Evidence-based nutrition

Our approach is led by clinical evidence and research.

What is ‘evidence-based’ nutrition?

In scientific terms: Evaluating the most statistically robust evidence for controlled nutrition interventions in generalisable population groups in order to guide effective clinical decisions tailored to the individual.

A practical example: Appraising claims that Magnesium cures insomnia.

What does ‘cure’ mean in terms of clinical measures and health outcomes? How do we know that a supplement ’caused’ the ‘results’? What statistical evidence do we have to show that it wasn’t just chance, or another factor? How can we be sure there are no medium or long-term undesirable effects?

We need more than anecdotal evidence to recommend interventions to others.

We look at the research. What studies have been done? In what population? At what time of their life/stage of their disease? What type of study? What magnesium formulation was used, at what dose, and for how long? What number of people were included? Was there a control group? Were confounding factors adjusted for? What bias could occur in their design and execution?

Evidence can be ranked in order of its weight:

At the top is meta-analyses and systematic review of randomised controlled trials RCTs (which is essentially combining the results of several good quality RCTs, which measured the same intervention ideally in similar population groups). Clinical guidelines are generally based on the results of these analyses.

In the middle there are cohort studies which include various types of observational studies on groups of people but are limited to concluding correlation between factors and cannot determine causation. (Only intervention studies – RCTs can truly do that.)

At the bottom is the kind of evidence most of us are bombarded with — anecdotal, and is often lurking down an internet rabbit hole, perhaps triggered by a well-meaning friend telling us that magnesium spray helped his daughter’s insomnia, leading us to an online article backing up that theory, citing a study which ‘confirms’ this without mentioning that the study was statistically inconclusive, used oral and not topical magnesium and that the population group, of elderly men in a care home, was not generalisable to adolescent girls.

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By the way, Magnesium may help with insomnia in some circumstances, and for some people. However a spray formulation is no better than placebo because it’s not actually absorbed effectively via the skin, and the side effects of some tablets can cause gastro-intestinal upset in some people in some circumstances.

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