Mikkipedia

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Episode Summary

Dr Sisi Jia is a research fellow and accredited practising dietitian at the University of Sydney, where she leads the food environments work in the Youth Well Lab. Her research looks at diet and food environments as modifiable risk factors for cardiovascular disease, and in particular at how food delivery apps and other digital platforms are shaping what young people eat. Sisi trained in dietetics, but seeing how hard it is to change long-standing eating habits one client at a time pushed her towards public health and prevention.

Mikki and Sisi talk about how delivery apps steer our choices through rankings, discounts, free delivery and checkout upsells, why nutrition information that is required in store often disappears online, and what Sisi's group found when they looked at dark kitchens, schools and the transport hubs earmarked for new housing in New South Wales. They also discuss what young people themselves say about food courts and ordering food to school, why framing food choice as purely personal responsibility misses the influence of marketing, cost and time, and some practical ideas for families who use these apps.

Key Topics

• Sisi's path from a Bachelor of Science and Master of Nutrition and Dietetics into public health, after seeing how hard it is to change an individual's long-held eating habits
• How the food environment, including paid placement and commercial influence, shapes what we choose, and whether the same thing is happening on delivery apps
• Why young people are a key concern: delivery apps grew rapidly with COVID, are marketed to younger people, and Uber Eats has launched a feature aimed at teenagers
• Nutrition information online: kilojoule labelling has flaws, but Sisi argues it is still better than nothing, and her group found kilojoule information that is mandatory in NSW fast-food outlets was often missing on delivery apps
• How apps nudge choices through prominent positioning, discounts and vouchers, free delivery and "do you want fries with that" upsells, and why fast-food chains take up more of the visible space even though most outlets on the apps are independent restaurants and cafes
• Commercial determinants of health and personal responsibility, and how community voice helped stop a proposed 24/7 McDonald's in Redfern
• Sisi's study of food outlets around eight NSW transport hubs set for accelerated development, and why planning for healthy food before development happens is easier than fixing it afterwards
• Dark kitchens: one kitchen trading under several brand names on delivery apps, the food safety and transparency questions this raises, and Oporto's delivery-only brand Basted
• What young people said in a consultation for Sisi's group's school food environment study, including ordering food to school and seeing food courts as important places to socialise
• Practical ideas for families (a balanced diet most days, and choosing options like brown rice or extra vegetables when ordering) and the inequities that make healthy food harder to access for some groups

Chapters

00:00 Introduction
03:22 From dietetics to public health
07:22 Food delivery apps and young people
11:03 Nutrition information and kilojoule labelling
15:55 How delivery apps nudge our choices
22:11 Personal responsibility and community action
28:15 Transport hubs and planning policy
32:41 Dark kitchens
36:53 Regulating the digital food environment
40:05 Young people, schools and food courts
42:47 Practical tips and food inequities
47:00 Youth Well Lab and wrap-up

Guest / Resources

• Dr Sisi Jia, Youth Well Lab, University of Sydney: youthwelllab.com. Sisi says the lab also shares its latest papers and presentations on LinkedIn
• Cassano S, Jia A, Gibson AA, Partridge SR, Chan V, Farrell P, Phongsavan P, Allman-Farinelli M, Jia SS. Benchmarking online food delivery applications against menu labelling laws: a cross-sectional observational analysis. Public Health Nutrition, 2024: doi.org/10.1017/S1368980024000673
• Jia SS, Brown H, Moore HJ, Lake AA, Gibson AA, Partridge SR. Digital chameleons of the food environment: an exploratory analysis of the shapeshifting nature of dark kitchens in Australia and their regulatory challenges. BMC Public Health, 2026: doi.org/10.1186/s12889-026-28642-0
• Yuen SC, Pavlicevic M, Astell-Burt T, Woodcock I, Gibson A, Partridge S, Jia S. Evaluating the food environment in eight transport hubs identified in the New South Wales transport oriented development program. Cities & Health, 2026: doi.org/10.1080/23748834.2026.2685258
• Tse K, Zeng MX, Gibson AA, Partridge SR, et al., Jia SS. Retrospective analysis of regional and metropolitan school food environments using Google Street View: a case study in New South Wales, Australia with youth consultation. Health Promotion Journal of Australia, 2024: doi.org/10.1002/hpja.930
• The Boden Institute at the University of Sydney, where Sisi did a Year 10 work experience placement shadowing a research dietitian

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Episode Summary

In this solo Monday episode, Mikki asks a question many women in midlife are asking: can diet fix hot flushes? She walks through a new systematic review in the American Journal of Clinical Nutrition from a Bond University team, which looked only at food-based randomised controlled trials in women aged 40 to 65. Fifteen trials covering 1,952 women made the cut, and the headline finding was that soy foods may reduce hot flushes. Mikki explains why the evidence behind that is shakier than it sounds: the trials were small and short, they disagreed with each other, most were in post-menopausal women, and placebo response and weight loss make results hard to pin on any one food.

She then puts the review alongside the clinical approach of her friend Lara Briden, naturopathic doctor and author of Hormone Repair Manual. She looks at what trials and clinical experience can each tell you, and finishes with a practical way to run your own n-of-1 experiment, from a symptom log to soy, alcohol, magnesium and taurine, and when to see your GP.

