Why convincing nutrition advice fails

Philip Pape 0:00

Let's say you come across a supplement or protocol that sounds legitimate. The person selling it explains the mechanism, cites a study or two, and seems to know what they're talking about. So you buy it, you try it out, and then nothing happens. Or maybe something happens and you can't really tell. Or it makes things worse, and sometimes you're paying hundreds of dollars for worthless supplements in your cabinet. Then you think, is it just me? Am I not taking it long enough? Or does it just not work the way it's been described? My guest today are a registered dietitian and a journalist who are masters at evaluating claims like that for a living, including the underbelly of online marketing and sales. You're going to learn why the most convincing claims often have the least evidence. How women's nutrition products and services, especially marketed for menopause, became big business, even when they're often unnecessary. And how you can evaluate all of those claims flying around in the nutrition and fitness circus of social media. Welcome to Wit and Weights, the show that puts a popular piece of fitness advice under the microscope, finds a hidden reason it doesn't work, it gives you the deceptively simple fix that does. I'm your host, Philip Pape, and today we're going to challenge the idea of doing your research when it comes to nutrition, supplements, training programs, all of it. Because a lot of you do the research. You're curious about studies, who funded them, does the reasoning or mechanism behind this or that product or method make sense? You're genuinely skeptical of the fitness industry, just like I am, as are our guests. But what if that's not enough? Today I invited on Kylie Van Horn and Zoe Romm, host of the Your Diet Sucks podcast, which is just as much fun as the name implies, so go give them a follow. Kylie is a registered dietitian. She runs a virtual practice for endurance athletes. She sees probably a lot of underfueling and gut issues, and athletes who've been eating too little for years, maybe they had no idea, all of that. Zoe is a journalist. She comes from a different perspective, which is why I like the way the two of them work together. She's written for NPR, outside high country news. She used to run Trailrunner Magazine as editor-in-chief. And she's also an elite ultra runner who took second at the Leadville Trail 100 back in 2024. So we've got a super duo on the show to cover all the bases. And today we are going to examine what is behind all of those confident nutrition claims that you see from the talking heads on social media that often don't hold up. How women's nutrition, especially from cycle syncing to hormone protocols to detoxes, all of it became big business, but only adds to the confusion. And how to sort out good stuff from the BS. So with that, Kylie and Zoe, thank you for coming on. Wits and Waits.

Zoë Rom 2:45

Pumped to be here, excited. You've already used the word mechanism. So I feel like we're right at home.

Philip Pape 2:50

Oh, we're nerded like that. So please, please drop the big words. The listeners love it. And so, you know, speaking of

Social media rewards the wrong information

Philip Pape 2:56

that, right? Our listeners are hopefully super smart. We love them. They research everything before they buy. And yet, there's still a ton of confusion. There's a ton of disappointment. There's a lot of wasted money. There's a lot of frustration. I can't tell you how many of my own clients have tried so many programs before they even reach out to me and they're like, why is this going to work any different? So why isn't that good enough? Like, why isn't it enough that they're just doing the research and they're still hitting the wall?

Zoë Rom 3:21

I think it's worth acknowledging that we exist in a really noisy information ecosystem. There's never been more information available, and there's never been, I feel like, less infrastructure well suited to helping people connect with what of that information is actually useful and correct, particularly when it comes to applying it and trying to get prescriptive with it. So again, like sort of with the age of the internet and particularly social media, which is increasingly social media, podcasts, things like that, is increasingly where people are getting health, fitness, and nutrition information from, which isn't inherently bad except for that the incentives of the algorithm and of social media are pretty poorly suited to helping people make logical, less emotional sort of decisions here. So I think you just have to start by acknowledging like we live in a data swamp and it's built to be hard to find information. It's built to be noisy. It's built to take advantage of all the wrong parts of our psychology, our short attention spans, the fact that we're like our brains are just built to prioritize anecdotes over data and to sort of confer authority to a lot of the wrong people. So when you mix all that together, you get a pretty potent stew of just it's really difficult to wade through everything that we have and come out on the other side armed with something that is true and helpful to your specific use case.

Kylee Van Horn 4:52

Well, I think also if we look at, you know, a lot of times when people work with practitioners like ourselves, they really want to have guidance and an answer. And if something sounds like there's a lot of nuance, they're kind of like, oh, like that might be harder, you know. I kind of want to latch on to this other thing that I saw online or this protocol, and it just tells me exactly what to eat. And I think that that, you know, that nuance and the having longer conversations and having to dig in deeper into like the psychology around food, like a lot of people kind of shy away from that because it's it's scary or it's like more anxiety-inducing, you know.

Philip Pape 5:31

Yeah, there's there's so much in there. I mean, ending on psychology, you're gonna hit a button that I really love because I think that's the heart of so much of this, right? Like if we just taught habit formation and adherence and things like that and sustainability, it would go a long way. But you mentioned, both of you mentioned several things that I can see the noise of this ecosystem. You talked about a data swamp, and at the same time trying to find a solution and get through the confusion, of course, makes people easy prey, right? But would this imply then that we need to go back to being Luddites and like get rid of all technology in our quest to figure this out? Is that one solution?

