are actively in research with their products, which I think is a major step forward in the nutritional medicine world. Because it allows you to validate your product in a scientific study to say these were the outcomes that we saw. Yeah. So can you talk about some of your studies that you guys do?
Ben Brown:Yeah, absolutely. So the so the background on that is historically, I think, I think there may be over 30 or 40 studies now involving pure encapsulations products, and it's not necessarily that pure, have initiated all of those there, they've actually come from research groups all over the world that have selected pure encapsulations to use in their research trials. And then what happens is, sometimes as that relationships set up Pure helps with some funding or donates the products or so forth, it is it is unique, there's not a lot of brands, which can, in fact, I can't think of any which can make a claim that many clinical trials involving finished products across the range. So you know, in terms of what areas have been studying, studied, it's incredibly diverse. lipoic acid, you know, has been looked at for cognitive decline and vitamin D just for like, vitamin D response type studies. And, you know, so it varies quite a lot. But there's, there's quite a bit out there
Peter Williams:Let's imagine we wanted to give sort of some brush strokes advice to people listening in what would be your your advice, given that you don't have any testing, given that these people you we will consider are on a moderately healthy diet? I mean, we could argue about what what what does it well, what does that mean? And of course, you know, we're not personalising, is there some sort of broad strokes that you would look at and say, Look, this is where I feel as though you're probably going to cover your bases.
Ben Brown:Yeah, so I think it's a really easy question for me to answer and I, you know, as healthcare providers who need to be, you know, everything needs to be personalised and you know, safeguarded and so forth. But there are some really basic things that most people could be considering. And what I will say as a caveat and as I'm a big fan of as taking as little as possible, so although you know, I work with supplement brands and I, you know, speak about the topic I'm, I also think, you know, don't overdo it, and if you're taking a lot you should go and see someone who, (I agree, totally agree) to get it filtered out. But some really simple things that I think are very relevant for most people are like a good multivitamin, magnesium on top of that, because you'll never get enough in a multivitamin alone. And it's just the very...
Peter Williams:Can you explain why it's so.... So what's really interesting about this is that we've never seen an increased, we've never seen anyone who on test is optimal with magnesium. Again, we've never seen it. And depending on what tests we use that come back , we're usually looking at an additional, you know, I think a really good result is almost like an additional 200 additional Mgs a day of magnesium. And that would be the best case scenario that we ever see. Usually, what we see coming back is 600 600 to 800 to over over a gramme of magnesium, additionally, on top of their diet, I mean, you know, why do you think that is?
Ben Brown:I think it's, it's because people are deficient one, statistically, in the United Kingdom. If you're a man or women, woman, you're not reaching the RDA of magnesium or the NRB, whatever you want to call it. So the general recommendation for magnesium on average, no one's hitting it in their diet. They're, they're below a basic optimal level. And that basic optimal level is depends on sex and age and stuff, but it's about 240. milligrammes something like that is sort of the recommended basic, minimal intake, and you're seeing this is why you probably got more to say about this than me, but what we're seeing in the research to get people to a better blood level, like up into an optimal range to that looks like on top of your diet, you need about four to 600 milligrammes that would help simple magnesium that would
Peter Williams:The would absolutely fit the datasets that we see. It's almost like, Oh, my, it's almost like you don't even need to, you know, we know what we're going to see it. Yeah. So there's a couple of things on that, is that just because, you know, the life and the planet and the way we exist, is just not optimal for getting everything that we need from from a diet that doesn't seem to be able to provide it. I mean, that's, you know, I think I'm pretty clear that, you know, I wish we could everything from food, but I just don't see it. And it's like, you know, it's just, that's not how the world is, you know, I've just never seen it. So yeah, sure, I'm biased on the datasets that we get at work, and do you think the RDA needs to change? They seem to be so backward?