Key Topics

• What the review included: randomised controlled trials of whole foods, dietary patterns or calorie restriction only, with no supplements, isoflavone capsules or extracts
• Why most of the trials were in women already through menopause, which leaves perimenopause, when symptoms are often worst, with the least data
• The headline soy result: pooled across four trials and about 200 women, soy foods came out ahead of control for hot flushes, but the results varied widely between trials
• Equol: why only around 30–50% of people can convert soy isoflavones into this more active compound, and why that may explain why soy works for some women and not others
• Soy safety, including a 2025 meta-analysis that found isoflavones didn't act like oestrogen in post-menopausal women, and a practical intake of around two serves of traditional soy foods a day
• Why hot flush research is so hard: strong placebo responses, symptoms that wax and wane, women joining trials at their worst, and diet trials that can't be blinded, illustrated by linseed and flaxseed trials where the control groups improved too
• Weight loss as a confounder: in several trials the diets that looked most impressive also produced weight loss, so it is hard to tell which made the difference
• What the evidence says on mood and cognition, including the Mediterranean, DASH and MIND diets and a trial where exercise, not fasting, improved memory
• Lara Briden's recommendations set against the evidence: alcohol, magnesium glycinate with taurine (plausible mechanism and clinical experience, but no human trial of the combination), building muscle, insulin sensitivity and progesterone
• A practical n-of-1 plan: a week-long symptom log first, then soy foods for 8–12 weeks, an alcohol experiment, solid nutrition and strength training, and talking to your GP about hormone therapy if symptoms are affecting your life

Chapters

00:00 Introduction: can diet fix hot flushes?
02:52 Soy and the headline hot flush result
05:00 Equol, soy safety and how much to eat
07:10 Placebo, linseed and the weight loss link
09:39 Mood, cognition and dietary patterns
11:51 Lara Briden's practical recommendations
16:04 Running your own n-of-1 experiment

Guest / Resources

• O'Neill et al. (2026), Dietary interventions for menopausal symptoms: a systematic review, American Journal of Clinical Nutrition
• Viscardi et al. (2025), Effect of Soy Isoflavones on Measures of Estrogenicity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, Advances in Nutrition
• Effect of intestinal production of equol on menopausal symptoms in women treated with soy isoflavones (2008)
• Dalais et al. (1998), Effects of dietary phytoestrogens in postmenopausal women, Climacteric
• Dodin et al. (2005), flaxseed vs wheat germ placebo in menopausal women, Journal of Clinical Endocrinology & Metabolism
• Barnard et al. (2021), the WAVS trial of a low-fat vegan diet with daily soybeans, Menopause
• Imayama et al. (2011), Dietary weight loss and exercise interventions effects on quality of life in overweight/obese postmenopausal women, International Journal of Behavioral Nutrition and Physical Activity
• Effects of combined dietary intervention and physical-cognitive exercise on cognitive function and cardiometabolic health of postmenopausal women with obesity (2024), International Journal of Behavioral Nutrition and Physical Activity
• Hitchcock and Prior (2012), Oral micronized progesterone for vasomotor symptoms: a placebo-controlled randomized trial, Menopause
• Lara Briden, naturopathic doctor, author of Period Repair Manual, Hormone Repair Manual and Metabolism Repair for Women
• Professor Jerilynn Prior, endocrinologist and long-time mentor to Lara
• Dr Lise Alschuler on soy safety, Mikkipedia episode 424: Living Well With and Beyond Cancer
• Ethical Nutrients Mega Magnesium powder (magnesium glycinate with taurine, also contains vitamin B6)
• Find Mikki on Instagram, Threads and X at @mikkiwilliden, Facebook at Mikki Williden Nutrition, and at mikkiwilliden.com

Contact Mikki:
https://mikkiwilliden.com/
https://www.facebook.com/mikkiwillidennutrition
https://www.instagram.com/mikkiwilliden/
https://linktr.ee/mikkiwilliden
NZ listeners - save 10% off Calocurb by using the code Mikkipedia10 at www.calocurb.co.nz
Save 20% on all Nuzest Products WORLDWIDE with the code MIKKI at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.com
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Episode Summary

Brandon DaCruz is an online nutrition and physique coach and the host of the Chasing Clarity Health and Fitness podcast, and he is a familiar voice to Mikkipedia listeners. In the latest Mikkipedia and Chasing Clarity collaboration, he and Mikki put together a protein masterclass, working through the questions they are asked most: how much protein you need, how that changes with your goal and life stage, and which details deserve your attention.

They cover why protein is still so confusing despite being added to everything from yoghurt to chocolate bars, why resistance training and protein work together, the difference between the RDA and an intake that supports muscle, and why needs rise in a calorie deficit. They also discuss lean mass loss in people with a lot of excess body fat and those on GLP-1 medications, protein and appetite, protein quality and plant versus animal sources, how much protein one meal can use, and the anabolic window. Brandon finishes with practical starting points for muscle gain, recomposition, fat loss and very lean athletes, and Mikki does the same for endurance athletes, older adults and vegans.

Key Topics

• Why protein advice is still confusing: "proteinification" of food, lingering myths about kidney harm, and experts with similar authority saying very different things
• Why training creates the signal for muscle growth and protein supports the response, and why adding protein without resistance training does little for muscle
• How much people actually eat: Mikki sees most clients under-eating protein even when they think every meal is covered, and Brandon sees protein skewed towards dinner and dropping at weekends, in men as well as women
• The RDA of 0.8 g/kg is an adequacy figure, not a target for muscle; around 1.6 to 2.2 g/kg covers most of the benefit for people training at maintenance or in a surplus, while Mikki aims for at least 1.8 g/kg for endurance athletes and around 2 g/kg for those eating lower carb
• Fat loss: a deficit suppresses muscle protein synthesis, so Brandon scales protein with the risk of muscle loss, from around 1.9 g/kg up to 2.5 to 3.2 g/kg for very lean and physique athletes
• Lean mass and GLP-1s: why Brandon worries less about some lean mass loss in people with a lot of excess body fat, and how DEXA "lean mass" includes more than muscle
• Don Layman's informal 100 g a day floor, and why both hosts increase protein in steps rather than all at once
• Protein and satiety: protein is the most filling macronutrient, but fibre, water, energy density, food volume and regular meal timing matter too, and protein-fortified snacks are still processed food
• Protein quality and plant-based diets: leucine and the full essential amino acid profile, what vegan and mycoprotein trials show, leucine in plant protein powders, and why Mikki adds an essential amino acid powder for plant-based athletes
• Per-meal protein and timing: the body can use more than 20 to 30 g at once, three to five protein meals a day works well, and the post-workout window is wider than 30 minutes, though protein soon after fasted training still matters

