Health Claims Under the Microscope: A Scientist Explains with Nicolas Verhoeven, PhD

[00:00:00] Dr. Nicolas Verhoeven: It sounds a little odd coming from me, but I would say get less of your information from social media. And this is coming from a person who shares information on social media. I just think that we have so few really reputable people that are putting out valuable information. And even if they are releasing valuable information, they're not marketers. And the people that are releasing really terrible information are marketers. So, they just outpace, they outgrow basically everybody else.

[00:00:33] Dr. Melinda Ring: This is Next Level Health. I'm your host, Dr. Melinda Ring, Director of the Osher Center for Integrative Health at Northwestern University. On this show, we explore ways to take actionable steps towards optimizing our health with leaders in the integrative, functional, and lifestyle medicine fields who believe in science-backed and time-tested approaches to well-being. Let's take your health to the next level.

[00:01:08] Dr. Melinda Ring: Every year thousands of studies are published about what might improve our health, what might harm it, and what could help us live longer. But for everyday people who just want to make better decisions about their health, making sense of all that research can be incredibly difficult. My guest today, Dr. Nicholas Verhoeven, has made it his mission to help bridge that gap. He is the creator of Physionic, an online platform where his deep dives into health research have attracted nearly 400,000 YouTube subscribers and more than 51 million views. Nick holds a PhD in molecular medicine and a master's degree in exercise physiology. He's been creating science-based content on YouTube since 2014. His approach goes well beyond summarizing the latest study. He digs into the biological mechanisms behind the findings and translates really complicated science into information that people can understand and use. So today we're going put that approach to work. We'll talk about how we can become smarter consumers of health research and talk about the evidence behind some of today's most talked about health and longevity topics like mitochondrial health, omega-3s, creatine, collagen, and more. Nick, welcome to Next Level Health.

[00:02:24] Dr. Nicholas Verhoeven: Yeah, thanks for having me. That was quite an introduction. I didn't know, I didn't even know some of those statistics. 400,000 subs and you said 51 million views. I haven't looked at that in a while, so it was a pleasant surprise for me too.

[00:02:38 Dr. Melinda Ring: Yeah, probably by the time this airs even more; you're really impacting people's lives. So what drew you to wanting to spend so much of your career helping people make sense of health research?

[00:02:49] Dr. Nicholas Verhoeven: The way I describe it is actually usually from starting out from selfish desire because I got into school and then I wanted to learn at an accelerated pace. So I was going obviously to my courses and whatnot, and I was peppering my professors with tons of questions. But eventually just got to a point where I was like, I wanted to learn even faster. So I just decided to take it on myself to start writing articles and creating videos and I thought why not just upload these to YouTube and put them on a website so that people can consume them as well? And it's been a learning journey along the way. So I'm very happy though, of course, that it's helped other people or hopefully it has.

[00:03:28] Dr. Melinda Ring: Let's talk about your approach, because every day there are thousands of new health studies and papers published, and PubMed alone adds roughly, I don't know, 5,000 citations a day. So how do you even decide which of those studies or health topics are worth taking a closer look and sharing with your audience?

[00:03:52] Dr. Nicholas Verhoeven: Usually I try to focus on things that have broad appeal. So they focus, and I'm sure we'll talk about this throughout this discussion, but usually focusing on outcomes. So there's, like you said, thousands of studies that release even every day. But a lot of those studies, I would say the vast majority, focus on some really insular mechanism or elucidating some tiny aspect of cell biology, which to me is absolutely fascinating. And I'm so thankful that the researchers do this kind of research. But the broad appeal isn't there, right, for most people. It's not going to actually help them defeat diabetes or get over cancer or whatever it might be. So I tend to put those studies aside and kind of absorb them for my own nerdy love for reading research, but in terms of actually creating content, the articles and the actual videos and whatnot, that gets reserved to a much smaller pool.

[00:04:49] Dr. Melinda Ring: Do you weigh them differently too when you're doing that focus? A hierarchy as to what you're reviewing and how you share that with audiences and differentiate between their relevance to outcomes?

