[Examine Newsletter] December 2022 Updates

See what's new on Examine for the past month!  ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ ‌ [Examine]( [View in browser](=) Hello! Here’s your recap of Examine's December 2022 updates. 📧 Reminder: If you would like to switch back to weekly emails instead of a monthly newsletter — just [click here](). --------------------------------------------------------------- Quick sale + year in review Dec. 29, 2022 First things first: We’re having a New Year's Sale on Examine+ that's on right now and lasts until Monday! [Save over 30% on yearly and lifetime subscriptions](). Some of you are die-hard Examine fans and might want to know a little bit about how 2022 went for us. In classic transparent fashion, I’ll list both the good stuff and the bad stuff. Good stuff: 84 brand-new [health condition pages]() From acne to anxiety and menopause to multiple sclerosis, we made a ton of progress creating new health condition pages during the past nine months. These condition pages are forming the [backbone of the website](). We aim to be a one-stop shop, where you can learn the essentials of every health condition in easy-to-read FAQ format and also access the latest evidence — which we’ve graded — on interventions for specific health outcomes. Bad stuff: Too many brand-new bugs Reid Hoffman, the founder of LinkedIn, once said, “If you’re not embarrassed by the first version of your product, you've launched too late.” I think that’s a bit silly. But maybe that’s why he’s rich and I’m not? To me, bug-filled redesigns and new products often seem to result from management pushing teams to work faster and less thoughtfully than they should. Of course there are bound to be bugs with anything new, but I doubt waiting a week or two would derail launches too much, and it would make the user experience much less confusing. All that being said, we ended up launching Examine 2.0 with too many bugs, although the core functions all worked. There were a few reasons for this, but no matter how many excuses we’d like to make, the bottom line is that we should have planned better. To make sure this doesn’t happen again, we’re starting to build a public road map of bugs and features. In a few short months, anyone will be able to see the status of Examine at a glance by using this road map. Good and bad stuff: Artificial intelligence & machine learning Artificial intelligence is the ultimate double-edged sword — not for humanity (please don’t target us, [Skynet](=)), but for the Examine website. You see, we extract data from mountains and mountains of papers. Other health websites don’t dive this deep into the data, so they don’t have to put in the thousands of hours we do, scanning the full text of papers for effect sizes, study inclusion criteria, and the like. AI might be able to help us with this grunt work at some point, which could save us soooooooo much time. And now for the bad. First, the AI tools we’ve tested aren’t quite accurate enough to extract the data we need without a lot of hand-holding. They’re getting better every month, though, so hopefully this will happen soon. Second — and perhaps more important — Examine’s evidence pages are handcrafted and labor intensive to create. Conversely, answers from AI tools such as ChatGPT are nearly instantly synthesized using fancy algorithms that try to automatically cull the best information from the web. These are two very different approaches. Examine won’t be able to answer every question you ask, but we put a ton of thought into the questions we do answer: rigorous discussions and debates among Examine researchers, frequent digging into the nitty-gritty of related papers, and so on. We read the actual papers and evaluate them. Yet, if an AI tool ends up answering health questions kinda sorta accurately, what proportion of the answers will be up to our standards? How many people will still want expert analyses? These issues really came to the forefront for us in 2022. Who knows what the distant future will bring, but we’re hoping to harness AI to help with our data extraction and avoid being replaced wholesale by AI tools (except for you, of course, Skynet overlords). Good stuff: A drastically faster, flexible, modern website I mentioned all the bugs that came with the launch of Examine 2.0. Part of the reason for these bugs was that our developers rewrote the entire code base for the website. We can’t use off-the-shelf software, due to our custom database and complex structure, so this rewriting was difficult. Now that we have brand-new, clean code, the site is blazing fast and clean. [Try it]()! Just go to any page on the site and see how fast it loads compared with the laggy days of the old site or the majority of pages on the web that load flashy ads along with content. The part that matters most to you, though, is the flexibility that comes with this new code. It used to take forever to develop website features because of clunky code and limited staff. We doubled the size of our tech team this year, which means that we can come up with new features and implement them. So watch out for new features as 2023 progresses. Good stuff: [23 researchers on the Examine team]() Fifteen years ago, I worked as a researcher at a major, federally funded Evidence-Based Practice Center. We had a large research team of around 15 people. Never ever in a million years would I have imagined that a scrappy, self-funded company of nutrition nerds could grow to a team of 23 researchers (though this is roughly split in half between full-timers and part-timers). These researchers are also some of the nicest people around, are incredibly smart, and come from a wide variety of backgrounds and interests. I’ll take a page created by Examine