Chapters

00:00 Introducing Brandon and the protein masterclass
03:13 Why protein still confuses people
08:06 Protein, resistance training and muscle
15:54 How much protein people actually eat
22:28 The RDA versus an optimal intake
27:50 Protein needs for endurance athletes
30:15 Protein needs during fat loss
39:50 Lean mass, excess body fat and GLP-1s
47:45 A 100 gram floor and building up gradually
52:35 Satiety and metabolic health
1:02:14 Protein quality and plant versus animal sources
1:17:21 Per-meal protein, distribution and timing
1:26:10 Practical targets by goal and population

Guest / Resources

Brandon DaCruz

• Instagram: @brandondacruz_
• Website: brandondacruzfit.com
• Chasing Clarity: Health & Fitness Podcast, on all major podcast platforms
• Chasing Clarity EP. 93, Dr Scott Stevenson on whether there is an upper limit to protein-stimulated muscle anabolism (the Trommelen study): listen here

Earlier Mikkipedia episodes mentioned

• Mikkipedia 482, Brandon DaCruz on body recomposition: podcast.mikkiwilliden.com/482
• Mikkipedia 492, Rapid fat loss with Brandon DaCruz: podcast.mikkiwilliden.com/492
• Mikkipedia 466, Prof. Don Layman on protein, policy and dietary guidelines: podcast.mikkiwilliden.com/466
• Mikkipedia 238, Putting perspective on protein with Prof. Don Layman: podcast.mikkiwilliden.com/238
• Mikkipedia 460, José Areta on energy deficit and muscle adaptation: podcast.mikkiwilliden.com/460

Why protein matters and how much people eat

• Brenner BM, Meyer TW, Hostetter TH. Dietary protein intake and the progressive nature of kidney disease. N Engl J Med, 1982 (the "Brenner hypothesis"): doi.org/10.1056/NEJM198209093071104
• Mertz KH et al. The effect of daily protein supplementation, with or without resistance training for 1 year, on muscle size, strength, and function in healthy older adults. Am J Clin Nutr, 2021: doi.org/10.1093/ajcn/nqaa372
• Layman DK et al. Dietary protein and exercise have additive effects on body composition during weight loss in adult women. J Nutr, 2005: doi.org/10.1093/jn/135.8.1903
• Bray GA et al. Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating. JAMA, 2012: doi.org/10.1001/jama.2011.1918
• University of Otago and Ministry of Health. A Focus on Nutrition: Key Findings of the 2008/09 New Zealand Adult Nutrition Survey, 2011 (protein chapter): health.govt.nz

How much protein for muscle

• Morton RW et al. A systematic review, meta-analysis and meta-regression of the effect of protein supplementation on resistance training-induced gains in muscle mass and strength in healthy adults. Br J Sports Med, 2018: doi.org/10.1136/bjsports-2017-097608
• Greg Nuckols, Stronger By Science. Protein Science Updated: Why It's Time to Move Beyond the "1.6-2.2g/kg" Rule: strongerbyscience.com/protein-science

Protein during fat loss<...

Episode Summary

In this solo Monday episode, Mikki tackles a question she gets constantly from clients and on social media: why the scales can jump two kilos after a big weekend when that much fat gain seems impossible. She traces the familiar rule that a kilo of fat is worth about 7,700 calories (3,500 per pound) back to Wishnofsky's 1958 paper. She explains why it is a reasonable estimate of the energy stored in mostly-fat body weight, but a poor prediction of how much fat a given surplus will add.

Using overfeeding studies, including the Levine NEAT study and the Bouchard identical twin study, Mikki works through three problems with the rule: extra food isn't all stored, not all weight gain is fat, and energy balance shifts as your body changes. She then reruns the maths on a genuinely big weekend and shows why a Monday-morning jump is mostly glycogen, water, salt and food in transit. That understanding should change what you do next.

Key Topics

• Where the 7,700 calorie (3,500 kcal per pound) rule came from, and why it is defensible as an estimate of the energy in a kilo of mostly-fat body weight
• The difference between a kilo of pure lipid, a kilo of adipose tissue and a kilo on the scales, which can represent anything from about 1,000 to more than 9,000 calories
• Why digesting and storing food costs energy, and why a carbohydrate surplus is stored a little less efficiently than a fat surplus without meaning carbs cause more fat gain
• What extra protein changes during overfeeding: in a metabolic ward study fat gain was similar across protein intakes, but higher-protein diets added lean tissue and raised resting energy expenditure
• How NEAT (non-exercise activity thermogenesis) explained much of the tenfold difference in fat storage between people eating the same surplus
• The identical twin overfeeding study: about 11 kg predicted by the rule, 8.1 kg gained on average, with a range of 4.3 to 13.3 kg and responses that clustered within twin pairs. Mikki notes that these were young men, and the results can't be mapped directly onto women in perimenopause
• How glycogen and water, sodium, alcohol and food in the gut drive short-term jumps on the scales, and why the water-to-glycogen ratio isn't as fixed as often stated
• Why energy balance isn't static, and why the energy content of each kilo lost is lower early in a diet and in leaner people
• Rerunning the maths: roughly 9,000–11,000 surplus calories to add a kilo of fat tissue, and around 400–500 g of fat at most from a 4,500 calorie weekend surplus
• Why the 7,700 rule creates false precision in both directions, from panic after a big weekend to disappointment after week one of a new plan

Chapters

00:00 Introduction: the Monday morning weigh-in
02:52 Where the 7,700 calorie rule comes from
05:17 Why extra food isn't all stored
07:30 NEAT and the twin overfeeding study
10:29 Glycogen, water and short-term weight gain
13:00 Why energy balance isn't static
16:15 What a kilo on the scales really means
18:09 Big weekends, new diets and what to do next

Guest / Resources

• Wishnofsky (1958), Caloric Equivalents of Gained or Lost Weight, American Journal of Clinical Nutrition
• Horton et al. (1995), Fat and carbohydrate overfeeding in humans: different effects on energy storage, American Journal of Clinical Nutrition
• Antonio et al. (2014), The effects of consuming a high protein diet (4.4 g/kg/d) on body composition in resistance-trained individuals, Journal of the International Society of Sports Nutrition
• Bray et al. (2012), Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating, JAMA
• Levine, Eberhardt and Jensen (1999), Role of nonexercise activity thermogenesis in resistance to fat gain in humans, Science
• Bouchard et al. (1990), The response to long-term overfeeding in identical twins, New England Journal of Medicine
• Olsson and Saltin (1970), Variation in total body water with muscle glycogen changes in man, Acta Physiologica Scandinavica
• Hall and Chow (2013), Why is the 3500 kcal per pound weight loss rule wrong?, International Journal of Obesity
• Leibel, Rosenbaum and Hirsch (1995), Changes in energy expenditure resulting from altered body weight, New England Journal of Medicine
• Heymsfield et al. (2012), Energy content of weight loss: kinetic features during voluntary caloric restriction, Metabolism