Ben Brown:Yeah, they're good questions. So the first question is, you know, I think the reason we have higher requirements versus what our diet can provide is complex. But it's not just the fact that our food environments changed and say mineral levels of even healthy foods are declining. That's also that our requirements may be affected as well, you know, we have a lot more chronic disease, for example, like diabetes, heart disease, and so forth. And we'd know for sure that many disease states will increase requirement of nutrients as well. So for example, if you're, if you have high blood pressure, your magnesium requirements are a lot higher than the average person, because that disease state increases your demand for lots of different reasons. So there's that Joule effect? And that's the first question but the second question on that on the recommended amount. So I think something that's really important for listeners who don't have a background in nutrition to understand is that the recommended amounts, you know, the NRV, or the RDA or whatever it's called in the in the UK, it's called the NRV, or the nutrient reference value, is that most people mistakenly think that the NRV is an optimal level, or even that you shouldn't exceed it. But what an NRV, actually is, with the exception of vitamin D, and calcium, is, it's the bare minimum amount that you should be eating, as, you know, as an average in the general population. So it's not specific to you. It's just if you took a you know, a broad shot at everyone and had a guess, essentially, so it's not an optimal at all, and people really missed this point. And so then the question is for the, the people who are ticking onto this is like, well, what's the optimal level? Like, is there a reference range for those? And unfortunately, there isn't. No one's worked it out yet. And lots of people have tried different ways of assessing this. But what we know for sure, and you're seeing this as well, Pete, is that it's a lot more than the NRV for most people is what we would consider optimum, but we don't have a range. You know, we even don't have good tools to work out what that optimum is across the board.
Peter Williams:It may be another layer that goes on that. Obviously, I always think about, you know, the way people live their lives the way life is, and whether their just digestive tracts have you know, are optimal and have that capacity to break things down and metabolise and, you know, I do feel as though that regardless of the quality of the supplementation as well, I think there's inherently may be some, you know, you're not getting everything from that supplement, you know, depending on how good your digestion is, as well. So yeah,
Ben Brown:that's, that's definitely possible is that, um, you know, we like there are some classic examples of, of how, you know, poor digestion and digestive function can affect nutrients. Like with older age, B12 deficiency becomes very common because of atrophic gastritis. And there are definitely subtle variations of that earlier in life. The other thing to I'll mention is that actually, food preparation and culture is a form of digestion. So when you're chopping and cooking and preparing your own food, which no one does, is that is a form of optimising the nutrients in your food. And then you can even step back to like fermentation and, and so forth, which will release nutrients and soaking things like legumes and pulses, which also no one ever does. You know, be lucky if someone buys chickpeas in a can let alone soak it at home. You know, these, these old school techniques for preparing food, fermentation, soaking, stewing, slow cooking, optimised nutrients from the food, it's a form of digestion before it even gets into your mouth.
Peter Williams:Yeah, yeah. And of course, you need time for that. And there's not a lot of time in life, which almost sort of batters there sort of increased need. I believe that, you know, supplementation has a very specific and important role to play, if you're not going to decide to you know, you need to change your life on that. And look, I think the other thing as well, is that, I think one of the misconceptions, I mean, this happened with a lot of the long COVID inquiries we got at the beginning, where I still think people think about, I'll give an example of vitamin C will be helpful on this. And, you know, they recognise that, well, I've been taking vitamin C, I don't feel any better. So I suppose there's a there's a way we've got to think about what supplements what supplementation does and the perception of what people think, you know, that was a waste of time. And actually, you know, maybe if we tested for it, we actually found that that supplementation absolutely hit the mark. I think they are part of the puzzle, a helpful part of the puzzle, but they're not the only puzzle by any means. And I think anyone who is going to take a supplement thinking that you know, the disease's or disorder, or their symptoms are going to completely change is probably in for a little bit of a shock. Unless, of course, it's something really quite frank, like vitamin D deficiency with bone pain, like, as you say, with a, almost like a B12 Like dementias where, again, very high dose of certain B vitamins suddenly, wow, okay, that's you feel a bit better on this. Mate is there any sort of any sort of new exciting stuff in there? I mean, I know you've got a new brain health product out, do you want to give a little bit of a pun on that? And maybe give us an explanation on some of the stuff that's in there? I haven't tried it yet. But I'm pushing for a free bottle there.
Ben Brown:You're always welcome. But yeah, yeah, happy to talk about that. So pure have launched a product called Cogni active this year. And, and you know, very, it's a good example of a food supplement that sort of ties in with our conversation. And really, this is specifically designed to optimise function. So it's more utilised almost like a, like a medicine, you know, than, ah correcting a deficiency or so forth. And one of the key ingredients, there's several, but it has B vitamins to modify homocysteine, if it's elevated,
Peter Williams:just can you just expand on homocysteine, and it's link to brain health. And
Ben Brown:yeah, no, no problem. So homocysteine is a protein that builds up in the blood, if you have a low intake of B vitamins, there are other things that can elevate it, but that's the main factor. And as a biomarker, it's quite useful for indicating low B vitamin intake, which it then responds to, but it also is a sort of a surrogate marker for some diseases as well, including heart disease and cognitive decline. So if it's up you take some B vitamins and drop it, you know, and that's useful to learn on it.