[00:05:01] Dr. Nicholas Verhoeven: Definitely so. The process that I go through is basically a three-step process. First of all, you might find an interesting study or you might have a headline from some news article and whatnot. So I'll either dig into that study, which will give me kind of a springboard to go off of, or I'll have a bunch of studies that are sent to me by different journals. I think I'm subscribed to like 150 journals and they send it to my email, and then I can just kind of go through those. Or with the use of AI, you can also kind of sift through some of those. Then from there, the study might be based on some animal work, which is fantastic for discovering mechanisms. There are certain advantages to those, but they don't have to go back to this broad appeal or they don't have much translation. So the next step for me, which I've done a lot more recently the last few years, is to take that, study the mechanism, and then try to broaden that to the broader literature and see if there is any sort of corroborative as well as—and that's really important—to see if there's any disagreeing literature and then try to marry. Those different components together to create a compelling story. And if the story is very much focused on the literature clearly shows that the outcomes are true and the mechanism could explain some part of those outcomes, then I can say, okay, the evidence is very strong for that. But if the evidence is mixed, let's say three outcome studies show that yes, they agree, and then two of them show that they disagree, you have to be able to bridge that gap. And that's where you start to try to introduce a little bit of doubt into the viewer's mind so that they understand, Hey, look, the science is not settled on this. We really need a lot more research. It might be through this mechanism that's recently been described. It might be through some other mechanisms that we don't know. We have a lot more research that needs to be done and actually conveying that, actually communicating that is really important.

[00:07:02] Dr. Melinda Ring: For better or worse, I feel like that's really where most science lives, right? Where like one study will say something's beneficial and then you can also find studies or other ones get published that say the exact opposite. I feel like so many research studies, they'll always end up with, "but more studies need to be done to confirm this." That seems to be the mandatory tagline, so. How do you handle that? Because for me, I am always thinking about what is the relative harm versus the risk. So if we're talking about, for example, getting a massage for back pain, I'm like, I probably don't need an overwhelming amount of evidence to say like, it's okay, you can go get the massage if it's helping your back pain. But when we're talking about some of the things that you talk about, like medication, pharmaceuticals, dietary supplements, then I want to see a stronger weight of evidence. But even then, it's not always raw—we're going to see conflicting information. What do you look for to determine whether a finding is actually meaningful or how do you guide somebody? 'Cause you're really breaking that down for people. Like, should I actually do this or should I wait?

[00:08:15] Dr. Nicholas Verhoeven: Yeah. To your first point about what researchers put into their studies of, "Oh, well we need more research on this," I feel like it's almost like a universal stamp that they have to throw on there, which for good reason—I mean, I don't think that they're just throwing it out there. Researchers tend to be quite conservative when it comes to actually trying to translate that to the public, and it makes sense, right? You want to have multiple studies to actually show, yes, all of them are directing in this particular direction. I think that my process is definitely an evolving one, and it's one that I've had to refine over the years. The first question is, was the study in humans? If it's not, then honestly, it has not reached a bar where it's enough value to indicate you should change your habits in any meaningful way. So, if it is not in humans, I would immediately dismiss it as, this is interesting at best, and we need more research, as the researchers like to put out. The second thing is, did they give an intervention to people? So what that means is, did the people not have this particular intervention, let's say omega-3 fats, creatine, can be Repatha, can be a statin, whatever it is. Peptides, yeah, exactly. Just literally anything. Just the person should ask themselves, were these people actually given something at the beginning of the study? That is called an intervention, and that also means that then you're looking at an intervention trial or intervention study as opposed to an associative study. Which associative studies are fantastic and they have their certain strengths that I certainly value. But again, I'm talking about it from a person who doesn't have a scientific background. That should be number two. That should give you a clue as to, okay, it's in humans and it's an intervention. The next thing that I look for is, did they measure a hard outcome or a biomarker? A hard outcome is death, cardiovascular mortality, if that's cancer mortality, it can be something like cardiovascular events like heart attacks, rates of dementia, things that are actually measurable and actually make a tremendous difference on a person's life. A biomarker would be the things that most people are familiar with like a blood test, if that's LDL cholesterol or looking at blood glucose or something along those lines, triglycerides, whatever it might be. If the study covers that, then okay, now you can move on to the last question that I would ask myself: how strong is the effect? So what's the magnitude of the effect? 'Cause there's a lot of supplements that will say, yes, it is effective, and maybe it fits all the criteria that I mentioned before, but the effect size is so small that it's basically meaningless. You just don't need to even worry about it because it's not going to have much of an impact. So if I can go through those three to four questions, and the end result is, yes, there's consistency in the literature, I think that's a pretty good indication that it is an intervention that may be worthwhile.