Contact Mikki:
https://mikkiwilliden.com/
https://www.facebook.com/mikkiwillidennutrition
https://www.instagram.com/mikkiwilliden/
https://linktr.ee/mikkiwilliden
NZ listeners - save 10% off Calocurb by using the code Mikkipedia10 at www.calocurb.co.nz
Save 20% on all Nuzest Products WORLDWIDE with the code MIKKI at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.com
Curranz supplement: MIKKI saves you 25% at www.curranz.co.nz or www.curranz.co.uk off your first order

Save 20% on all Nuzest Products WORLDWIDE with the code MIKKIPEDIA at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.com
Curranz Supplement: Use code MIKKIPEDIA to get 20% off your first order - go to www.curranz.co.nz  or www.curranz.co.uk to order yours

NZ listeners - save 10% off Calocurb by using the code Mikkipedia10 at www.calocurb.co.nz

Episode Summary

Dr Matthew Cook is a Senior Lecturer in Sport and Exercise Science at the University of Worcester in the UK. He completed the first PhD examining the effects of New Zealand blackcurrant on physiological responses at rest and during exercise in trained cyclists, under Prof Mark Willems at the University of Chichester, and he is still researching blackcurrant and performance, recovery and health. Mikki has used CurraNZ for years, including during the Grand to Grand Ultra, and wanted to hear from one of the researchers behind the evidence. Matt explains what is in New Zealand blackcurrant, why his group thinks the metabolites formed after we eat anthocyanins matter more than the anthocyanins themselves, and how an extract compares with eating the whole fruit.

The centre of the conversation is Matt's recent meta-analysis of 15 studies and 226 participants, which found a consistent increase in fat oxidation during exercise. Matt is careful about the size of it: about 0.042 grams of fat a minute, or roughly 2.5 to 3 grams over an hour of moderate exercise, "physiologically detectable" and possibly meaningful, but modest. He also notes that more fat use does not automatically mean glycogen sparing. They talk about why some people respond more than others, including a study where women with more body fat responded more (an observation in 11 women that needs repeating), and how little is known about perimenopausal, menopausal or insulin-resistant women. Matt finishes with the most-studied dosing protocol, timing before events and the evidence on recovery.

Key Topics

• Matt's path from an undergraduate degree at Southampton Solent University to a master's and PhD at the University of Chichester, and his ongoing collaboration with Prof Mark Willems
• What makes New Zealand blackcurrant distinctive: high UV exposure, an anthocyanin profile dominated by delphinidin and cyanidin, and the idea that metabolites made in the liver and by gut bacteria drive the effects
• Whole fruit versus extract: two capsules (600 mg) give about 210 mg of anthocyanins, roughly 70 to 80 g of fresh fruit by Matt's rough calculation, with seasonality, consistent dosing and fibre load favouring an extract
• The consistent finding that blackcurrant shifts fuel use towards fat at the same exercise intensity, and why that does not automatically equal glycogen sparing
• Matt's meta-analysis of 15 studies and 226 participants: a pooled increase in fat oxidation of 0.042 g per minute, about 20 kcal over an hour, and why percentage changes can look larger than they are
• A study of 11 men and 11 women: both increased fat use, but only in women did the size of the response track body fat percentage, an observation Matt says needs repeating
• Research gaps in women across the lifespan, including perimenopause, menopause, insulin resistance and higher body fat, since most participants so far have been men or lean, active women
• Responders and non-responders: people burning more carbohydrate at baseline (a higher RER) had more room to respond, and why a smartwatch cannot measure RER
• A Liverpool John Moores University muscle biopsy study showing greater use of fat stored inside type 1 muscle fibres, and what that might mean beyond athletes
• Practical dosing: 600 mg a day split morning and evening, starting seven days before an event, two capsules about two hours before the start, practising in training first, and some evidence for taking it for a few days after damaging exercise to help recovery

Chapters

00:00 Introduction
03:53 Matt's background and blackcurrant research
09:53 Anthocyanins, metabolites and the gut
18:20 Whole fruit versus extract
24:28 Fat oxidation during exercise
27:39 Putting the meta-analysis effect in context
31:59 Men, women and body fat
36:48 Responders and non-responders
40:22 Baseline fuel use and RER
43:18 Muscle fat use and metabolic health
50:43 Dosing, timing and recovery
54:29 Upcoming research and contact details

Guest / Resources

• Dr Matthew Cook, University of Worcester: worcester.ac.uk/discover/matthew-cook.html. Matt says his email address and papers are listed on this page, and he would like to hear from people and coaches who have used blackcurrant
• Cook MD, Bateman JJ, Willems MET. Blackcurrant Anthocyanin Supplementation Alters Exercise-Induced Substrate Utilization - A Systematic Review and Meta-Analysis. Journal of Dietary Supplements, 2026: doi.org/10.1080/19390211.2026.2624114
• Cook MD, Shan Y, Willems MET. Effects of New Zealand Black Currant Extract on Exercising Substrate Utilization and Postexercise Blood Pressure in Men and Women. International Journal of Sport Nutrition and Exercise Metabolism, 2025: doi.org/10.1123/ijsnem.2024-0108
• Willems MET, Cook MD. Alterations of Exercise-Induced Carbohydrate and Fat Oxidation by Anthocyanin-Rich New Zealand Blackcurrant Are Associated with the Pre-Intervention Metabolic Function: A Secondary Analysis of Randomized Crossover Trials. Nutrients, 2025: doi.org/10.3390/nu17060997
• The Liverpool John Moores University muscle biopsy study: Jones LA, Leung L, Barrett JS, Fortis HO, Strauss JA, Shepherd SO. New Zealand blackcurrant extract augments muscle glycogen storage at rest and enhances intramuscular triglyceride degradation during prolonged exercise. European Journal of Applied Physiology, 2026: doi.org/10.1007/s00421-025-05995-9
• Prof Mark Willems, University of Chichester, Matt's PhD supervisor and long-time collaborator
• CurraNZ, the New Zealand blackcurrant extract used in this research, is a sponsor of the show. Use the code MIKKIPEDIA for a discount: curranz.co.nz
• Mikki's earlier episodes with Fleur Cushman of CurraNZ, including Fleur Cushman - the science behind blackcurrants

