Episode 89
Gastrointestinal Studies
- Does S. Boulardii reduce diarrhea in hospitalized covid patients?
- Clinical trial: 120 hospitalized patients w/ covid related pneumonia
- Antibiotics alone
- Antibiotics + S. boulardii
- Treatment led to:
- 64% reduced diarrhea
- Shorter hospital duration
- Do probiotics and synbiotics improve constipation?
- Summary: 34 RCTs, ~1200 participants w/ constipation
- Control
- Probiotics (formulas varied, included soil based, lacto, bifido)
- Synbiotics
- Probiotics improved overall stool frequency (medium effect size), but no change in stool consistency
- Synbiotics had no effects on constipation
- Do probiotics improve outcomes in those undergoing abdominal surgery?
- RCT: Women with recent abdominal surgery were treated with:
- Placebo
- Soil based probiotics
- Probiotics led to reduced surgery side effects (9% probiotics vs 40% control)
- Does FMT work better than antibiotics for recurrent C. Diff infections?
- Summary: 10 RCTs, 765 participants with recurrent C. Diff
- Antibiotics
- FMT
- C. Diff cure rates were 7-8x higher with FMT compared to antibiotics
- Does FMT improve GI symptoms in children?
- Clinical trial: 12 children with functional GI disorder, treated with FMT
- After 2 months, FMT led to:
- Improved GI symptoms (bloating, pain, diarrhea)
- Shift towards healthier microbiome (similar to healthy controls)
- Do mindfulness practices reduce flares in UC patients?
- RCT: 43 inactive UC patients treated with:
- Placebo
- Mindfulness practice
- After 1 year, IBD flares occurred in:
- 22% in placebo group
- 0% in mindfulness group
Thyroid & Hormones Studies
- Does myo-inositol + selenium improve subclinical hypothyroidism and thyroid antibodies?
- 148 women with either:
- SCH
- Euthyroid + TPO/Tg
- All treated with myo-inositol and selenium
- Treatment improved:
- TSH levels (5.9 → 4.6 mU/l)
- Tg-ab (-46 IU/L)
- TPO-ab (-21 IU/L)
- Other benefits:
- More regular menstrual cycles
- Improved fatigue
- Notes: This study didn’t report % SCH converted to euthyroid
Diet & Lifestyle Studies
- Does exercise improve cognitive function?
- Summary: 10 RCTs, 575 participants with mild cognitive impairment
- Control group
- Exercise (aerobic, strength, dancing)
- Various types of exercise led to improved overall cognition function (medium effect size)
- Does fish oil improve strength training outcomes?
- RCT: 28 healthy participants
- Strength training
- Strength training + fish oil
- Fish oil + exercise did NOT lead to greater strength gains than strength training alone
- Does stress reduction and exercise improve GI symptoms, sleep and mood?
- RCT: 60 perimenopausal women with dyspepsia
- Stress reduction (breathing and muscle relaxation)
- Aerobic exercise + stress reduction
- After 2 months, BOTH groups had improved:
- GI symptoms
- Sleep
- Mood
- Trend in greater symptomatic improvements with addition of exercise
- Note: Exercise group saw significant improvement in estrogen levels
Glucose-lowering effect of berberine on type 2 diabetes: A systematic review and meta-analysis
- Does berberine improve blood sugar in diabetics?
- Summary: 37 RCTs, ~3,000 participants with type 2 diabetes
- Medication
- Berberine +/- medication
- Berberine led to greater reductions in:
- Fasting glucose (-15 mg/dL)
- HbA1c (-0.6%)
- Medication side effects (-27%)
Episode 90
Gastrointestinal Studies
- Do healthy infants/toddlers benefit from supplementation with probiotics?
- Summary: 26 RCTs, 3,495 healthy infants and children
- Placebo
- Probiotics (formulas highly varied across studies, included strep thermophilus, lacto/bifido +/- prebiotics)
- Probiotics led to reduced:
- Colic (large effect size)
- Regurgitation (large effect size)
- Need for antibiotics (large effect size)
- Respiratory infections (small effect size)
- Do synbiotics improve functional diarrhea?
- RCT: 39 participants with functional diarrhea and elevated calprotectin
- Placebo
- Synbiotics (lacto/bifido + FOS)
- After 2 months, synbiotics led to improved:
- Stool consistency
- Bowel movement satisfaction
- There was NO difference in:
- Stool frequency
- Fecal calprotectin
- Does shift work increase risk of GERD?
- Summary: 26,940 shift workers
- Shift work was associated with a 53% increased risk for GERD
Therapeutic Effects of Butyrate on Pediatric Obesity: A Randomized Clinical Trial
- Does butyrate improve obesity in children?
- RCT: 48 obese children
- Diet and exercise
- Butyrate + diet and exercise
- After 6 months, the addition of butyrate led to greater improvements in:
- BMI (-3 butyrate vs -0.8)
- Waist circumference (-5 vs -0.3 cm)
- Insulin (-7.7 vs -2.4 μU/mL)
- NO effect on lipid or fasting glucose levels
Thyroid & Hormones Studies
- Does adequate dietary selenium intake reduce the risk of Hashimoto’s disease?