[00:11:25] Dr. Melinda Ring: I also know you have this series that is breaking down some of the popular influencers—how often do you find that when you're doing your Centrifuge series, that there is truth behind the claims versus like, well, they're skewing this in a more positive way than I would?

[00:11:46 ]Dr. Nicholas Verhoeven: The Centrifuge series is also a biased sample, right? I'm selecting people that I already get the sense—like, I've heard their claims, I haven't assessed their claims yet, but I've heard their claims—I'm like, ah, I don't know if that's the way I would characterize it. So when a person makes a claim, there have been instances where they've made a claim, I look at the literature, I'm like, okay, it's at least defensible. We could probably argue, and I try to give grace in those situations—it's actually not necessarily to give grace to the person, it's more so to make the audience aware that I'm not trying to chase this person down. I'm not trying to ruin them or anything like that, but I'm trying to give everything a fair shake. But there have been many instances where a person has said something that's just completely not at all backed up by the science, and in fact, the science would strongly suggest something completely different.

[00:12:42] Dr. Melinda Ring: Wow. Okay. Okay. I would hope I would not end up on the naughty list of your Centrifuge series.

[00:12:49] Dr. Nicholas Verhoeven: I also do episodes on people that I really respect, because I want to also highlight this is good scientific practice. So,

[00:12:57] Dr. Melinda Ring: Yeah, that's great.

[00:12:58] Dr. Nicholas Verhoeven: it's not all negative.

[00:12:59] Dr. Melinda Ring: So let's shift into how you've used your framework to look at some of the health topics that are getting a lot of attention these days. We can start with mitochondrial health. I feel like that's a hot topic—what happens to mitochondria as we age and what you found that evidence tells us that we can do to keep them functioning well, including maybe some of the supplements that you think have promising evidence.

[00:13:23] Dr. Nicholas Verhoeven: Mitochondria are incredibly dynamic organelles. As people often like to characterize, the powerhouse of the cell, right? We don't need to get into all the different ways that mitochondria impact our cells. It's far beyond just cellular energy, but ultimately we just know that they're incredibly important. With age, just as time goes on, we are continuously exposed to different insults—and insults meaning some sort of factors, some sort of molecule, whatever it might be that does damage to the integrity of our cells. That just happens. And our biology is incredibly good at fixing those imperfections that occur over time. And those start to speed up as we get older because the different processes struggle more and more with age. You'll have issues in mitochondria like increases in the production of what's known as reactive oxygen species, which generate largely from mitochondria—not exclusively, but largely. And those can outpace the opposite side of that coin, antioxidants, which are these molecules that will neutralize those reactive oxygen species. So with age, if you outpace, that's called oxidative stress. So that's one factor; it can damage the overall architecture of your cells, but it can also damage the mitochondria in itself. Another thing is you've got these proteins that actually allow us to generate cellular energy called OxPhos, or oxidative phosphorylation proteins, the electron transport chain. And those can also get damaged, or you can get mutations in the DNA that contribute to the production of new mitochondria, and those can get damaged. So I'm just listing a few different examples of how over time, as you're constantly bombarded by different insults, you can get these damages that aren't always fully fixed over time. So, the best way to combat that is by doing the basics. So I'll quickly mention supplements just as a quick input here. I would recommend basically no supplements for mitochondrial health. There are some, like Urolithin A, there's some like CoQ10 and NAD precursors. They've been studied, but just because they've been studied doesn't mean that they necessarily fit this criteria that I talked about. CoQ10 has a little bit more evidence for—

[00:15:42] Dr. Melinda Ring: Yeah.

