Sunday, 15 November 2026Nutrition, with receipts
Plate & ProofArchive
66 pieces, newest first. Each one ends with the documents it leans on — mostly EFSA and the WHO.
A chromatogram gives you an area percentage, not an identity. Mass spectrometry gives you an identity and a purity, but a different one. Detection is not identification, and an endotoxin number comes from a test that about a quarter of samples disagree with itself. Four documents, four different questions.
A 2025 systematic review pulled 72 papers and reached a level of evidence of 4. Prevalence among athletes is estimated at 1 to 3 per cent, thirteen case reports describe 15 cases, all men with a median age of 32, all taking them orally for a mean of eight weeks, and eight of the fifteen identified as athletes.
A prospective cohort of 17,705 middle-aged and older Chinese adults tracked across cardiovascular-kidney-metabolic stages 0 to 3. After full adjustment, each one-unit rise in the composite index was associated with a 111 per cent increase in all-cause mortality. Observational, one country, one index, no mechanism.
A 2019 meta-analysis of 16 randomized trials and 1060 people with diabetes found probiotic and synbiotic supplementation lowered hs-CRP (SMD -0.38) and malondialdehyde (SMD -0.61) and raised three antioxidant markers. Every one of those is a blood biomarker. None of them is a symptom. The same review notes the methodological quality varied across trials.
A peptide certificate carries two numbers that are easy to confuse. Purity is the share of the correct molecule — usually reported above 95 %. Content is how much of that molecule is in the vial. A 2023 Pharm Res paper on reference standards shows why content-uniformity and value assignment are separate work, and a 2023 J Chromatogr B method resolves chirality down to 0.1 %.
Thymosin beta 4 prevented cardiac dysfunction and fibrosis in mice 28 days after ischaemia and reperfusion, and the effect vanished when the ErbB2 pathway was blocked. In a randomised, double-blind, placebo-controlled trial of 96 people with a heart attack, infarct size was significantly reduced in the subgroup dosed within 8 hours of angioplasty — and the difference across the whole trial was not significant.
A phase 2 trial of 338 adults reported a mean weight change of −24.2% at 48 weeks in the highest retatrutide group against −2.1% on placebo. A 2025 substudy with DXA scans found total fat mass down by more than a quarter in the higher groups, with a body-composition substudy of 103 people scanned twice. Neither paper says anything about a product sold under a research name.
A 2018 review notes that many multi-ingredient pre-workouts hide their amounts behind a proprietary blend, and that a supplement can carry banned substances as deliberate ingredients or as contaminants. A second review explains the regulatory gap: a supplement manufacturer is not required to submit evidence of safety and efficacy before selling. Neither paper can tell you what is in the vial you are holding; they tell you what a document cannot tell you either.
A network meta-analysis of 28 randomised trials in 23,622 people with type 2 diabetes puts tirzepatide ahead of semaglutide on both HbA1c and weight. An independent review of 22 network meta-analyses, published a year later, says the tirzepatide numbers are less impressive than some meta-analyses claim, because several amounts and time points get merged. Both can be right.
Silymarin pools 26 randomised trials in 2,375 patients with fatty liver disease and moves liver enzymes by a wide margin; N-acetylcysteine has a meta-analysis too, and every one of its thirteen studies is an animal study. Two meta-analyses on coffee disagree with each other about the same question, which is the most useful thing in this file.
A 2004 review of oxandrolone in wasting and catabolic disorders found significant gains in body composition, strength and nutritional status across most well-designed trials — and simultaneously noted that it has never been studied in sarcopenia. The drug is also the only orally active anabolic steroid approved in the US, which tells you something about the alternatives.
A 2022 review of the whole field reaches a blunt conclusion: many drugs targeting myostatin and activin signalling failed in clinical trials, and more often than not because they could not improve muscle function despite preserving muscle mass. A 2023 sarcopenia review reaches the same line about the entire drug category.
A 2024 meta-analysis of nine randomised trials pooled 11 641 people on once-weekly semaglutide and 10 479 on placebo. Body weight fell 11.49 percent against placebo, waist 9.06 centimetres, and nausea was four times more likely. Serious adverse events were not significantly different, but stopping for adverse events was about twice as likely (odds ratio 2.22).
Across 3 132 supplements analysed in a 2022 review, 875 contained substances that were not on the label, and a Dutch market survey found 38 percent of 66 high-risk sports supplements carrying undeclared stimulants and steroids. Independent testing exists, works, and settles far less than the word certificate implies.
A 2024 meta-analysis of 11 trials and 349 people with hypertension found systolic blood pressure down 5.31 mmHg — and a certainty of evidence rated low. A 2017 analysis found the effect only in clinic measurements, with nothing in 24-hour ambulatory monitoring. That is the whole story in two papers.