Contact Mikki:
https://mikkiwilliden.com/
https://www.facebook.com/mikkiwillidennutrition
https://www.instagram.com/mikkiwilliden/
https://linktr.ee/mikkiwilliden

Episode Summary

In this episode, Mikki looks at three tests clients keep bringing to her that sound scientific but don't deliver what they promise: live and dry blood analysis, skin carotenoid scanners and IgG food intolerance panels. For each one she explains what the test actually measures, what it is sold as measuring, and why the gap between the two matters when people end up on a raft of supplements or a long list of foods to avoid.

She also walks through a 2025 randomised, sham-controlled trial of an IgG-guided elimination diet in IBS. The effect was real but modest, and the sham group did well too. Mikki explains why that trial doesn't justify the commercial panels sold online. She finishes with the tests and approaches that are worth your money if you have gut symptoms, fatigue or suspected food reactions.

Key Topics

• Why live and dry blood analysis is appealing when your standard bloods are "in range" but you still feel unwell, and why what practitioners point to on the slide is clotting and drying artefact
• Blood pH is tightly regulated at around 7.4, so a test claiming to show your blood is "acidic" isn't measuring anything real
• Robert O. Young, author of The pH Miracle and a prominent promoter of live blood analysis, was convicted in the US of practising medicine without a licence
• Skin carotenoid scanners use a genuine technique and measure a real biomarker, but the score mostly reflects fruit and vegetable intake and says nothing about iron, B12, vitamin D, zinc, thyroid or overall antioxidant status
• The conflict of interest when the scanner's manufacturer also sells the supplements that raise your score
• IgE versus IgG: why IgG to foods largely tracks what you eat, and why rising IgG4 signals tolerance rather than intolerance
• Why ASCIA, the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology advise against IgG food testing
• What the 2025 IgG-guided elimination diet trial in IBS did and didn't show: 59.6% vs 42.1% responders, roughly one extra responder for every six people, using an 18-food research assay rather than a commercial panel
• The costs of unnecessary restriction: avoiding 15–30 everyday foods, food fear in midlife, and months of delay before a proper diagnosis
• Better routes: specialist assessment and specific IgE for allergy, coeliac serology before removing gluten, breath testing for lactose, and a supervised low FODMAP trial with reintroduction for IBS

Chapters

00:00 Introduction
00:45 Live and dry blood analysis
05:28 Skin carotenoid scanners
07:54 IgG food intolerance panels
11:02 The IgG-guided elimination diet trial
14:28 The harms of unnecessary restriction
16:13 Better ways to investigate symptoms

Guest / Resources

• Robert O. Young, author of The pH Miracle
• Dr Jim Faed, haematologist, University of Otago Medical School, quoted in the NZ Herald (April 2025) on clinics offering live blood analysis
• Pharmanex BioPhotonic Scanner (S3), a Nu Skin skin carotenoid scanner
• Veggie Meter, a research-grade skin carotenoid device
• European Academy of Allergy and Clinical Immunology (EAACI) task force report on IgG4 testing to foods
• American Academy of Allergy, Asthma and Immunology (AAAAI)
• ASCIA, the Australasian Society of Clinical Immunology and Allergy
• Singh et al. (2025), A Novel, IBS-Specific IgG ELISA-Based Elimination Diet in Irritable Bowel Syndrome: A Randomized, Sham-Controlled Trial, Gastroenterology
• Low FODMAP diet (supervised, with reintroduction)

Contact Mikki:
https://mikkiwilliden.com/
https://www.facebook.com/mikkiwillidennutrition
https://www.instagram.com/mikkiwilliden/
https://linktr.ee/mikkiwilliden
NZ listeners - save 10% off Calocurb by using the code Mikkipedia10 at www.calocurb.co.nz
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Episode Summary

Dr Lara Courtenay is a New Zealand-trained GP and bariatric physician with the Weightless Specialist Team at the MacMurray Centre in Auckland, and she has worked in obesity medicine since 2020. Mikki has talked about GLP-1 medications with plenty of international researchers and doctors, so after hearing Lara speak for the Goodfellow Unit she wanted a New Zealand view from someone working with patients every day. Lara explains why GP knowledge of these medications here is variable, and why, in her clinic, the dietitians and psychologists around the medication matter as much as the prescription itself.

They talk about perimenopausal women who are doing everything right and still cannot shift fat, and Lara's analogy of the medication letting go of the handbrake. They also cover prescribing criteria and the limits of BMI, dose escalation and cost, appetite and food noise, and why some plateaus come from eating too little, where Lara's clinic often lowers the dose and has people eat more. Lara is candid about what she does not know. She says the evidence suggests most people need to stay on something long term, that she cannot predict who will manage without it, and that her view on high-intensity exercise is clinic advice she "could be wrong" about. The conversation finishes with regular eating and breakfast, exercise intensity and HRT.