researchers over a page created by AI any day. And now that we’ve laid the groundwork for the new site, 2023 will be full of updates and new pages created by our larger research team. There’s more to update you on, but this email is already getting long, and it’s best if I collate all the information to make it accessible on the Examine site. If there’s anything about Examine you have a question about, never hesitate to ask. Just hit reply. --------------------------------------------------------------- Everything about lactose intolerance Dec. 22, 2022 One of our new condition pages is on [lactose intolerance](), which is arguably the most common nutrition-related condition in the world, with around 75% of people experiencing it. As Jerry Seinfeld might say, “What’s the deal with lactose?” What’s so special about lactose, as opposed to glucose or fructose? When, where, and why did humans start drinking milk from animals? If you want to give your family the gift of random nutrition facts at the holiday dinner table, check out some choice ones I’ve gathered below. How important was milk to our ancestors? Very. Consider this: the first two beings created in Norse mythology were not man and woman, but a massive dairy cow named Auðumbla and a giant named Ymir. Ymir’s sole source of nourishment was suckling milk from Auðumbla, and Auðumbla’s was licking away at salty ice blocks, eventually revealing the first man. So milk has quite an important role in certain cultures, even popping up in creation myths. In other areas, animal milk has little to no cultural significance, partly due to lactose intolerance, which also happens to be the most concrete example of regional ancestry influencing how we currently eat. Milk, milk, everywhere, nor any drop to drink Milk and other dairy products are everywhere, but if you can’t digest lactose (the sugar in milk), your options are limited. For the lactose intolerant among us, here are the three most common routes to take when confronted by a bowl of delicious ice cream: - Eat it anyway, or eat less of it. This is the most enjoyable option. But it’s also likely to result in gas (from intestinal bacteria eating the lactose and releasing gas) and borborygmus (a delectable word for tummy rumbling from gas and liquid sloshing around) — along with an extended stay on the toilet, for some. - Avoid it at all costs. Lactose-intolerance sufferers commonly avoid any hint of dairy, be it milk, cream, or cheese. But there is often some misunderstanding of lactose going on here, which we’ll get into in a bit. - Take a lactase enzyme pill. Lactose intolerance is, by definition, a lack of sufficient lactase enzyme. So lactase enzyme pills reliably help with lactose digestion. In some parts of the world, lactose intolerance probably wasn’t a big deal in decades past. Home refrigerators only became widespread in the 1930s. Before then, if you didn’t have a cow for fresh milk, you might not encounter it that often. Longer-lasting dairy products that weren’t as dependent on refrigeration, including cheese and yogurt, had the upper hand. It turns out that processed dairy (not in the ultraprocessed sense of modern life but simply processing milk into something else) is also lower in lactose. Whereas a cup of 2% milk contains 11 grams of lactose, cheddar cheese only has around 0.5 grams per serving. The very thing that makes cheese solid — straining it out of watery whey — also eliminates most of the lactose along with the liquid. Yogurt also has a lower lactose content than milk, as some of the lactose is fermented by bacteria, producing the lactic acid that gives yogurt its characteristic tartness. These bacteria also help our lactose digestion in an interesting way: The lactase enzyme the bacteria themselves employ to digest lactose is protected within bacterial cells. It enjoys safe transport through our acidic digestion process, buffered by the relatively alkaline yogurt that surrounds it. Fuller-fat yogurts, such as Greek yogurt, have less lactose than other types because of containing less lactose-laden whey. Pastoral cultures and the rise of lactase persistence Babies are typically able to digest lactose, but in early humans, this ability quickly declined after breastfeeding years. The continued ability to digest lactose, termed “lactase persistence”, is due to a relatively new mutation to a single gene called LCT (with mutations allowing for increased activity, emerging roughly 10,000 years ago). Why would that mutation be beneficial? In a word: pastoralism. Raising livestock can provide a steady supply of meat and milk, and certain regions were well set up for animal husbandry. One place that falls in that category, Sweden, provides some interesting data. Nearly all modern Swedish people can digest lactose, but as little as 4,000–5,000 years ago, there was a stark divergence in that area: DNA from Swedish hunter-gatherer populations of that era show only 5% had lactase persistence, whereas 75% of cattle-raising populations did. If you’re a modern-day Swede, you probably owe your milk-digesting ability to the success of the latter population. Why lactose? Now that we’ve looked at the history of lactase persistence, let’s take a step back and think about the substance in question: lactose. Why is there even lactose in milk to start with? All mammals feed their young milk, but that milk is rich in lactose rather than sugars we see in other foods (namely sucrose, or table sugar). This isn’t likely an accident: lactose is made up of galactose and glucose, and that galactose could play a crucial role in infant development. For example, galactose is part of a complex structure called galactooligosaccharide (GOS), which serves as food for beneficial gut bacteria. This role as a