[00:15:43]Dr. Nicholas Verhoeven: Urolithin A is one of those that's really popular right now, or at least became popular about two years ago. And they do have randomized controlled trials. So it is in humans, it is an intervention. So it's starting to fit those criteria. The issue is that those studies don't really look at outcomes. They don't look at outcomes and they also don't look at biomarkers that really matter. So they may look at something like autophagy or some very cell biology-oriented thing. How can we translate that? That's the question. And the answer is we don't. And the few things that they have looked at, the effect size, which is their last question, "how strong is the effect," is really minute. So you're paying a lot of money for something that may impact mitochondria. And ultimately, what does that translate to? We just don't have good evidence. So I'm not saying that it's not something that could become bigger in the future, but the evidence that we have now just doesn't fit that bar. So what can you do? Exercise. Let's be real, right? I mean, I'm just going to warn everybody right from the beginning, we are talking about the basics. I'm talking about good sleep. I'm talking about adequate sleep, making sure of the quality of your sleep. It's not just the amount, but also the quality. So making sure you go to bed at a reasonable time and making sure that you wake up at a reasonable time, making sure that obviously you're getting the seven to eight hours; making sure that with exercise, especially focused on aerobic exercise. So that'd be long duration exercise. If that's walking, if that's what you can do, then that's great. If that's any sort of jogging, that also is a fantastic option. High-intensity training, which is kind of a hybrid between getting it from aerobic to more anaerobic, which is more like resistance training. So high-intensity interval training is a really short form, these bursts of exercise. Another one is resistance training. It's not going to have as much direct impact on mitochondria as endurance exercise will, but overall exercise is probably the most potent way to universally affect your mitochondria. And then of course, in general, staying within a normal weight can make a huge difference. Making sure that you're consuming adequate amounts of a wide variety of different foods. Those are the best ways to really strongly impact mitochondrial health, especially as we age.

[00:18:14] Dr. Melinda Ring: So this goes to the next thing I think about in terms of supplements and the conflicting headlines that we'll see: maybe CoQ10, maybe we don't have enough robust evidence that it works for mitochondria, there's a through line to outcomes. But we do know that if you take it, if you get a blood level over two, it lowers blood pressure, which is an important outcome when we think about prevention of chronic disease. Omega-3s to me are another classic example of a headline: "helps this," "oh, it doesn't help this." And then people are like, wait, I was taking this, but now my cardiologist is saying, oh, I shouldn't take it, but I'm taking it because I have this inflammatory condition, so my rheumatologist said I should take it. So what should people do when they see this new headline come out?

[00:19:09]Dr. Nicholas Verhoeven: That's one of the things that I wrestle with the most because a lot of people ask me in that same mentality, because it's true. Like, you have one headline that says one thing, then another headline that says something else. And if we take omega-3s as just one example, There are plenty of randomized controlled trials, large ones, huge ones. That have been done, that show no effect on cardiovascular disease, for example. On the other hand, we also have, looking at the exact same outcome, cardiovascular disease, omega-3s do seem to reduce cardiovascular disease endpoints. So what do we make of that, right? For omega-3s, for example, I'm immediately looking at methodology. I'm immediately looking at the population they studied. I'm looking at the length of the study, I'm looking at the dose. All these different things are just running through my head for me to start to try to segment these studies and figure out why they disagree with one another, and then I come to a conclusion of what might be happening here and how I would approach things going forward. And that's a big reason why I started Physionic, or I've been continuing to do Physionic. So for example, you mentioned a person has maybe two different scenarios. They have some form of arthritis and they're at higher risk for cardiovascular disease. So in that situation, let's say their one doctor, their cardiologist, is saying don't bother with it, and their rheumatologist is saying, yeah, I think that there's some evidence for it being helpful. Well, you can go back to actually one of your original points of what's the safety data, right? And say, well, what are the drawbacks of taking an omega-3 supplement or, if you don't want to supplement, just consuming more omega-3s? And I think in general, the understanding is that omega-3s tend to be a net positive, even if there are some indications that it may not offer any sort of benefit.

[00:21:07]Dr. Melinda Ring: Anytime we think about an intervention, whether it be a dietary approach, a pharmaceutical, or a dietary supplement, it has to be individualized to the patient. And ideally, you work with somebody who has expertise and can look at you as a whole picture and let you know the relative risk and harm of those supplements, because it can be challenging. Now, my patients have the advantage—if one doctor says, "Oh, I think you can stop that," and it's something I've recommended, they can come back to me and tell me and we can have that conversation. So I would always encourage people to look for an integrative physician who has that kind of big-picture view and can look at the person as a whole. And for people who don't, to at least when they are reading those headlines, say, "Well, am I part of the population that was studied in this particular study that warrants me either starting or stopping something?" Well, let's go to creatine. It's moved from being just for athletes, which it used to be over the decades, and there's now this interest in: could it be helping cognition, brain health, aging in general, or frailty in the elderly? I think of you as one of the experts in this particular compound. What is it doing in the body, and what do you recommend it for based on the research?