Peter Williams:And isn't that crazy that I mean, literally, homocysteine we run all the time. And the beauty of that is how simple it is. When you get the correct supplementation it almost always takes care of the numbers and you know, what, if that was a medication that would be up for awards that you know, there would be Nobel Peace Prizes on that I mean something that's so incredibly simple and that's sometimes when you see the power of targeted supplementation. So continue mate...
Ben Brown:no, it's it's true and you know, the people that are really expels that relationship, should bloody get a Nobel Prize. Like you know, David Smith and his group here at Oxford. He's since semi retired, but oxford university in the UK, they were able to show that by lowering homocysteine with B vitamins, you can essentially reverse cognitive decline. And I'm don't make that statement lightly. The data is there, if you want to have a look at it, it's pretty incredible.
Peter Williams:So let me let me, let me get you on that one. Why don't we hear about it? I think,
Ben Brown:unfortunately, without sounding like a conspiracy theorist, there are inherent biases against nutrition at many different levels within society and medicine. And this really comes back to you know, that example of Tim Spector saying supplements are useless at the beginning is, you know, I don't blame him for saying that, because anyone who studied conventional medicine gets no nutritional training. And they don't understand, you know, it's not taught in the schools, and then it's not taught to them as as graduates either. So there's this huge gap between what actually exists like there is a tremendous amount of research on nutrition, nutritional intervention, supplements, and so forth, like this example we've just spoken about, but people are not exposed to it is the is the fundamental problem. And not only are they not exposed to it, there's an inherent bias. There's an anti nutrition bias. That's all through medicine, unfortunately. I mean, that's slowly changing, I would argue, but it's still there. And it's very powerful. And it's not just medical training and doctors, it's science itself. Like if you, you know, if you look at some of the science, like it's just incredibly biassed against nutrition. So it's navigating that and understanding those problems, and, and trying to better appreciate it.
Peter Williams:And you know, I'll tell you what COVID did for me, because, you know, I've come up through what I would probably consider a pretty conventional background. But obviously, you know, I've got a pretty good and robust understanding of nutrition. And when those certainly those two particular studies that came out of Spain, looking at high dosage, vitamin D in ITU, and the results on those were so overwhelming, I think it was 75% reduction in ICU usage based on using vitamin D at high dose when people were coming in for early stage COVID. And it never went anywhere, there and then they were never brought to fruition, and it just makes you think it's just doesn't make any sense. Yeah, yeah, I just I just I find that I find that whole situation quite unbearable. It's like what's going on here? Yeah, this is this is these are interventions that are pennies at best?
Ben Brown:Yeah, it's, it was particularly bad during COVID. Because the we were sort of railed into, you know, avoid other people vaccinate and wear a mask. And that was about it, you know, yeah. Other interventions, particularly nutrients weren't given the light of day, even though there's a tremendous amount of overwhelming research for vitamins before COVID, we knew, you know, they can be useful for preventing infections and their complications and
Peter Williams:basic antiviral therapy. It's,
Ben Brown:it's accelerated, like we went, you know, from studies of nutrients in influenza and cold, there was about 80, a year, prior to COVID. Happening Now, there's hundreds of clinical trials every year looking at the effect of nutrients like this one in Spain was one of hundreds. But did you ever hear about them? No, you know, but they're there. And I think that's, you know, you can't fight with that there's, there's more and more research is coming out, I think what we're going to see is a more and more of a sort of tipping point where you can't argue with the science.
Peter Williams:I think that's why we can I'm not gonna say that we can be slightly smug on this, because you can't I mean, that's the argument. It's like, so you know, why do you disagree with me, the science is there, and there's probably 100 papers there that are backing up what I'm saying?
Ben Brown:Yeah, exactly. And that's really important, I think, is to understand that there is data there and it shouldn't, you know, people are anti supplements or anti nutrition as an intervention for anything, they should really check themselves and do a bit of research before, you know, dismissing it just based on their own bias and background.
Peter Williams:So can we go back to homocysteine and your Yeah. cognition product?