Ninety randomised trials, 72,598 participants. The relationship is not one curve: triglycerides and non-HDL cholesterol fall roughly linearly with intake, while LDL and HDL describe J-shaped curves. A meta-analysis that averages those four together tells you nothing you can use.
Three US cohorts followed for up to 32 years, 5.54 million person-years and 14,806 cardiovascular events. One egg a day or more against less than one a month: hazard ratio 0.93, interval 0.82 to 1.05. The meta-analysis of 33 estimates and 1.7 million people lands at 0.98.
Two 2023 and 2024 meta-analyses of randomized trials agree on memory and disagree about the rest. Sixteen RCTs, 492 adults: memory SMD 0.31, attention time and processing speed improved, overall cognition and executive function did not. Ten RCTs in healthy people: overall memory SMD 0.29, but SMD 0.88 in adults aged 66 to 76 against 0.03 in adults aged 11 to 31.
The class marketed as gut-friendly is the one class the gastroenterology guidelines treat as a trigger. Polyols are a FODMAP category in their own right, low-FODMAP trials score 22.8 mm of global symptoms against 44.9 mm on the comparator diet, and a 2023 cohort links high erythritol to a 1.80 hazard ratio for major cardiovascular events. The dental benefit, meanwhile, is 13 per cent in low-quality evidence.
Just under 135 million person-years from 185 prospective studies and 58 trials: the highest fibre consumers had 15 to 30 per cent lower all-cause and cardiovascular mortality, with the largest risk reduction between 25 and 29 grams a day. An umbrella review of 45 meta-analyses graded the inverse association with fibre as convincing. The glycaemic index was graded low to very low.
Twenty-five thousand eight hundred and seventy-one people, 1,991 fractures, and no effect: VITAL found a hazard ratio of 0.98 for total fractures on 2,000 IU of vitamin D a day. A JAMA meta-analysis of 33 trials and 51,145 people reached the same null. What the trials did find is a real change in bone density and a real rise in kidney stones.
One randomized trial replacing saturated fat with safflower oil found higher mortality; the 2025 analysis of 65,179 adults with 20,571 deaths found the opposite for polyunsaturated fat. Both are real. The difference is what was substituted, what was compared with what, and what was actually bottled.
One 52-week randomized trial found 7.5 kilograms lost on non-sugar-sweetened drinks against 6.1 on water — and called the 1.4 kilogram difference not clinically significant. The WHO review of 56 studies found a BMI difference of minus 0.6. The two literatures do not agree, and the reason is design.
Ten trials, 475 people, both diets hypocaloric. Low-carb produced no better body composition, lowered triglycerides and raised LDL, and very-low-carbohydrate diets measurably reduced flow-mediated dilation, which is the opposite of what the marketing implies.
The headline organic-cancer result comes from one French cohort of 68,946 people with a hazard ratio of 0.75 and an absolute risk reduction of 0.6 per cent. The companion study of 43,209 Danish people is the reason that result is hard to interpret.
The 2012 BMJ meta-analysis found that reducing free sugars moved body weight 0.80 kg, and that swapping sugar for other carbohydrate at equal energy moved nothing at all. The mechanism is energy intake, and the paper says so in its own conclusion.
A 78-person randomised trial gave one group half a litre of orange juice a day with a reduced-calorie diet and the other the same diet without it. Both lost the same weight. The biomarkers moved in the juice group — and the authors still wrote that juice did not improve insulin sensitivity or the lipid profile.
A 74-trial meta-analysis says more daily protein adds small gains in lean mass and smaller strength gains in people already lifting. The DIAAS score is the tool that separates one protein from another, and it works on digestibility at the end of the small intestine, not on grams per serving.
A nutrient absence claim is regulated on what is in the tub, not on what is missing from it. An audit of 276 Australian baby-food pouches found 59 per cent carried a no-added-sugar claim despite free sugars, and a Canadian supply analysis found claims on half of all packaged food.
An EFSA substantiation opinion is a document with a fixed structure, and most of the rejections are decided by three things: the design of the study, whether anyone has replicated it, and whether a mechanism was proposed. Three published opinions show the same three reasons.
The multi-level meta-analysis that set out to test the anabolic window found no significant difference for strength or hypertrophy once covariates were controlled, and named total protein intake as the strongest predictor. The pre-versus-post trial that refuted the window had 21 men in it.
The headline meta-analysis finds plant protein 0.20 standard deviations behind animal protein for muscle mass, and nothing at all for strength. The best-designed trial in the field puts whey and pea at identical rates of muscle protein synthesis in older men.
Eleven meta-analyses and roughly 1,200 participants. The pooled effect of BCAA on muscle size in older adults is 0.34 on a standardized index; the pooled effect on handgrip strength in a different meta-analysis carries a low-certainty rating. The recovery effect is larger than the growth effect.
The UK stopped measuring iodine in its national diet survey a decade ago. The reason is a measurement problem, and it is worth understanding: urinary iodine is a population instrument, and the same number means very different things in a spot sample, a large person and a full day.