Zoë Rom 6:05

You know, as much as I'm skeptical about these things, I also love them. And so we also have never been better set up to also correctly parse things out because we do have more and better science than we ever have. There are more people doing better research and coming to more nuanced and wonderful, lovely conclusions than we've ever had. I think that the main sort of breakage is in the pipeline that connects people to this high-quality science to the like that communication pipeline. And that that challenge of communication is going to exist no matter what technology exists, right? So I think that the issue is less with the specific technologies, though I would also argue that the incentives of the algorithm and social media are a little bit different because they sort of have their own incentives that act outside of like a neutral technology framework. But I also think there's a world where we could harness those same technologies, but just have better communication with more understanding of human psychology. So I think it's less inherently broken in the technology and more just like kind of a bad melange of this flawed technology. You have to acknowledge that essentially these technologies have been hijacked by people who want to make money off of your vulnerabilities. And this is an exceptionally good technology and an exceptionally good information ecosystem to do exactly that. So I think with more guardrails on both the technology and on the communication generally, we could get to a better place where we're linking people who are receptive to these ideas and who are curious and who want to make better decisions for themselves with this richer sort of wealth of information that we have available in the form of research, of authority, of like genuine novel understanding.

Kylee Van Horn 7:55

Well, and then the the problem is how like people in society are set up like to expect them to wade through everything out there is a big ask too, right? So people have jobs and kids and like all these things. So they're kind of like, well, I want the simplest thing, you know? I don't want to have to wade through all that stuff. So I think there's that component to consider, and then also like the human element, too, which I think is missing a lot of times in like the quick answers, the technology, even with AI, like it's like not being able to get some of that conversation and nuance and understand emotion behind things, I think is is going to be really hard to maybe replicate from a technology perspective.

Zoë Rom 8:44

There's a really fascinating study by one of my favorite researchers, Sedona Chin, who specifically looks at health misinformation online about doing your own research. And she found that online, people who claim to a place prior, like to prioritize and to value doing their own research and arriving at independent conclusions, actually, we're doing some of the least research and we're arriving at some of the less independent conclusions because doing research is hard. And so often, I think one of the best places for us lay folk, and I would, you know, even though I'm a science communicator and kind of just a normal gal operating in the world, it's really hard to acknowledge when you have a blind spot or a prior that's going to motivate your research. And when you sort of add that to again, how the algorithm works and how search engines

When scientific mechanisms mislead you

Zoë Rom 9:35

work, it's really hard to do neutral research. For instance, if I was interested in finding out if the paleo diet was backed by a lot of evidence, if you Google paleo diet science, the first two pages are going to be a boatload of absolute garbage websites telling you all about the wonderful science that supports the paleo diet. We're, of course, all cringing because that is, in fact, absolute nonsense. And there is not a robust body of evidence supporting this particular restrictive diet. But how you do the research and where you start from again for lay people, particularly in this information ecosystem, that is really going to shape and inform the conclusions that you will come to.

Philip Pape 10:18

There's so much there. Like I took 20, 20 different notes, and I would love to go in all these different directions. How do we suss out the hierarchy of evidence, do it in a logical way, not fall prey to logical fallacies? And oh man, I was listening to a podcast the other day. They were talking about the old school bodybuilders and like in the 70s, 80s, 90s, you know, where did you get your information? It was all hearsay, anecdote, it was bros. But a lot of times, because that's all you had to rely on, like the practice and just giving it a shot and experimenting for yourself ended up getting into a better answer than if you plocked them 30 years in the future today, and now they had AI to give them the answer. So, how I guess, you know, people are getting sold on stuff all the time. And you just said that there's this confirmation bias, or I don't know if that's the right term where by trying to research in the first place, if you ask Google the wrong question, it's gonna confirm what you're looking for. So, what is that first step then? Maybe let's just start there. Like, people are listening to podcasts, that's step one. Follow your podcast, follow mine. What's step two?

Zoë Rom 11:17

Yeah, I genuinely think like identifying and being aware of your priors. I think that's really one of the most important places to look. Like, for instance, if you're like it's rare that people start from a place of like, what is the best diet for science? It's usually they're coming with like some prepackaged idea of like, well, this guy from my gym said that going keto is amazing. And, you know, my aunt Linda said that she really likes eating paleo, but you know, I heard on a podcast that the Mediterranean diet's pretty good. So you're bringing in a lot of prior beliefs that can be really challenging to tease out, and those are always going to get sort of like upcycled into the questions that you end up asking. So I think trying to be honest with yourself and doing some interoception around like what beliefs am I bringing to this and how is that shaping my starting point is a really, really good place to look because again, there's so much motivated reasoning happening and we don't always realize that we're doing it. But I think it's always worth acknowledging that like there's a huge part of us that always wants these things to be true. Like, sure, I'd be out of a job, but it would be amazing if supplements did, it would be amazing if XYZ workout fad, you know, could really be the answer to like, you know, cardiovascular health and longevity, and we're all on metformin and doing high-intensity interval workouts, and it's it's great, but we have to acknowledge that like there's a strong desire within all of us for these things to be true. And that I think a lot of times shapes how we both engage with the research, how we engage with the evidence and the fact that we're even looking for a solution to begin with, because it's sort of this thing of like, well, are you even actually trying to solve a real problem too? Like, is the thing that you're looking for a solution for a genuine problem? Or is it a problem that you've you think is a problem because someone who has a vested interest in you having insecurities has really tried to pry open this new vulnerability in you where, you know, 20 days ago I was not at all worried about my glucose response to bananas, but now my glucose response to bananas is the only thing that I can think about.

Kylee Van Horn 13:23

Well, and then is there actual science behind what you're looking for too? Because a lot of times I feel like when you do Google things, blogs will come up that like don't really have any scientific

How to identify trustworthy experts

Kylee Van Horn 13:35

research behind them, or if you're like looking for sources and they might not have any sources at the very bottom of the blog post. And then the the heart, the tough part here is right, like it's the time factor, and like, are they gonna go through every single study if there are sources and then like look at all of those and then see are there any, you know, like vested interests like sponsoring this study and like you know, all of these questions that you kind of have to ask yourself. Was the study set up? Well, what were the methods?