[00:22:32] Dr. Nicholas Verhoeven: This might be a bit of a surprise, but I think if a person is very conservative about supplements, as in they don't want to take very many supplements, creatine is just not necessary.

[00:22:43] Dr. Melinda Ring: Not on your list.

[00:22:44] Dr. Nicholas Verhoeven: No, it's definitely not. I take it, and I think if a person is a little bit more liberal and happy to take a few supplements, then creatine's definitely right up there on my list. I just generally don't think that supplements are necessary except for very specific use cases. But if you want that added little bit of help, then it's a fantastic molecule and so are several other supplements. So let me just say that from the start. But in terms of how it works, I'll give a quick rundown. If we were to zoom into your cells, in your cells you have these cellular energy molecules known as ATP, so adenosine triphosphate, and the name gives us a huge clue. So it's adenosine, tri meaning three, and then phosphate. So it's got three phosphates attached as part of this molecule. What happens is your cells go through a process to liberate energy to use for function, just like you would pay a currency to be able to buy a coffee or to do anything. Your cells have to have this currency system, which is this ATP. So when you break one of those phosphates off, you liberate some of that energy. And that turns it from an ATP to an ADP—diphosphate, which is di, right, for two phosphates, 'cause we just lost one. So that's a really simplistic understanding of how our cells use energy. However, creatine comes in and it fills our cells, and inside of our cells, they will actually accept a phosphate and hold onto that phosphate for the time that the cell uses ATP and converts it to ADP. So then it will redonate that phosphate back to that ADP and recreate the ATP. So now you have more currency there to be able to do the cellular functions. That's a really basic explanation. And creatine researchers—which I would definitely jump in here and say it does way more than that. Right? It has effects on mitochondria, has effects on all kinds of different functions, but that's the classic understanding—that's the way that it has the greatest impact. I think that we can largely agree on that. So as you pointed out, the initial research was focused—and we've got thousands of studies on creatine at this point. The initial research was focused on muscle, that it does allow us to eke out a little bit more performance, which is actually relatively noticeable when it comes to weightlifting specifically—not so much endurance training, but specifically weightlifting or even high-intensity interval training that I mentioned earlier. So for that, creatine is definitely a big plus. It's effective for about 70% of individuals. I think that's the right percentage. And about 30% of people are non-responders. And the reason for that is because your body produces its own creatine. So it produces a few grams of creatine on its own. And my intuition—I haven't actually looked at the research on this specifically, but my intuition is that those individuals already produce a significant amount of creatine. So supplementing on top of that is not going to have—at least from the muscle perspective—much of an impact. On the other hand, now research has started to extend, especially over the last 10 years, but even a little bit before that, to higher-dose creatine. So for muscle saturation, it's usually three to five grams, usually about three grams for women and usually about five grams for men. But for brain, now we're starting to see that there may be some effects for the brain, and I think that the evidence here is definitely much spottier than it is for performance. The performance literature is rock solid, but from the brain perspective, we've got some randomized controlled trials that look at it. It does show improvements in different indices of brain performance. So we're actually looking at some of these outcomes, so that's great. However, the evidence is trying to figure out if it's effective for people that are just over the age of 60, or is it also effective for people that are younger? And I think that evidence is weaker. So I think the evidence right now—and this of course may change—is leaning towards being a better benefit for people over the age of 60, especially people that may be dealing with kind of those initial stages of mild cognitive impairment. However, there are some indications that it may also be helpful for younger individuals. That's where dosing is another thing that people are really researching more. Some people argue for 10 grams, some people argue for 20 grams as the total consumption. So I don't think that we have a specific set target yet. The final thing is on sleep. So interestingly, there's been some research that's looked at what happens when you're sleep-deprived and you take a single dose of really high creatine. So we're talking 20, 30 grams of creatine. And what they found is that it essentially nullifies the negative cognitive effects that happen from sleep deprivation. Now, let me interject here. This is sleep deprivation. We're not talking about continuous sleep deprivation. Creatine can't solve all of our issues. It can't solve—

[00:28:18] Dr. Melinda Ring: Help my son who doesn't go to sleep until five in the morning some nights, yeah.