Key Topics

• Why knowledge of GLP-1 medications among New Zealand GPs is "variable": some GPs will not discuss them and refer on, while others are highly skilled prescribers
• How Lara came into obesity medicine through gastric balloons in 2020, and a clinic model where patients could not get the medication without seeing a dietitian
• Older options such as Saxenda and Contrave, which could work well, and how much of the shift to the weekly drugs is effectiveness versus marketing and online hype
• Perimenopausal women who exercise, eat well and still cannot lose fat, and Lara's explanation that the medication lets go of the handbrake
• Prescribing from a person's heaviest documented weight, taking ethnicity into account, and why both Lara and Mikki see BMI and the word "obesity" as flawed
• Dose escalation in practice: a set schedule to start, then stopping wherever each person needs to stop, with nutritional needs always met, and cost as one of the biggest barriers
• Whether people can come off these medications: Lara has seen some "unicorns" do it, but she says the evidence points to most people needing something long term and she cannot tell in advance who will manage
• Appetite and food noise: most people get some appetite restriction, being hungry on the medication is not a failure, and Lara is now seeing patients who escalated without support and under-ate
• Why people plateau, including strict eaters falling short on fats and nutrients, and why Lara's clinic often lowers the dose and tells people to eat more
• The clinic dietitians' advice on regular eating and eating before 10am, why high-intensity exercise is not always the best fit during weight loss, and Lara's strong support for HRT

Chapters

00:00 Introduction
02:58 GLP-1 knowledge among New Zealand GPs
05:31 From gastric balloons to obesity medicine
08:24 Older drugs, newer drugs and support
11:43 Perimenopause and releasing the handbrake
13:39 Prescribing criteria, BMI and the scales
18:03 Dose escalation and cost
20:53 Coming off the medication
25:59 Appetite, under-eating and food noise
32:28 Why people plateau
37:08 Regular eating and breakfast
41:33 Exercise intensity and cortisol
45:04 HRT and contacting the clinic

Guest / Resources

• Dr Lara Courtenay at the MacMurray Centre: macmurray.co.nz/doctors/lara-courtenay
• The MacMurray Centre, Auckland: macmurray.co.nz. Lara says patients can call the clinic and ask for the weight loss doctor, and the dietitians can see patients whose own GP is prescribing
• The Goodfellow Unit, where Mikki first heard Lara speak: goodfellowunit.org
• Medications discussed: semaglutide, tirzepatide, Saxenda and Contrave
• TJ Power, The DOSE Effect, the book Lara mentions reading

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Episode Summary

A friend sent Mikki a link in a WhatsApp group — an NZ Herald article, originally published in the Washington Post, under the headline that popular supplements could harm the ageing brain. It named three: vitamin D, omega-3 and glucosamine. In this solo episode Mikki goes back to the three separate studies behind that single article and works through what each one actually found.

Along the way she lays out the difference between observational research and randomised controlled trials, and why healthy user bias makes supplement users hard to compare with non-users in the first place. The three studies do not point the same way: the vitamin D finding is statistically significant but amounts to about a third of a point on a 27-point scale over six years, the omega-3 signal is more substantial but runs directly against the randomised evidence from VITAL, and the glucosamine work is the most interesting of the three because it pairs experimental biology with human health records — though it concerns people who already have cognitive impairment. Mikki finishes with the questions worth asking of any study like this, and where she has landed on each supplement.

Key Topics

• Why the NZ Herald headline claims more than the evidence behind it can support, even though the article itself acknowledges the findings are preliminary, mostly observational and sometimes contradictory
• Observational studies versus randomised controlled trials, and why observational work is hypothesis-producing rather than conclusive
• Healthy user bias — researchers can statistically adjust for some differences between supplement users and non-users, but not for a healthy user lifestyle, and not for anything that was never measured
• The vitamin D observational study: over 5,000 adults, average age 67.5, followed six years, showing faster decline in global cognition and executive function — but only about 0.31 points on a scale running to 27
• Why very large databases can make clinically trivial differences statistically significant, and why the vitamin D result disappeared when users were compared against people taking neither vitamin D nor a multivitamin
• The omega-3 analysis using ADNI data, which found faster decline on three cognitive measures plus greater FDG hypometabolism in Alzheimer's-vulnerable brain regions — a real signal, but an observational one
• Why that omega-3 analysis has been challenged in published letters, covering exposure classification, residual confounding, omega-3 formulation, and its inconsistency with previous evidence
• What the VITAL randomised trial found for both vitamin D and omega-3: no significant difference in cognitive decline, which means no demonstrated benefit but also no demonstrated harm
• The glucosamine paper, which combined post-mortem human brains, Alzheimer's mouse models and electronic health records, and found roughly 25% greater progression from mild cognitive impairment to dementia among users
• The questions to ask of any supplement study — who was studied, were they deficient, what dose, was exposure randomised, how big was the effect, does it agree with the randomised trials, and has it been replicated

Chapters

00:00 A headline about supplements and the brain
02:11 Observational studies versus randomised trials
05:18 Vitamin D and cognitive decline
07:53 Small effects, big databases, real limitations
11:11 Omega-3, fish oil and the ADNI study
15:00 Why the omega-3 findings were challenged
18:55 Glucosamine, mice and health records
21:59 Bringing the three studies together
23:55 Practical bottom lines for each supplement

Guest / Resources

The article that prompted the episode

• NZ Herald: "Why scientists are starting to worry popular supplements could harm the ageing brain" — https://www.nzherald.co.nz/lifestyle/why-scientists-are-starting-to-worry-popular-supplements-could-harm-the-ageing-brain/premium/VHMO7A5XQBAORA7PZPHXVCNHLE/
• Originally published in the Washington Post, 10 September 2026: "Why scientists are starting to worry popular supplements could harm the aging brain" — https://www.washingtonpost.com/health/2026/09/10/scientists-are-investigating-whether-popular-supplements-could-harm-aging-brain/

The three studies discussed

• Vitamin D — "Association between vitamin D supplement use and cognitive functioning: a longitudinal cohort study", BMJ Open, January 2026. Used the US Health and Retirement Study; 5,065 participants, mean age 67.5, 2,004 (39.6%) vitamin D users, six years of follow-up. Global cognition declined by an additional 0.052 points per year and executive function by 0.021 points per year among users. https://pubmed.ncbi.nlm.nih.gov/41571412/
• Omega-3 — "The association between omega-3 supplementation and cognitive decline in older adults", The Journal of Prevention of Alzheimer's Disease, 2026. Used Alzheimer's Disease Neuroimaging Initiative (ADNI) data; 273 omega-3 users compared with 546 matched non-users over about five years, with FDG hypometabolism in Alzheimer's-vulnerable regions acting as a mediating pathway. https://pmc.ncbi.nlm.nih.gov/articles/PMC13099475/
• Glucosamine — "Hyperglycosylation is a metabolic driver of Alzheimer's disease", Nature Metabolism, 2026. Combined post-mortem human brain tissue, Alzheimer's mouse models, experimental manipulation of glycan biosynthesis, and electronic health records. https://www.nature.com/articles/s42255-026-01538-4