Philip Pape 14:06

Yeah, and so given that you're like trying to abstract to the right level. It's kind of like when you're a kid and they teach you the earth is round, it's like you're not gonna question it, right? You just accept it. And if you did try to question it, you can spend years and years researching how we got to that point. So, like, I subscribe to some research reviews, for example. That's a good way that I found to abstract it to guys that I already trust. I've seen enough and synthesized enough to say I trust how they interpret the research for me and it shortens my time and they speak in a very reasonable way. So, like, are there a few criteria you would look for in the sources you listen to on podcasts and social media, where you could at least say, okay, I'm gonna go to the next step and maybe I can start to trust someone what this person is saying, even if I haven't seen the studies directly.

Zoë Rom 14:48

Yeah, I think that's actually a really sort of important framework because what we sort of waded into this morass of like, actually, it's really hard to know, but we're all using heuristics, right? Like if you try to like actually interrogate how many things you don't know and how many assumptions we're all making. Like, I have no idea how this mason jar works. Like, I could there's only so many things you can understand. We all have to outsource our understanding at certain points, right? Like it is ludicrous and almost worse to say, like, do your own independent research about absolutely everything because it is not true. So you have to have heuristics of like, I am going to outsource my like belief and authority to these sort of specific things. And so, I mean, one resource I really like is examine.com, which does a great job of collating research, particularly around like supplements and different health and fitness dietary interventions. But I think in terms of like looking at our, again, information ecosystem, there are some sort of like red flags or like you can play like influencer bingo of like maybe should I not trust this person? Of like, do they have a Lincoln bio that's selling affiliate codes and discounts for things? I think that should always raise your hackles when there's like a clear conflict of interests. An unclear conflict of interests is even worse. Like if they don't disclose that and it's sort of like packaged in a way that's overtly misleading, that's worse. And I would say worth like immediately sort of disconnecting from that particular channel. I think also, again, looking at whatever sort of logical fallacies that they might be engaging in as well. Like, are they appealing to some sort of health halo? Are they appealing to popularity? Are they committing the naturalistic fallacy? Like, is this person frequently engaging in lines of thought that don't like that fall apart under the any amount of scrutiny? And where are they getting their authority? Because I think it's always really interesting to look at the particular media. Like I'm a talkie gal, so I do well on podcasts, but I'm not gonna thrive on social media because I'm not a six-pack shirtless kind of gal. And so people that have that are really attractive do really well on visual media. People who talk really convincingly do really well in this media. That in and of itself is not a signal of their actual earned authority. So you have to go look for the like real credentials of like what type of education does this person have? And are they staying in that lane? Because just because someone might be an amazing dentist, I'm still not going to be taking like my, you know, training advice from them. So making sure that like this person has some earned level of authority, and that's the lane that they're trying to speak from.

Kylee Van Horn 17:30

Or, well, however, like we see it like physicians writing books about like certain topics in nutrition or something to try and sell a diet, you know, like I think sometimes it falls asleep there. Well, yeah, yeah, yeah.

Zoë Rom 17:45

Authorities can also get stuff done, which is the upsetting.

Kylee Van Horn 17:48

Well, and then the other thing that I was thinking about was the podcast sponsorship type stuff, you know. We have like a particular like ethics code on our website and like how we look at partnerships and sponsorships for the podcast and try to see if that aligns with our values. Um, because it is really interesting looking at some bigger podcasts sometimes, and like it seems like they would not want to partner with certain brands, but then they do, and then it's like, well, then it starts to get really confusing for people because they're like, should I trust this person? Because they're trying to sell me this thing that I feel like they wouldn't because they're a scientist, you know what I mean? So it starts to get murky there, I think too. However, I can see the other side because people have to make money, you know. So I think it gets tricky to some extent in in like the sponsorship area of things. Yeah.

Philip Pape 18:43

Yeah, yeah. Logical fallacies go both ways, don't they? Right. It's like equally, you wouldn't just say just because somebody has a certain conflict of interest ergo, they're not saying the truth. But of course, it maybe makes their job difficult in communicating as well. I mean, I have a partnership with a protein powder company that I use personally. I love them, and I talk about protein all the time. To me, that's aligned with my values, right? But I've probably pitched a few things here and there over the years that I go back and I'm like, yeah, you regret it. So it's like we we all have to get better and learn. When it comes to that, then like going back to that whole checklist. I mean, I I get that, but let's say where do you draw the line, right? Is what I guess the question is.

Zoë Rom 19:21

I think I'm always looking for that transparency because again, we're all existing in this economy. And I unfortunately don't have the power to dismantle it myself anytime in the immediate future. And like journalists have to,

Why women’s nutrition became big business

Zoë Rom 19:35

we have to get paid. Like, and that is, you know, increasingly people are not valuing content in the like one-to-one individual supports creator type way. So it all has to sort of get like scaled up to like reliance on brands to do the actual financial support. So I again I think that it just comes down to that transparency and people who are willing to communicate of like, here's what this means. And like we again, like our sort of like statement of ethics is that sponsors do not get to in any way shape, approve, or have prior knowledge of our content. And so we have like a really absolute firewall, and people might land on different, like their firewalls might be different, and I think that's fine, insofar that it's transparent, so you can understand the decision making.

Philip Pape 20:20

Yeah, transparency. That makes a lot of sense. And even having a statement of ethics, which I think is really cool. Okay, so let's dive into one specific subject, and you know what's coming, and that is women-specific nutrition. Now, I don't know who you follow or who you've had on the show or whatever. Lauren Calenzo Simple is one who I admire in the world because she's constantly fighting back against claim cycle syncing of nutrition and training, or that there's such massive differences between men and women that you have to do things in a certain way. When, you know, if you just start back from the skepticism we talked about earlier, assume every human is individual, individual, men, women, whatever, and start from that point, right? And assume that there isn't a one size fits all of anything. But given that, like, let's talk about that industry, especially the peri-postmenopause stuff, because going back to what we just talked about, like I have a lot of clients in that in that age range and who are women just naturally come to me. And I think there's a preponderance of that population who are seeking solutions right now for a variety of reasons. People in my life, you know, women in my life. At my age 45, of course, I'm seeing them go through some of these struggles. And you want to help people, right? And you want to also not gaslight, because that's another big side of the equation, and you want to empower and like give people the tools at work. But there's so much junk out there. So talk to me about that.