prebiotic (a substance that promotes beneficial bacterial growth) has made GOS a highly researched compound these days, even for adults. Galactose is also part of complex molecules that are essential to the nervous system and immunity. Given that infants have increased nutritional needs, to bolster their developing physiology, their intake of lactose makes sense. So why, then, is glucose our primary carbohydrate fuel, accounting for nearly all of the sugar in our blood? The same characteristics that allow galactose to form complex molecules also make it too reactive to be used as a main fuel source. Feeding lots of galactose to rodents actually makes them age faster, which may give you pause when considering your dairy intake. Luckily, research doesn’t seem to show adverse effects for humans. That being said, don’t presume your ability to digest lactose with ease also means you’re meant to consume tons of dairy. Nobody knows all the effects of dairy for sure, either positive or negative. We do know that humans are unique in drinking milk past childhood, and also in routinely drinking the milk of other animals. Milk consumption arose due to its physiological benefits, such as providing water, [vitamin D](), and [calcium]() in times of low food availability. Nowadays, we no longer have to rely on dairy as a main source of these nutrients. So, your choice of how much, if any, dairy to consume can be influenced by a variety of factors, from how it may affect your own health, acutely or long term, to your ethical stance on dairy production methods. If you’ve managed to read allllll the way down here, I applaud you and wish you the happiest of holidays! --------------------------------------------------------------- Top 5 Study Summaries for December Dec. 15, 2022 Every month, we summarize 150+ recent studies for our [Examine Members]( (Sale: over 30% off!). You can read five of this month’s most favorited Study Summaries for free by clicking the links below. The three Study Summaries marked with are Editor’s Picks, which provide more details about the study, mention related studies, and include helpful graphics. [Combining caffeine and taurine for improved physical and cognitive performance]( The results of this crossover trial in elite boxers suggest that coingestion of caffeine and taurine improves power output and reaction time more than either substance ingested alone. = [Nature nurtures the mind, but how?]( In this randomized controlled trial, a one-hour walk in an urban forest produced changes in stress-related brain regions and increased perceived restorativeness, when compared to a one-hour walk on a busy street. Still, the underlying mechanisms behind the health benefits from exposure to green space are unclear. [“Exercise snacks” amplify protein synthesis during long bouts of sitting]( In this randomized controlled study, people who walked or performed body-weight squats during prolonged sitting sessions had elevated muscle protein synthesis compared to when they sat uninterrupted throughout the day. [Eat your greens: Mediterranean diet variation may enhance visceral fat reduction]( =In this randomized trial of a low-carbohydrate Mediterranean diet, supplementing with and partially replacing animal protein intake with polyphenol-rich foods enhanced visceral fat reduction compared with the diet alone, despite similar weight loss. [Can beetroot juice boost recovery from exercise?]( In this systematic review, supplementation with nitrate improved the recovery of muscular performance, reduced muscle soreness and pain perception, increased antioxidant activity, and enhanced cardiovascular recovery after fatiguing exercise. However, the study protocols varied widely, and larger well-controlled studies are needed. You can also check out the [most-favorited summaries from previous months](.🔥 --------------------------------------------------------------- Embarrassing Topics Dec. 8, 2022 There are certain things you don’t bring up at the dinner table. I’m not talking about lightly embarrassing things, such as my love for easy listening music and Hallmark holiday movies. No, I’m talking about health-related topics. I’m guessing you haven’t had many conversations like this: Person 1: Hey, so glad you could finally make it over for dinner! Person 2: Happy to be here! Before we eat, can I ask you about my constipation? It’s okay to avoid discussing these things at length with friends and family. The problem arises when you feel too ashamed to mention them to your doctor or even research the topics yourself. We spent nearly a year creating brand-new health condition pages to help tie the Examine site together. Linked below are a select few that cover traditionally taboo topics. Remember that anatomy isn’t inherently shameful, so don’t let society’s norms interfere with doing what’s best for you! Gastrointestinal Health [Constipation]([Irritable Bowel Syndrome (IBS)]( Skin and Hair [Acne]( [Dandruff]( [Hair Loss]( Men’s Health [Benign Prostatic Hyperplasia (BPH)]( [Male Sexual Dysfunction]( Women’s Health [Female Sexual Dysfunction]([Primary Dysmenorrhea (Menstrual Cramps)]([Vulvovaginal Candidiasis (Yeast Infection)]( --------------------------------------------------------------- So, did you find something of interest? If not, please reply to this email to let me know which topics you’d like us to tackle. And if you’re ready to stay on top of the latest research, consider becoming an [Examine+ Member (Sale: over 30% off!)](. Sincerely, Kamal Patel Co-founder, Examine Follow us on: [Facebook]( [Twitter]( [LinkedIn]( [Instagram](=) [About Examine]( | [Careers]() | [Member’s Area]() [Unlock Examine+]( PO Box 592, Station-P, Toronto, Ontario M5S 2T1 [Switch to weekly emails]() | [Opt out of all emails](