- Observational study of ~8,700 participants
- Higher selenium intake was associated with a 45% reduced risk of Hashimoto’s thyroiditis
Diet & Lifestyle Studies
Association between vitamin D supplementation and mortality: systematic review and meta-analysis
- Does vitamin D supplementation reduce risk of dying from any cause?
- Summary: 50 RCTs, 74,655 participants
- Control
- Vitamin D
- No effect on:
- All cause mortality
- Cardiovascular-related death
- 15% reduced risk of cancer
- Does aerobic exercise improve cognitive function in those with Alzheimer’s disease?
- Summary: 15 RCTs, 909 participants with Alzheimer’s disease
- Control
- Aerobic exercise
- Cognitive function was improved with just 30 minutes of aerobic exercise, 3x/week
- Note: Those with the worst baseline cognitive function saw the greatest improvement
- Does strength training improve fibromyalgia-related concerns?
- 41 women with fibromyalgia treated with strength training (60 min 2x/week)
- After 6 months, strength training led to improved:
- Pain
- Physical performance
- Sleep quality
- NO effect on anxiety or fatigue
- Note: Consistent finding in literature that strength training doesn’t improve energy for ME/CFS either, but aerobic training does. Supports the use of both strength and aerobic training for comprehensive symptomatic improvement.
Episode 91
Gastrointestinal Studies
- Do probiotics help with weight loss?
- Summary: 21 studies, ~1,200 overweight adults
- Diet and exercise
- Diet and exercise + probiotics (varied by study, included lacto/bifido, streptococcus) +/- prebiotics
- Compared to diet and exercise alone, probiotics/prebiotics led to an additional 1.6 lbs of weight loss
- Do probiotics affect hormones associated with hunger?
- Summary: 26 RCTs, 1,536 participants (healthy and metabolically unhealthy)
- Placebo
- Probiotics (lacto/bifido) +/- prebiotics
- Probiotics +/- prebiotics led to:
- Reduced leptin (small effect size)
- Increased desire to eat (small effect size)
- NO effect on weight
- Do pregnant women benefit from taking probiotics?
- RCT: 83 healthy pregnant women
- Placebo
- Probiotics (lacto/bifido)
- Probiotic supplementation during pregnancy led to:
- Reduced pregnancy-associated GI symptoms (moderate effect size)
- NO reduction in strep B colonization (common issue during pregnancy)
- Do synbiotics improve ulcerative colitis outcomes?
- RCT: 40 participants with mild-to-moderate ulcerative colitis
- Placebo
- Synbiotics (lacto/bifido, Enterococcus, Streptococcus + prebiotics)
- After 2 months, synbiotics had NO effect on:
- Remission rates (56% synbiotics vs 33% controls)
- Quality of life
- Note: Trend in high remission rate for synbiotics, but not statistically significant likely due to small sample size
- Is candida associated with increased risk of gum disease?
- Summary: 26 studies assessing the oral microbiome
- Compared to healthy people, the presence of Candida spp in the mouth was associated with a 76% increased risk of developing gum disease
Thyroid & Hormones Studies
- What percentage of euthyroid, TPO positive women will progress to hypothyroidism?
- Observational study: 940 euthyroid women with TPO antibodies
- Placebo
- Levothyroxine
- 7% progressed to either SCH or over hypothyroidism, with no significant difference between treatment groups
- What effect do ginger, cinnamon and metformin have on women with PCOS?
- RCT: 83 women with PCOS
- Placebo
- Ginger
- Cinnamon
- Metformin
- After 2 months, metformin and cinnamon led to similar improvements in:
- Testosterone
- Insulin
- Weight loss
- Note: Cinnamon was as effective as a medication for improving some aspects of PCOS
Diet & Lifestyle Studies
- What effect does cold water immersion have on acute exercise recovery?
- Summary: 28 studies on adults after exercise
- Control (active recovery, cryotherapy, etc)
- Cold-water immersion (<59℉)
- Cold water immersion was the most effective for reducing muscle soreness
Effects of exercise on obsessive-compulsive disorder symptoms: a systematic review and meta-analysis
- Can exercise improve obsessive/compulsive thinking?
- Summary: 6 studies, 137 participants with obsessive-compulsive disorder (OCD)
- All Treated with physical activity (aerobic exercise, yoga, etc)
- Regular exercise led to reduced:
- OCD symptom scores (large effect size)
- Depression (medium effect size)
- Anxiety (medium effect size)
- Interesting thought: How does OCD compare with those who are obsessed/overly focused on their health condition?
- Does aerobic exercise improve metabolic health?
- Summary: 16 studies, 710 participants with fatty liver disease
- Control
- Aerobic exercise
- Aerobic exercise led to improved:
- Blood sugar balance (glucose, insulin, A1c)
- Lipids (triglycerides, LDL-C)
- What effect does stress reduction and exercise have on cognitive function?