Zoë Rom 21:40

I'm gonna sort of set the cultural table and then I'll let Kylie, I think, speak to the specific, like the individual sort of application of it all, because that's really her strong suit. But women have forever been sort of disenfranchised from science and medicine, right? Like there is not a great track record in us being served by the powers that. So there isn't earned skepticism here, right? Like there are a lot of questions that haven't been answered and haven't been taken seriously. So I think a lot of people arrive at these particularly tender times of life. I think puberty, reproduction, and then peri and post-menopause are particularly fraught times because you're going through a lot of changes that have historically been ignored or like you've been burned as a witch. And then you sort of have all of these adult. Your uterus is just wandering around, you know, just quit. And so, you know, that's to say that there are a lot of earned and valid skepticisms and a lot of unanswered questions. And so there's this huge vacuum of information. And science honestly hasn't done a great job at researching women. Like there's been a slight uptick, but an often cited statistic is that six percent of exercise studies are done on women specifically, which is not a lot. That is very few studies. And like it's like several thousand people total, right? Like that's just not a huge sample size. That's not an amazing base of information to build prescriptions from.

Philip Pape 23:09

Why is that? Does it have to do with trying to get rid of the variable pregnancy and hormones and everything?

Zoë Rom 23:14

Yeah, exactly. And that is honestly debated. Like there are exercise physiologists who've and and folks who kind of do meta science who've created protocols so that you can minimize that. There's debate around how much of that matters. And then me, as just a gal in the world, is like, yeah, so my life is a variable. Like, let's still do the science. Like, I'm still because of that, you're just not gonna give me stuff. Like, no way. So it's like again, it's not a totally like it's sort of born out of like good old fashioned sexism and then has sort of failed to be backfilled by a little bit of good old fashioned sexism and then a little bit of like science sexism of like those variables can be hard to control for. And there's a bit of debate, though increasingly we have evidence that those variables are like not as important as you control for to the extent that you want to totally excise over half of the population from your base of research. And so there's this huge vacuum. And the people who often step in to fill that information vacuum do not always have women's best interests at heart. I think there's a lot of people that have pretty good intentions, but when they start trying to actually apply themselves to science communication, they get way out over their evidentiary skis really quickly because, again, the base of information isn't that amazing. And women want answers. And we don't have a lot of great answers, but what's really easy to sell is a very specific protocol, is something that acknowledges women's real frustrations and real vulnerabilities and answers those extremely legitimate gripes with less than legitimate solutions of like, well, you should just sink your strength training to wherever you are in your cycle, or you need to somehow completely change your approach to eating protein as if you're a totally different species and we absolutely wouldn't have evolved to be where we are today if women needed a completely bananas different approach to like how we, you know, synthesize, you know, muscle protein. And so it becomes super specific in a way that will occasionally be backed up by some amount of evidence, but it's where the things get really prescriptive that I think a lot of it starts to fall apart in translating research to individual applications. So when you look at a lot of times those prescriptions or those individual applications, what's incentivizing

Menopause, metabolism, and body composition

Zoë Rom 25:35

that isn't the base of knowledge, it's the algorithm because it sounds sciencey and specific enough to be true, because it again gives women a solution to a problem they've had and it acknowledges and validates a very real feeling. So oftentimes what we're seeing is driving the ship is the culture and sort of the yas queen that like feels good to look at science that's like done by a woman and that is for women, by women, and sh don't talk about how small the sample size is and sh don't talk about like if the conclusions are actually good. Like it just there's I think been a reluctance to tear a lot of this apart and to question it because again, women have been underserved.

Philip Pape 26:16

Yeah, but now you have a metabolic reset hormone optimization plan for that. Exactly. So let's get in a little bit of the science then. There's obviously a whole bunch of areas here, but one that I think is top of mind of a lot of our audience is metabolism, body fat distribution, and weight gain or resistance at that time. And you know, there is some now, fortunately, some studies started to look at those populations, like Dr. Bill Campbell at USC, you know, University of South Florida. I mean, I don't know how familiar you are with his research, but he, his wife is, you know, peripostmenopausal and she's struggled kind of at the outlier level of challenge. And so he personally took it on to start studying the population in terms of, you know, what happens when you put them on a very aggressive diet, what happens to their metabolism, what happens with training. But I just recorded a podcast on like things I've changed my mind about, right? And I used to say, okay, with women in peri and postmenopause, you've got the estrogen, you've got the all the things changing, and it seems like your metabolism might be declining for some mysterious reasons, we don't know. You're gaining weight for some mysterious reasons we don't know. But it's on the behavior side, right? And then come to find out, the more you dig into the research, you're like, wait, maybe there's other stuff happening here. Why do women gain so much belly fat? And why do, you know, you can do everything right, quote unquote. And even yes, you're tracking your calories, and yes, even you're doing this and that and training the right way, and you are lifting weights, and still it's not working. So stop telling me that I'm the same as a small man or whatever the pre the you know packaging is, right? So let's kind of unravel that, the metabolism piece. Yeah, we know that metabolism stays the same for men and women from 20 to 60, but then why doesn't it? Right? And why do we fail to be able to, you know, maintain our physiques and our health and et cetera? We're not trying to solve the problem here, guys, right? We're just trying to understand the miss the interpretation of the science and what what the state of it is today.