Three-dimensional MRI puts the strain in a healthy free Achilles tendon at about one per cent. Paired-leg training studies show stiffness rising while cross-sectional area often does not. The gap between loading a tendon and changing its structure is where most of the confusion lives.
Eighty-four trials, nearly 740,000 people. A small signal on cancer incidence, nothing on cardiovascular events, nothing on death, and a real downside that belongs to single nutrients rather than to the pill.
IARC put processed meat in Group 1, the same shelf as smoking. A NutriRECS panel looking at the same literature told adults to carry on. Both verdicts are defensible, and the gap between them is the interesting part.
Twenty grams a day for six days or three grams a day for a month: the classic muscle-creatine study tested both against each other, and strength trials added the rest. The numbers are less dramatic than the forum debates.
One egg a day used to break the cholesterol budget. Then the budget itself was withdrawn. What a 29,615-person analysis and the current guidelines actually say.
A nutrition label tells you what is in the jar. A certificate of analysis tells you what was measured, in which batch, by which method. We read the federal release rules and the validation guidance for analytical procedures, then set out the five lines worth finding first - and why a perfect-looking PDF is often the wrong sign.
A trial that pits two drugs against each other and a trial that pits one drug against a dummy are not a stronger and a weaker version of the same thing. Reading the 2025 tirzepatide-versus-semaglutide study and the 2023 retatrutide study side by side, the design does more work than the headline number.
A 48-week phase 2 trial in 338 adults reported striking weight change. Its side-effect profile is worth reading before the headlines.
For years the two drugs were compared through cross-trial guesswork. SURMOUNT-5 finally tested them against each other: 751 adults, 72 weeks, and a clear gap in average weight change.
The same sentence gets written about two completely different evidence bases. One substance has 35 preclinical studies and one clinical trial; the other has a small, well-run phase 1 trial in healthy volunteers. Both are on the prohibited list. Here is what each dataset can and cannot support.
PREDIMED assigned thousands of high-risk adults to a Mediterranean diet with olive oil or nuts, or to low-fat advice. After nearly five years, major cardiovascular events ran about 30% lower in both Mediterranean groups.
EFSA sets adequate total-water intakes at 2.5 litres a day for men and 2.0 for women, food included. Almost nobody can quote their own intake — here is how to count it honestly.
The EU reference value is 0.83 g per kilogram of body weight per day — far less than gym culture assumes, and easier to reach than most people think.
NOVA is a classification of how food is made, not a measure of how good it is. Almost every argument about ultra-processed food comes from confusing the two.
EFSA's adequate intake is 350 mg a day for men and 300 for women. The gap between that and what the pill bottles promise is where most of the confusion lives.
Per-100 g is the comparison tool, the ingredient list is sorted by weight, and three lines tell you most of what the front of the pack won't.
EFSA sets an adequate intake of 3,500 mg a day. Most sodium advice quietly assumes you are also hitting it, and most Europeans are not.
EFSA's reference range is 20 to 35 per cent of energy from fat. Inside that range, the composition matters far more than the total.
The WHO advised against using non-sugar sweeteners for weight control. What it actually said is narrower — and more interesting — than the headlines.
EFSA put numbers on caffeine in 2015 — 400 mg a day, 200 mg in one go. Most people are further from those limits than they think.
Frozen vegetables, brown eggs and fancy salt — what the evidence and the regulations actually say about the aisle's most persistent folklore.
EFSA's adequate intake for adults is 250 mg of EPA plus DHA a day. That is two portions of oily fish a week, and almost nothing else on the shelf.
EFSA's reference intake is 950 mg a day for adults over 25. Dairy is the easy route there, and it is not the only one.
EFSA sets 11 mg a day for men and 16 mg for premenopausal women. The gap between those two numbers explains almost everything about iron deficiency.
EFSA's adequate intake is 15 micrograms a day for adults — a figure set for the case where your skin is making none of it. Between October and March in northern Europe, that is the case.
In EU law, light means the same as reduced: thirty per cent less of something than a comparable product. Thirty per cent less than what is the interesting part.
Free sugars below 10% of daily energy — around 50 grams on a typical adult intake — with extra benefit suggested below 5%. And why 'free sugars' is the phrase that matters.
Those two phrases are not marketing language. They are defined in EU law, to the gram, and the definitions are lower than shoppers assume.
The WHO updated its fats guidance in 2023. The headline number is 10% of energy — but the sentence that matters is about what you swap it for.
EFSA's adequate intakes are 2.0 litres a day for women and 2.5 for men — counting all drinks and the water inside food. The eight-glasses rule was never the source.
The WHO's number is under 5 grams of salt a day. Most of Europe eats roughly twice that, and almost none of it comes from the salt cellar.
EFSA puts adequate fibre intake at 25 grams a day for adults. Intake surveys keep finding averages below it — here's what 25 grams actually looks like.