- RCT: 585 older adults with subjective cognitive concerns
- Exercise (aerobic + strength)
- Mindfulness based stress reduction
- Exercise + mindfulness
- After 6 months, NO groups saw improved cognitive function
- What effect does a mandibular advancement device have on sleep apnea?
- 27 participants with sleep apnea, 32 healthy controls
- All treated with mandibular advancement device
- Long-term treatment (~1 to 2 years) led to:
- Reduced daytime sleepiness (large effect size)
- Improved energy levels (moderate effect size)
- Does magnesium improve blood sugar control?
- Summary: 18 RCTs on participants with type 2 diabetes
- Control
- Magnesium (~500 mg/day)
- After 6 months, magnesium led to improved:
- HbA1c (-0.48%)
- Fasting blood glucose (-15.58 mg/dl)
Episode 92
Gastrointestinal Studies
- Is FMT safe and effective for treating children with C. diff?
- Summary: 14 studies, ~ 900 children with acute or recurrent C. Diff infection
- All treated with FMT
- FMT led to resolution of C. diff infection in 86% of participants
- 15% had side effects
- Does psyllium improve IBS in children?
- RCT: 81 children with IBS received
- Placebo
- Psyllium
- After 1 month, psyllium led resolution of IBS symptoms in 44% (vs 10% in placebo)
- Do probiotics improve anxiety and depression associated with IBS?
- Interventional trial: 40 IBS participants with anxiety/depression
- All treated with probiotics (bifidobacterium only)
- Pobiotics led to improved:
- IBS symptoms in 82%
- Anxiety in 61%
- Depression in 61%
- Sleep quality
- Cortisol levels (cortisol awakening response)
- Note: IBS scores and cortisol returned to baseline 2 months after d/c probiotics, but anxiety/depression still improved
- Do probiotics and/or prebiotics improve upper respiratory tract infection outcomes?
- Summary: 42 studies, ~9,000 healthy adults received:
- Placebo
- Probiotics (formulas varied, included: lacto/bifido, Enterococcus, Lactococcus)
- Prebiotics
- Synbiotics
- Probiotics led to:
- 9% lower risk of getting URI
- Reduced duration and severity (small effect size)
- Unclear benefit of prebiotics/synbiotics (only 3 studies)
- What’s the prevalence of SIBO in fatty liver disease?
- Summary: 18 studies, ~1,200 participants with liver disease
- SIBO detected in about 35% of those with fatty liver disease
Gut microbiome signatures reflect different subtypes of irritable bowel syndrome
- Are certain microbiome profiles associated with different IBS subtypes?
- 942 participants with IBS, 942 controls
- All underwent PCR stool testing
- Compared to controls, ALL IBS subtypes had:
- Increased Escherichia/Shigella bacteria
- Reduced bacterial diversity
- IBS-D, but NOT IBS-C, had reduced bacterial richness (# of bacterial species)
- Authors conclusion: “These findings highlight the importance of personalized gut microbiome modulation approaches in different subtypes for optimal therapeutic effects.”
Thyroid & Hormones Studies
- Does environmental exposure to toxins affect thyroid function?
- ~2500 euthyroid participants tested for perchlorates (common in drinking water)
- Higher levels of perchlorates was associated with:
- Lower fT4 and fT3
- Higher TSH
- Note: Did not look at conversion rate to hypothyroid
- Does physical therapy improve endometriosis symptoms?
- Summary: 6 RCTs, women with endometriosis received
- Placebo
- Physical therapy
- Physical therapy led to significant improvements in:
- Physical function (large effect size)
- Pain (moderate effect size)
Diet & Lifestyle Studies
Effect of resistance training on heart rate variability of anxious female college students
- Does resistance training improve anxiety?
- RCT: 27 sedentary women with anxiety
- Control
- Strength training (2x/week)
- 2 months of strength training led to reduced anxiety (large effect)
- Does respiratory muscle training improve sleep apnea?
- Summary: 7 RCTs, 160 participants with sleep apnea
- Control
- Inspiratory muscle training
- Improved sleep quality and fatigue
- NO change in sleep apnea severity
- Note: Symptom improvement, no lab improvement
- Does intermittent fasting + increased protein intake lead to more weight loss?
- RCT: 41 obese participants
- Calorie restriction (~70 g protein/day)
- Fasting + higher protein (~135 g/day)
- Caloric intake and exercise equal between groups
- After 2 months, both groups had similar reductions in:
- Weight (-18 lbs IF vs -11 lbs calorie restriction)
- Visceral fat mass (-33% vs -14%)
- Desire to eat (-17% vs -1%)
- Note: Small sample size, hence not statistically significant difference
- Do vitamin D or omega-3s fatty acids lower inflammation?
- RCT: ~2,700 participants received:
- Placebo
- Vitamin D
- Omega-3 fatty acid
- Vitamin D + omega-3s
- Only Vitamin D led to a reduction in hsCRP (-19%), but this effect was not found after long-term follow up (4 years)
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