Kylee Van Horn 28:06

Well, I think with changing hormone levels, you know, we know when estrogen goes down, that can cause central fat storage change changes. So that can change body composition. And then we know that your muscle protein synthesis rates can go down because you start losing muscle mass at a certain point. And so that's going to change body composition. You might have to work harder to keep that muscle mass on. So I think there are real things going on. I think one of the big challenges that I encounter with a lot of women is, you know, how am I handling my body changing? Like I know this is maybe a complicated topic, but I'll have women that will put on a couple of pounds and they will like freak out because their body's changing and they'll have, you know, and I know it like in the world we live in, it is very difficult because there is a large focus on like how you look, and there's a lot of pressure to look a certain way and be a certain body composition. And we don't want how dare you want your body to change. You need to look like when you were 20. And so I get a lot of women that are like, well, when I was 20, I was this way, and now I'm this way. And it's like really hard from a psychology perspective to maybe gain some acceptance that like we might change as we get older. I'm not saying that like it's okay to say like it doesn't matter about any of your nutrition, or like we can't do anything from a weight and strength training perspective or exercise perspective to try and help. But at the same time, I think it becomes really problematic when we start getting like hyper focused on like a certain body image and things not changing because we're trying to control it so much. So, to your original question, I mean, yes, we know that there's changing hormone levels and that can change body composition. I think one of the things that I've been chatting more with women about, and I think there's more education coming out about getting on HRT and actually getting on it earlier and the benefits of that versus going off of a single study that made it look like HRT wasn't good for people. And I think, you know, having a like educating people more on that and that it could be okay for you to do HRT, like maybe that's something to consider. I also find that having those conversations, some people feel like maybe it's like a shortcut or like they don't want to do that because it's like not natural. But I mean, trying to have like a nuanced conversation with someone about that, I think could be really helpful when when trying to look at these sorts of things versus just like dismissing it and saying, well, you're, you know, you're this age, so you're just gonna gain weight. Cause that's the other side of things where I get people that are like, I went to my doctor and they said I'm in perimenopause and I'm gonna gain weight, so that's normal, you know, and then they just like dismiss them out of the office. I don't think that's really the right way to approach things.

Philip Pape 31:16

Right, or I yeah, or I've heard you're not you're not old enough to be in peri postmenopause. I've heard that's yeah, yeah, yeah. No, no, you're not old enough, you know. Come back. Yeah, yeah. So so it's interesting you mentioned, right, you mentioned HRT, and this is where we can kind of tease apart like legitimate things from all the bogus products that are out there. And you said single study, are you referring to the women's health initiative?

Kylee Van Horn 31:34

Yeah, yeah, yeah. Yeah.

Philip Pape 31:35

Yeah, yeah, yeah. Which which like it's one of those things where there's some some legitimate stuff there, there's not, and there's also how it's been interpreted, right?

Zoë Rom 31:42

Exactly. Yeah, intermedia has a lot of egg on its face for this one.

Philip Pape 31:46

Yeah, yeah, yeah, yeah. What do you think about when it comes to hormones and HRT and all that? You know, we've had some some individuals on who talk about managing symptoms and not focusing so much on lab work, and that's one area where I see a lot of grift and a lot of manipulation is you need to get your labs, you need to get hair, you need to get saliva, and we're gonna come back with like, you know, here's your hundreds of markers, and they're gonna find something. And they're gonna, they're gonna send you a video that's gonna walk through all the terrible things about you right now that you had to fix. And then here's our supplements.

Zoë Rom 32:13

Zoe said, You did that, you did that test. Which I mean, again, there's really not a lot you can tell from someone by a hair sample. Like, there's only a few like really specific tests you can get from hair. And also, I'm very confident the sample I sent it was like dirty as hell and just covered in like Paul Mitchell confounded variables out the wazoo. But like, like you mentioned, like the sort of like over-screening and over-pathologizing at every level, I think also can sort of open its own can of worms, right? Because again, it gives companies all of these different specific vulnerabilities to pitch into of like not only are you gaining weight and you're tired and your sleep is crap and you're having hot flashes, but also like your hair is dull and like your muscles aren't growing at the same rate, and like also probably your teeth aren't right, and like it's just all of these different specific things. And if you go screening for things, you're going to find problems because we're complicated humans, and a lot of these tests, and this is speaking in some gen some amount of generalization here, but a lot of them offer more of a snap shot, which would be a lot more useful when it's contextualized against a baseline. Because if you're if you go get like a test or a battery of tests done while you're experiencing these hormonal shifts, you've just had a bad day, you're caring for children, you're caring for your elderly parents, you're training for a marathon, you're not sleeping, your husband's unhelpful, you're trying to lift weights, those tests are not going to be great, right? And so a lot of the times when people go looking for problems, they're doing it at like the most problematic time in their life. And you're going to identify problems that are maybe not solvable or maybe not problems to begin with, just because of the sort of like over-testing. And that sort of just opens up, again, these vulnerabilities that companies will sell a specific supplement into. And so this is not to say that all testing is always bad. It's very complicated and it's certainly not always good, especially if you don't have an expert to help you interpret those results. You know, being left to just do that yourself or do it with like some like random Instagram lifestyle holistic coach or whatever. A lot of times, a lot of products and protocols will slot very neatly into these identified problems. But it it sort of becomes this own cottage industry and absent a lot of evidence, you get a ton of anecdote. And again, like there's a lot of changes that are anticipated during this time. But if you go looking for problems, you're certainly going to find additional ones.