Ben Brown:Yeah, no problem. Yeah. So this particular form has got some B vitamins for that reason, some lutein and zeaxanthin, which are phytochemicals. So they're quite cool. They're found in leafy green vegetables, and they concentrate in the brain where they've been shown to improve cognition and memory in several human clinical trials, which is quite neat.
Peter Williams:Can you can you can you take us into that point, because I think this is a really important point where to get the dosages that have shown the improvements that you want in clinical studies, you're not going to be able to get from food, you'll be able to get you'll be able to, you'll be able to get tiny amounts from food. Yeah, as in the dosages, but you won't be able to get those sorts of dosages that have been proven in clinical trials to improve certain outcomes. Without supplementation. I mean, that's pretty much where we're at, aren't we?
Ben Brown:Yeah, in some cases, that's true and others it's not. But the B vitamins, that's definitely an accurate statement, the doses that are used for homocysteine lowering are just, I don't even know how you would get that sort of dose from food alone. I've never done that sort of calculation. But I would assume that it's impossible for a few of them. lutein and zeaxanthin, you could get the doses to match from food, but you're gonna have to eat like a cup of spinach every day, which is not, you know, unachievable, but for most people, it's impractical. You know, it's not necessarily realistic. Yeah. Yeah, so so it's a very good point. And then the other the other ingredient in this product is probably the key thing that I think is particularly interesting. And that's a particular form of choline called Citicoline and, and Choline's a little bit like a vitamin. And in fact, it probably should be classified as a vitamin, but it isn't, for whatever reason. And choline in the brain is involved in just improving brain function and memory and through some specific ways I don't think we need to go into but that does have quite a lot of research on it over about 20 or 30 years, there's been clinical trials in all sorts of areas, not just cognition, but things like brain injury, and so forth. So very interesting ingredient with some some good data behind it,
Peter Williams:mate, let's, I'd like to sort of start rounding things up. And what I would love to do is to sort of what would be the do's and don'ts with regards to someone thinking about supplementing that maybe isn't going to a practitioner, but you know, is sort of general wellness? What would be the do's what would be the don'ts. From your perspective?
Ben Brown:Yeah, it's a good question. So I think do consider it don't worry too much about safety. I mean, in general, these things are very safe to consider. Yeah.
Peter Williams:Can we can we just can we just go on to that? Because I think if you were reading general statements on the internet, it does seem to it does seem to sort of make you feel like supplementation is dangerous, or much more dangerous than than it than it is because the reality is, is toxicity is incredibly rare, doesn't mean to say that it doesn't happen. But this is not like a medication. And I think I think what they tend to do is make you feel like taking supplementation is like taking medications, I think it's a very different picture. But can you just sort of just give us an idea on safety? Because they're incredibly safe?
Ben Brown:Yeah, absolutely. I mean, as you've rightly pointed out, there's toxicity is extremely rare. And I can't think of any examples where that would be an issue, if you're following the label dose, on a good quality product from a good brand, basically, I mean, there are some unusual examples with very high dose vitamin B six for but beyond that, it's if you're following the recommendations on the label of a good product, you're going to be fine. Don't necessarily read you know, get advice off the internet and then take an off label dose, just read the pack and trust what the manufacturer is saying. Unless you're getting the advice of a health professional, then it's a bit different. So there's that and what I would also suggest if you are considering using these things, just look at some basics. You know, things we've mentioned as being just sort of broad, generalizable things that are quite useful for most people. Magnesium we spoke about, multivitamins, I'm a bit of a fan of fish oil. And also just double check your multivitamin and make sure the vitamin D is at a decent level for an adult it should be about 2000 iu as a as a basic sort of generalizable recommendation. And I think they're just some basic things and don't be afraid to try stuff as well like it. I think one of the real positives that gets overlooked with food supplements is they're safe and people can self medicate. And that's a good thing because it reduces healthcare burden if you can go and take a product because you're feeling really stressed and anxious and it helps you and that's fantastic. You've just saved the healthcare system. Yeah, no amount of money and hassle and you're better and it's all good. So muck around try stuff, see if it helps you and then the next step is go and see someone like Pete or a good quality health professional that can give you advice that has training in this area. And then you know, if you want to take it to the next level.
Peter Williams:I think that's a that's a really good place to end so um, Sorry, this is our second go at it and let's just hope it's not our third because I'm on a different computer today. So hopefully, I'll get this all right, mate, really appreciate it.
Ben Brown:Pleasure, ya know, it's been fun. Thanks for having me.