Published responses to the omega-3 analysis

• "Oxidation over omega-3: Reinterpreting the paradoxical link between fish oil supplements and accelerated cognitive decline", The Journal of Prevention of Alzheimer's Disease — https://pubmed.ncbi.nlm.nih.gov/42612547/
• "Do methodological limitations and confounding factors explain the apparent acceleration of cognitive decline in older adults taking omega-3 fatty acid supplements?", The Journal of Prevention of Alzheimer's Disease — https://www.sciencedirect.com/science/article/pii/S2274580726001858

The randomised trial referenced throughout

• VITAL (Vitamin D and Omega-3 Trial) — randomised older adults to 2,000 IU vitamin D3 daily and to 1 g marine omega-3 daily providing 460 mg EPA and 380 mg DHA, against placebo. https://clinicaltrials.gov/study/NCT01169259

Cognitive measures mentioned

• MMSE (Mini Mental State Examination), ADAS-Cog-13 (Alzheimer's Disease Assessment Scale), CDR-SB (Clinical Dementia Rating Sum of Boxes), FDG PET imaging, APOE4 status

Also mentioned

• Pillar Performance — the omega-3 supplement Mikki takes herself. She states in the episode that this is not an ad.
• Mikki's recipe portal at mikkiwilliden.com — over a thousand recipes, $12 a month
• Instagram, Threads and X: Mikki Williden · Facebook: Mikki Williden Nutrition · Website: mikkiwilliden.com

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Episode Summary

Paul Booth, sports nutritionist, exercise physiologist and PhD researcher in ultra-running metabolism, is back on Mikkipedia, straight from UTMB week in Chamonix, where he raced OCC and worked with elite athletes. Mikki and Paul pick up where they left off a year ago, talking about how much carbohydrate trail and ultra runners actually need. Paul shares results from his own blinded field study comparing 90 g and 120 g of carbohydrate an hour over 55 km. It found no difference in total time, climbing or descending, but every runner had more gut distress on 120 g after about four hours.

They also cover how Paul builds race plans from lab testing, training files and years of race split times, and why he thinks faster ultra times owe more to better training environments than to race-day fuelling. He explains the everyday gaps he sees most (refuelling after training, protein at breakfast and meeting total energy needs), and why age-group runners may do well starting nearer 60 g an hour and building only if they need to. Paul is careful to say his findings apply to trail and ultra running up to the distances he has tested, not to cycling or triathlon.

Key Topics

• Paul's OCC race: just over 11 hours on a hot day, fuelled at about 60 g of carbohydrate an hour, completing his set of UTMB ultra races
• Caffeine at the elite end, including a CCC podium athlete who took far more caffeine than planned while racing through a knee injury
• Lab testing in heat and altitude chambers to find each athlete's gut ceiling, and using race modelling to find where carbohydrate can come down as well as up
• Why Paul thinks faster ultra performances are driven mainly by more professional, strategic training, and why over-fuelling on race day adds nothing but gut issues
• The risk of pairing very high in-training carbohydrate with "burgers and pizza" to meet energy needs, when fruit, vegetables, fibre, iron and micronutrients still matter
• The most common everyday gaps: delayed refuelling after training, too little protein at breakfast, and under-eating total energy on high-volume days
• Whether 120 g an hour is justified: Paul sees elite intakes settling around 100 g, and reported high intakes are often overstated once discarded gels and bottles are counted
• Paul's 90 vs 120 g field study: no significant difference in time, climbing or descending, with a consistent rise in upper-GI distress on 120 g after about four hours
• Practical advice for age-groupers: start around 60 g an hour, build towards 90 g only if you are comfortable and racing hard
• Glucose to fructose ratios: why 1:0.8 mainly matters above about 90 g an hour, and how sponsor products shape what athletes can take

Chapters

00:00 Introduction
04:02 Paul's OCC race at UTMB week
07:32 Elite race results and caffeine plans
11:52 Lab testing and race modelling
21:47 Why ultra times are getting faster
26:47 Training fuel versus overall diet quality
32:04 Timing, recovery and breakfast protein
34:27 Is 120 grams an hour justified?
41:52 The 90 vs 120 gram field study
53:55 Fuelling advice for age-group runners
56:29 Carbohydrate intake and recovery
1:00:05 The 10 grams an hour argument
1:05:00 Glucose to fructose ratios
1:08:56 Paul's podcast and how to reach him

Guest / Resources

• Paul Booth on Instagram: @ultra.endurance.nutritionist
• Paul's website, Performance Gains: performancegains.co.uk
• Paul's previous Mikkipedia episode (398): Fueling Tom Evans and Ruth Croft's Victories at UTMB: Inside Elite Ultra Nutrition with Paul Booth
• Plews DJ, Booth PD, Krieger T, Maunder E. Fuelled or Fooled? Examining the Evidence and Mechanisms Behind Ultra-High Carbohydrate Intake in Endurance Athletes. Sports Medicine, 2026
• Paul's 90 vs 120 g per hour field study in ultra runners, presented at the ECSS conference (not yet published)
• O'Brien WJ, Rowlands DS. Fructose-maltodextrin ratio in a carbohydrate-electrolyte solution differentially affects exogenous carbohydrate oxidation rate, gut comfort, and performance. American Journal of Physiology: Gastrointestinal and Liver Physiology, 2011. The origin of the 1:0.8 ratio discussed
• MNSTRY's podcast, which Paul co-hosts: mnstry.podbean.com
• Athletes and people mentioned: Tom Evans, Ruth Croft, Miao Yao, Gemma Hillier-Moses, Rachel Entrekin, Dan Green, Dr Dan Plews, Tim Podlogar, Alistair Brownlee

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Episode Summary

A client sent Mikki a link to a very flash Withings bioelectrical impedance scale — NZ$819, marketed as 99% as accurate as a DEXA scan — and asked the obvious question: is it worth the money? In this solo episode Mikki goes and reads the validation document behind that claim, and finds the problem isn't really the scale at all. It's a statistical sleight of hand that turns up constantly in health tech marketing: reporting a correlation and calling it accuracy.