Kylee Van Horn 34:41

But it's also like we have the two ends of the spectrum, like you're talking about, right? So it's like you go to maybe you go to a physician and they're like, oh, this is normal, but like you don't feel normal. So you're like, well, I want more answers. So I'm gonna go to a naturopathic doctor and I'm gonna get a million tests plus like $500 of supplements a month because this is what the test showed. So it's like you don't have a happy medium, unfortunately,

Cycle syncing and supplement stacks

Kylee Van Horn 35:05

I feel like, unless you're maybe researching an expert to work with that might not sell you those things. I don't know.

Zoë Rom 35:12

Yeah, and in these instances, I think something that we see a lot is this like idea of regression to the mean. If you identify, if you're like at a low point and you identify a problem, and then you try to pick, I mean, at minimum, one solution, but then you start throwing a bunch of interventions at it, maybe that thing was gonna get better on its own. And you just happen to do the test when your sleep and your energy and your overall health context wasn't at its best anyway. Like, was it actually the Joe Rogan supplement stack that helped you feel better, or was it time, or was it just paying attention to your health in general and finally committing some amount of resources and intention to it that you weren't prior?

Philip Pape 35:53

So it's interesting because there's the, like you said, the legitimate stuff from the knot. I'm I'm gonna I'm just gonna list some things that come up a lot, and you tell me if any of these have any legitimacy whatsoever. So DNA and genetic testing, and we don't have to do it like rapid fire, like each one. I'll just give you a little DNA and genetic test-based testing, cycle-based anything, menopause stacks. I guess we're talking supplement stacks, hormone balancing supplements, so not HRT, but supplements, detoxes, and gut resets.

Zoë Rom 36:23

Oh my god, I love this. So I would say everything but the DNA portion, I think, is is not a thing. Actually, that's not one I've heard of in the specific context of menopause. And I'm excited to hear why people are mailing their saliva into random grifters on the internet. But the the sort of deal with supplements is like these are not well regulated, which makes it really hard to test any claims against their efficacy. So, like, I think that that in and of itself makes that a pretty inherently problematic thing. And then cycle syncing, which is like you just keep thinking this is gonna die and it keeps getting reincarnated and getting breathed new life. And I think part of that is because it travels well on social media, because it sounds science-y, it sounds cool. It kind of sounds true. Like as a woman, you do feel different ways at different times, and it's confusing as hell. And so any protocol that acknowledges that feels kind of compelling on the surface. Unfortunately, the problem with women is that we're all individuals, and so you can't extrapolate that because this is how one individual feels on their luteal cycle, this is how all people are gonna feel on their luteal cycle. So any inherent system that tries to speak to a cycle is going to be flawed because every individual experiences that cycle extremely differently. Like there's been so many studies into performance during different parts of the menstrual cycle, and it's just been wildly inconsistent in terms of like where people can perform well, where they can't. And to add another exciting wrinkle, like on a meta science level, is when there have been studies, like the majority of studies on like women, it's self-reported where you are in your cycle. So you're asking me to guess or remember what day of my menstrual cycle I'm on, which I can't always do off the top of my head. And many women can't either. And there was actually one study that looked at how good women were at guessing it and then checked it against an actual hormonal assay, because my assumption was in all of these studies they were doing that. But in fact, no, most of the cycle data is self-reported. And women were about 21% accurate at knowing which day in their cycle they were, like which phase they were actually in, because it's confusing and it's changing and it shifts with stress and like how much you ate for breakfast. And so the data here is a mess, and the application here is an absolute mess.

Kylee Van Horn 38:49

So we also do some run coaching as well, and people will they'll say, like, I'm gonna feel this way in this part of my cycle because I read that that's how I'm gonna feel. And so I think it like makes you think you're going to feel a certain way, or I need to do a certain thing because it was it said this in this thing that I read.

Zoë Rom 39:08

I think you have a great take on you, like you, you, you helped advise people on the supplements piece specifically as well. Maybe you'll have to.

Kylee Van Horn 39:14

Yeah, I mean, I think with the with supplements and gener like the stacks and things, I'm not a huge fan of, but navigating things like I get a lot of questions about creatine. Um, and I'm not necessarily saying that, you know, specific to like post-menopausal women or something, that there's something that it's going to do for everyone. But I do think it is one of the best research supplements out there, and it potentially could be beneficial to people, to an aging population. So taking a I I'm all for having conversations with people about single supplements, what research is behind them, and whether I think it could be beneficial for them. But I think what we're talking about here, like the supplement stack thing, it's like, oh, take these five things in a pack and it's gonna be, you know, help you with all your symptoms from everything, yeah.

Philip Pape 40:08

Yeah, exactly.

Kylee Van Horn 40:09

Exactly. And then it's like people don't understand how those things interact in their body physiologically. And so I've actually had people come back and I remember a specific lady that was taking stuff that she ended up having like really high liver enzymes. And it was like she was like, I'm taking these things, and I've always been taking this like supplement stack for the last five years. So we took her off of it, and her liver enzymes totally went back to baseline. So people don't think about maybe some of the things that these things might do to you down the line, or you might not have a full understanding and physiologically, like you as an individual, what is this whole packet of supplements gonna do to you? You know?

Philip Pape 40:52

Yeah, which goes back to the the very beginning of this conversation about like how do you, you know, figure out this stuff and you really do have to find where the science is. But I mean, for women specifically, is there anything specific like anabolic resistance or like they need more protein than men, or it depends on your age? Like, are there legitimate differences?

Kylee Van Horn 41:11

I would say, I mean, we know after aging, yeah, like as you age, yes. I don't know if I know men and women, you're saying.

Philip Pape 41:18

Yeah, men and women.

Kylee Van Horn 41:19

I'm not sure that I know specifically enough about the research to be like, yes, for women, it should be two grams per kilogram body weight per day versus men are 2.2. You know, I'm not I'm not 100% sure on that.