[00:28:23] Dr. Nicholas Verhoeven: For one night maybe. But after that, we don't have any evidence so far that it would just completely eliminate issues from cognitive decline that occurs from continuous sleep deprivation. But still, there's at least a few studies that have looked at that and shown that's also the case.So, creatine's a cool molecule. It's a supplement that, if you're interested in supplements, is definitely way up there. It has some health benefits. It definitely has, especially if you exercise, especially resistance training—it's definitely something that would be probably number one, maybe behind whey protein or some sort of protein if you want that. But is it something that you have to supplement, otherwise you'll be unhealthy or anything like that? No, definitely not.

[00:29:07] Dr. Melinda Ring: I treat a lot of women in midlife. I've seen some things for what we think of as the menofog. Plus, women at that age are also, after around menopause, starting to lose more muscle and oftentimes trying to pump up weightlifting. So it is something I like for those women. It is relatively safe, with only a few contraindications. So I agree, it's kind of up there for me when people ask me about whether they should take it, and I'm like, I have no problem with you taking that one for most people. You mentioned whey protein as one that you would put up there. I know there are other ones, beet root and other sorts of ones, and you come from a background in exercise physiology. I think I saw you had something about high-dose vitamin D. Are there other things for people who are exercising and wanting to maximize the effect of their efforts?

[00:30:00]Dr. Nicholas Verhoeven: I'll preface this by saying I haven't assessed all the supplement literature, and there is some out there that I haven't covered in depth yet. But from the things that I have looked at, whey protein definitely has significant evidence behind it. But again, is it anything that special? It's just a complete protein source. If you get sufficient protein from your regular nutrition, whey protein is definitely not needed; you don't need to worry about it. If you do struggle with getting a little bit of added protein and you've got the calories to kind of fill in, then yeah. Whey protein is a fantastic choice. It is basically the gold standard when it comes to protein sources. Aside from that, I can't think of a whole lot of other supplements that I would strongly endorse. There may be a few that have some marginal benefits, but nothing crazy.

[00:31:00] Dr. Melinda Ring: And then speaking about protein, I don't know if this is something you've reviewed, but particularly the more recent US guidelines for Americans came out and big debate on social media: how much protein do we need? Is that something that you've looked into and have come up with your own answer on?

[00:31:22] Dr. Nicholas Verhoeven: As you well know, it's going to depend on the person because of the person's specific situation. If you're elderly, typically your protein needs are higher. If you are exercising, especially intensely, your protein needs are a little bit higher. If you are a person that's just kind of walking around and you don't need to exercise intensely, let's say you're 45 years of age or whatnot, then the recommendations right now—even what was before, I don't know what the recommendations increased to a little bit, but even the numbers that they had before, which was 0.8 grams per kilogram—were sufficient, because you're looking at a bell curve that covers the vast majority of individuals. So is it going to be maybe a little bit too low for a small number of people? Yeah, possibly. But for most people, that would be sufficient. So now with the recommendation, I believe, being a little bit higher than that, if you hit that and you're again in the condition that you're not, let's say, over the age of 60 or 65 and you're not exercising really intensely, then that would probably be sufficient, especially if you're getting it from whole protein sources.

[00:32:44] Dr. Melinda Ring: I've seen that you shared your own supplement stack; you shared one that you created for your dad. So just honing in on that for someone listening who's like, on the one hand, there's like 20 supplements in my cabinet, I want to narrow down on what I should take. Or if there's somebody who's listening who's thinking about taking any, but feels like they probably should—how did you come up with what's in your basic stack? And then do you have any others that you would say these are your favorites, if they're right for your particular situation?