Mikki explains the difference in plain terms, with a worked example where a scale reads exactly half the true value every single time and still produces a perfect correlation of 1.0. She then sets the company's own document against three pieces of independent research — a January 2026 systematic review of BIA against a four-compartment model, Siedler and colleagues' 2023 comparison of fifteen BIA devices, and a June 2026 study putting the InBody H20N up against DEXA — to show what honest reporting of a body composition device actually looks like. She finishes with the four readouts on these scales that aren't worth your attention, a practical protocol for getting genuine information out of the one you already own, and four questions worth asking of any health tech accuracy claim you meet in the next few years.

Key Topics

• Correlation is not accuracy. The 99% claim rests on a correlation of 0.99 for total fat mass across 80 people. Mikki accepts the correlation is real, and shows with a worked example why it says nothing about whether any individual reading is right.
• What you actually want is agreement. Mean difference and limits of agreement, via a Bland-Altman analysis — the standard approach since the mid-1980s, and one the company's document didn't use.
• What the validation document left out: mean difference from DEXA, limits of agreement, individual prediction error, the age and sex breakdown, the body fat range, whether hydration and fasting were standardised, and whether the validation sample was independent of the data used to build the algorithm. Mikki could find no peer-reviewed publication of it, and notes total body water was validated against a different device entirely.
• Better hardware doesn't settle the evidence question. Mikki is clear the Withings unit is well built — eight electrodes including a handheld bar, multiple frequencies, current through arms, trunk and legs rather than up one leg and down the other. That is a separate question from whether the accuracy claim stands up.
• The independent evidence. A January 2026 systematic review of 12 studies found mean bias for body fat percentage ranging from 3.5 percentage points too low to 4.4 too high, with limits of agreement typically spanning 15 to 20 percentage points, and concluded BIA was not equivalent to the four-compartment reference.
• Reliable does not mean accurate. Across 15 devices, precision error was 0 to 0.5 percentage points — these scales are very consistent with themselves. A device can be reliably wrong, which is why direction of change can still be informative even when the absolute number isn't. The longitudinal results were more mixed: some devices tracked change reasonably, others didn't.
• What honest reporting looks like. In 55 adults with obesity, the InBody H20N sat 1.64 percentage points from DEXA on body fat, with limits of agreement of −3.4 to +6.7 — good across a group, much looser for the individual standing on it. Skeletal muscle mass was worse, overestimated by 5.66 kg on average. Less impressive than 99%, and far more useful.
• Four readouts not worth watching: visceral fat (a proprietary index on an arbitrary scale, not a measurement of visceral adipose tissue like CT or MRI); bone mass (not bone mineral density, and no guide to osteoporosis risk — DEXA is the answer there); basal metabolic rate (calculated from an equation, not measured — that needs indirect calorimetry); and body water (better on a multi-frequency device, still modelled).
• How to use the scale you have. Standardise everything you can control, because hydration, glycogen and cycle phase move these numbers more than real change does over a short window. Measure three or four times a week, average weekly, read four-week trends, and triangulate against weight, waist, clothing fit, training numbers and photos. Swap "my body fat is 23.7%" for "my body fat estimate has trended down over the last 10 weeks".
• The transferable point. InBody's own product page claims over 98% agreement with DEXA — near enough the same move. When you're told a number is 99% accurate, ask what that means, what it was compared against, who paid for the comparison, and how far off an individual reading can be.

Chapters

00:00 The $819 scale and the 99% claim
02:15 Why correlation is not accuracy
04:27 Better hardware, missing evidence
06:48 What the independent research shows
09:10 InBody versus DEXA: the real numbers
11:53 Readouts not worth watching
13:27 How to use a scale well
15:40 Questions to ask of health tech

Guest / Resources

This is a solo episode — no guest.

Studies discussed

• The Validity of Bioelectrical Impedance Analysis Compared to a Four-Compartment Model in Healthy Adults: A Systematic Review — Journal of Functional Morphology and Kinesiology, 31 January 2026. Twelve studies; mean bias for body fat percentage −3.5 to +4.4 percentage points; limits of agreement typically 15–20 percentage points. https://doi.org/10.3390/jfmk11010065
• Siedler MR et al. Assessing the reliability and cross-sectional and longitudinal validity of fifteen bioelectrical impedance analysis devices — British Journal of Nutrition, 2023;130:827–840. Seventy-three adults across 15 BIA devices against a four-compartment model, with 37 returning 12–16 weeks later for the longitudinal analysis.
• Ellison KM, Gard W, Wood J, Layton C, Sayer RD. Assessing Body Composition for Resource-Limited Settings: Agreement of a Scalable BIA Device Compared to DXA and Clinical BIA in Adults With Obesity — Journal of Primary Care and Community Health, 2026. The InBody H20N against DEXA in 55 adults with obesity (mean age 62.6, 67% female), under an 8-hour fast with no alcohol or vigorous exercise for 24 hours. The research group is at the University of Alabama at Birmingham. https://doi.org/10.1177/21501319261459756

Methods and terms mentioned

• Bland-Altman analysis — the standard method for comparing two measurement techniques, giving mean difference and limits of agreement
• Four-compartment model — a stronger reference than DEXA alone, accounting for body volume, total body water, bone mineral and body mass separately
• DEXA — the reference method throughout, and the gold standard for bone mineral density
• Indirect calorimetry — what measuring basal metabolic rate actually requires, using a mask and a metabolic cart
• CT and MRI — what an actual measurement of visceral adipose tissue requires

Devices mentioned

• Withings bioelectrical impedance scale — the NZ$819 device that prompted the episode
• InBody H20N — the consumer-grade portable device in the June 2026 study, AU$529, with no New Zealand retailer found at the time of recording

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