Zoë Rom 41:33

This is one of the areas where there I would

Protein optimization misses the basics

Zoë Rom 41:35

say I would classify the evidence as emergent and interesting, but I personally wouldn't feel super comfortable offering a ton of like hyper-specific prescriptions because there is like ongoing sort of examination into if women or like at how different levels of hormones impact muscle protein synthesis. I think that's there. I would say for like 99.99% of women, like don't worry about it, like genuinely, there's just bigger fish to fry. Like if you're someone who is always like eating well, always engaged in activity, like a lot of times these hyper-specific things that, like, yeah, there's like a plausible mechanism and there's something worth investigating there. We don't currently, with the evidence we have now, suggest that it's something we should be like hugely focused on creating behavior change around. Not saying it's fake, but it's sort of like really not seeing the forest for the for the trees, when in fact, like it would benefit many women to get a little more protein. Like that's not inherently a bad thing, but you don't need to be slamming like 400 grams a day because your favorite female exercise science researcher did a podcast about it. Does that square with your understanding?

Philip Pape 42:45

It does. And and there's a dose response curve to all this stuff where I try to tell people like the 90% of the benefit is just from that first step change. And again, you mentioned behavior change. If you're not getting anywhere close to anywhere in the vicinity, like just work on that and step your way there. Like that's the way to you know, if you if you're getting 0.2 grams a pound, I'm not gonna say jump to 0.7, even though that's like our best understanding of like a reasonable minimum. It's like get 0.4, right? That's better, and then get maybe 0.6, like work your way there.

Kylee Van Horn 43:12

So well, that's where people, I mean, people get caught up in the weeds, right? Like they're like, we don't have these baseline things dialed in, but we heard that we should get this specific amount of input.

Zoë Rom 43:22

Yeah, and so are you even actually doing resistance training? Like, are you lifting? Like, what is like that's right, that's the first question.

Philip Pape 43:30

Are you lifting weights?

Zoë Rom 43:32

It's just like dry scooping protein if you're not engaged in some level of activity. Like, there's gonna be real diminishing returns on that. And so I think this is like a perfect sort of case of one of the things we see is like it's so attractive to get really into the weeds on, like, oh, a women specific thing, that's amazing. It validates my experience in a way that I haven't experienced before. And so it's really compelling. And it is in this case, unlike cycle syncing, there's some scientific legitimacy. But there's a lot more question marks, I think, in terms of like what the broad application and what the prescription should look like. And again, like if you're an elite athlete and you are dialed and you never miss training and your sleep is amazing and your like nutrition is totally like really consistent. Like if you're nailing the bases, then maybe this is something to think about. But that's such a small amount of people that I think that a lot of the folks who it's like eat three meals a day, let's get some activity in. Like let's not let perfect and like this hyper-specific prescription be the enemy of good enough and incentivizing those first critical steps.

Kylee Van Horn 44:38

Well, we now have in culture, I think more the maxing side of things too, right? Like, oh, we heard fiber's good, so fiber maxing and now protein. I'm gonna do a ton of protein. Like I actually have someone that I'm currently working with that they were consuming like five times the amount of protein that they should be. And they did legitimately have kidney markers that were off. And I was like, look, this is a serious health concern. Like you need to, you need to cut the protein down. And it was very hard for them because they couldn't understand that, like, even if they cut the protein down, they're not gonna lose their body. Like they couldn't understand that cutting back wasn't didn't mean that their muscles were gonna go away or something, you know. Instant atrophy. So the way that this is communicated, sometimes I think people think they need to like max out on it to get like a full benefit.

Philip Pape 45:30

So with all when all these things come up, right? Like what let's say with clients or listeners, and you get the inevitable question, like, how much should I do this? Should I take this? Blah blah blah, right? Very individualistic questions. You're like, I don't even know you yet. Like, let me let's learn. But do you do the Socratic approach of like, well, you tell me, like, how do you feel? Like, what's your biofeedback? You know, is that is that the approach?

Kylee Van Horn 45:50

Yeah, I I do that, but the problem is a lot of people don't know how to listen to their own bodies. We've become so accustomed to wearables and stepping on a scale and getting all the tests done that it's like when I ask about like energy, sleep, performance, and stress, they're like, wait, what does that mean? You have to help me even understand what that means. So it's really interesting, kind of walking people through how do I actually listen to my body and like what does that look like? And that might take time. That might not be something like in a first session that you're gonna understand fully. That might take years to understand if if you even understand it at all. Because we did we did an episode on hunger and how complicated hunger and fullness is, and that varies so much depending on the person. And to help people understand hunger and fullness is it can be a very challenging process, I guess I would say. Yeah.

Philip Pape 46:45

Yeah, guys. I was gonna say, check out that. It's called Why Am I So Hungry? Science and Psychology of Hunger. Good one.

Zoë Rom 46:50

Yeah, but to that point, I think just asking people like why, what are you trying to achieve with this outcome? Like, where did you get this from? Because sometimes people have a really legitimate and specific answer, and that's amazing. And a lot of times they'll be like, Well, my favorite influencer said I need 250 grams of protein a day. And it's like, you seem like you're recovering fine, like things are stable. Like, what are you actually trying to achieve here? And a lot of times people are less trying to fill a specific, like identified physiological gap than more immediately recognizable emotional gap. And it sort of becomes like emotional support protein or emotional support supplements of like I just feel insufficient in some way. I feel not enough, I feel unsafe, whatever it is. And I'm trying to like plug those holes with like cold plunging and greens powders.