[00:33:26] Dr. Nicholas Verhoeven: Sure. So I take creatine. I mean, it's my favorite. So I've definitely been taking that for 20 years now. I was taking lutein and zeaxanthin 'cause there are multiple randomized controlled trials—I was taking it for the eyes. There's multiple randomized controlled trials where it shows being helpful in staving off macular degeneration. Not something that I suffer from, but you know, I've got glasses, I've got a little bit weaker eyesight, so it's something that I want to just continue to support, and the evidence was quite compelling. Beyond that, I take some collagen. The evidence for that is a bit spottier, but I'm taking it just because if I don't take it now, it's going to be probably far less effective later in life. And the other one that I take is omega-3s, although I've kind of switched that to more just eating fish in general a few times per week. So I eat salmon; it's one of my favorite foods. So I usually don't supplement a whole lot from that, but every once in a while I do. And the final one that I just recently added, as long as I'm not misremembering, is resistant starches. There's some really compelling randomized controlled trials that released in Cell Metabolism and Nature Metabolism that I thought were just incredibly interesting and compelling from some outcome perspectives, looking at like visceral fat, looking at blood sugar, looking at all kinds of microbiome. Resistant starches in that class of fibers is something that I've started to really focus in on. As far as what I do for my dad, he's a little bit more experimental than I am when it comes to supplements, but he also doesn't want to take a ton. So I think the only real big addition is this combination of molecules called glycine and N-acetylcysteine, which is GlyNAC put together.

[00:35:25] Dr. Melinda Ring: was going to ask you about that. Okay.

[00:35:27] Dr. Nicholas Verhoeven: Yeah. So the research on that is absolutely mind-boggling. From a supplement standpoint, I think because the randomized controlled trials that have looked at that really looked at some functional outcomes, like people being able to walk faster, being able to get up better—I mean, these are things that actually matter in real-world situations, right? If you're in your sixties and seventies—which the population they studied were in their seventies—and you supplement with this for, I think it was several months, and suddenly these people were just functioning so much better. Their blood sugar declined. Their insulin resistance was significantly better. They're able to stand up better. I think there was one measure where it didn't have an effect, which I think was like blood pressure or something along those lines, but it was just huge numbers of different outcomes and biomarkers. We're not talking about like cardiovascular events, we're not talking about like mortality or anything like that. The only real caution that I have around GlyNAC—there's two. One is more so a note: I don't think that it's going to be very effective for younger individuals, so younger being defined as basically anyone, I'd say, probably below 40 years of age. Simply because the way GlyNAC works is that it increases a particular antioxidant protein within our cells. And for younger individuals, they already have pretty maxed-out levels of glutathione. So it automatically maxes out. We've already got maxed-out levels of glutathione, which slowly decline over age. So it makes sense to try to top those up as much as we can. The other warning—the actual warning—is that this comes out of a single lab. It's a really reputable lab, it comes out of Baylor Medicine. They've done multiple randomized controlled trials on the supplement, but fitting my own criteria, right, I like to see more studies, especially from independent labs, to actually verify the results that they've shown. And we don't have that yet. So he's willing to kind of jump ahead and go forward with it. But it's certainly not something I would take 'cause I'm under the age of 40. But also, it's probably not something that if a person is again very conservative with their supplements, that they should hop on.

[00:37:50] Dr. Melinda Ring: I just like to ask people, what you know from your perspective is one piece of personal wisdom that you would share to help listeners reach their own next level of health?

[00:38:02] Dr. Nicholas Verhoeven: A little odd coming from me, but I would say get less of your information from social media. And this is coming from a person who shares information on social media. I just think that we have so few really reputable people that are putting out valuable information, and even if they are releasing valuable information, they're not marketers, and the people that are releasing really terrible information are marketers. So they just outpace, they outgrow basically everybody else. And I think that if we just have a little bit more trust in what medical schools have to say, what some of these health agencies have to say, I think that in general—I'm not saying that in every situation, but in general—the trend tends to be a better lifestyle habit than what social media has to say, especially as we discussed earlier, this ping-pong back and forth of, well, one person says this, another person says this. I think that if the general guidelines aren't updated on a regular basis, that should give you an indication to just stick it out, stick to what's tried and true, and that will do 80% of the lifting for you in terms of a health perspective.

[00:39:27] Dr. Melinda Ring: Well, Nic, thank you so much for joining me today. As an integrative physician, I am constantly trying to help patients understand not only what the evidence says, but what makes sense for them. So I really appreciate the rigor and clarity that you bring to that. Same challenge.

[00:39:45 ] Dr. Nicholas Verhoeven: Thank you so much. It was an honor being here.

[00:39:47] Dr. Melinda Ring: Yeah, thank you. So everybody, Dr. Nicholas Verhoeven is the creator of Physionic. You can find his work on the Physionic YouTube channel, Instagram, and at physionic.org. Thank you for tuning into Next Level Health. We'll see you next time.