Underfueling and learning your body

Kylee Van Horn 47:35

Well, I get that level, like people use like creatine even or tart cherry juice or something, and they'll be like, Well, how do I know it's working? And so we have to like go through like what you can look for to see if if they can help them understand like whether it's working or not. And again, it goes back to like for like tart cherry or something, it's like recovery and muscle soreness and those sorts of things. Are you even paying attention to that stuff? Or like you were like, I'm sore all the time, so I'm just gonna take tart cherry. So it's just interesting, like how people measure progress or like understand themselves and maybe have a lack of understanding of how to interpret themselves.

Philip Pape 48:13

Okay. All right, then probably one more question based on what you just said. It's we're talking listen to your body, where you may not even be synchronized with what your body's telling you. And also, people have been underfueled for years. I mean, that's probably one of the biggest uh challenges here. And again, men, women, but I definitely see see it a lot in women just because of the dieting culture. How does that connect in terms of you don't know what your body could be if you were eating more and you were better recovered and better fueled? Like, what does that process look like? How prevalent is it? And should like most people look at that as one of the first, you know, actions to take?

Kylee Van Horn 48:46

Yeah, I mean, prevalence-wise, I think it's hard to maybe give a statistic. We know like in endurance sports, there's a high prevalence of eating disorders, like 50 to 60 percent of the population. But in other fitness areas and sports, I'm not sure what the statistics would be. But I think a lot of times people get caught up in the like yo-yo dieting culture. So they've always been kind of in the restrict, then eat more, restrict, eat more, which can kind of mess with your metabolism and how your body responds to fueling. So oftentimes I will pose the question to people to try to treat if they are ready to engage in the process of kind of like refueling their body and seeing what happens, engage in it as an experiment. And I think framing it as an experiment helps people be like, all right, well, there is an out, I guess, if I don't like this, you know, and and then I always try to set up again, it's this component of like having conversations, journaling, because if they are someone that's like tracking all the time with like my fitness power chronometer, something like that, it's very numbers-based. So helping people maybe journal in words as well, like throughout the process, can be really helpful to help them understand what changes they might be seeing or reflect on things that they might not have even thought about because they're like, oh my gosh, my body's changing. They get scared and they're like, this isn't working. But then, you know, you journaled about these other things. My GI system's getting better, waking up with more energy. I'm putting on muscle mass. Like, there are all these things that could be happening that you're missing out on because you're like the that anxiety and fear of the unknown is kind of taking over from the progress you're trying to make.

Philip Pape 50:35

That is really good. Like what you just said, giving yourself an out because this is always an experiment, which is like the essence of a growth mindset of learning of constant growth, but also qualitative tracking. Because we I'm a big numbers guy, I'm an engineer, and I do talk about tracking a lot on the show. But I also talk about, like you said, there's there's biofeedback, there's correlations you can make with things. Like if it's hunger is your challenge, how can you document what's happening before, during, and after you eat correlated with the hunger, it give you some interesting patterns. And maybe people don't want to spend the time to do that. That's the hard stuff we were talking about earlier. It's like you gotta do that to grow. But I guess the last question for both of you is like, is there one thing you would, you know, to motivate the person listening that that you think is maybe among the top three most important things that people are not doing, again, besides following our podcast, is what would that be? Such a good question. The basics. Yeah, no, of course. I I know it's such a it's a softball from that perspective. Lift weights, lift weights, got it. Right.

Kylee Van Horn 51:33

Yeah, but really, I mean, it is like baseline fueling. I think a lot of people, they're they've seen a protocol or like a certain calorie number, and they're like, this is what I have to do, but they don't really understand what that looks like, or they don't understand what they need for themselves. And so I really think people un having an understanding of yourself as an individual and what does food and fuel look like for me, and what do I need, and how does that make me feel? Like that kind of thing, I think is a really important skill to develop versus just saying, well, I'm gonna get on my fitness pal and just track and use the the calculated values that are on there, but that might not be like what exactly what you need. And we have a good episode about calorie counting and the history behind calorie counting, which is really interesting and the inaccuracies that can occur with calorie counting. So that and data tracking, and I think being able, like I use to be clear, I use data tracking with people. Like I'll use chronometer in my fitness pal, but I also use that other component, biofeedback component, and how do you combine intention with your intuition to create like a sustainable fueling lifestyle for yourself?

Zoë Rom 52:48

Yeah, and sort of building off trying to understand and listen to your own brain. I think paying attention to your own or to your body, paying attention to your brain is just as just as important and understanding like, why am I interested in this? What do I, what do I want to believe here? Is there an answer that I want to be true? And is that that the one that's actually true? Because I always like as a journalist try to check myself when I'm reporting a story or trying to answer a question, what is my prior? Like before I start the research, what do I think is true? What do I want to be true? Because it's more compelling. So I can get that out, externalize it, look at it objectively, and then pursue the actual evidence without being led astray by my own priors and sort of how those things can bog down your decision making. So I think just paying attention to your own attention, paying attention to how you make decisions, when you make decisions, where your reasoning is coming from is a really great place to start.

Philip Pape 53:42

Love it. So not just your physical muscles, but your mental muscles, develop your skills, understand yourself, get that relationship with food and fuel kind of figured out, combining all these tools, and then question your priors and your assumptions and maybe think like a journalist. I think that's another way to think about it. All right, guys, this has been so much fun. Where do we want to send people to find you? I'm definitely gonna include the podcast, Your Diet Sucks, and maybe one or two of these episodes we mentioned, but where else do you want them to reach out?

Zoë Rom 54:10

Yeah, your diet sucks pod on Instagram.

Philip Pape 54:13

Your Diet SucksPod on Instagram. We'll do that. All right. Thanks a lot, Kylie and Zoe, for coming on. It's been a pleasure. Thanks so much.

Kylee Van Horn 54:19

Thank you.