Alex Klintworth

Certified Nutritionist & Coach
Metabolic Health Researcher
Helping people regain control of their wellbeing
One Size Does Not Fit All

[Alex Klintworth @alexklint]

My wife, Karli, and I have been researching nutrition science for a decade because we love it. We do that for free. We make a living by helping people implement our knowledge in a way that is compatible within their lifestyle, the preferences, and their health context. Here are a few of the experiences our clients have had.

@HiEnergyLife Testimonial Montage https://t.co/AV3RYI7Oq8 via @YouTube

[Alex Klintworth @alexklint]

This is applicable to just about everything in health and life. So much of what we're told is unhealthy - elevated blood glucose, cortisol, stress - is false. Cycles are healthy. We want a morning rise in cortisol. High intensity exercise spikes blood sugar. Stress is a signal to improve. But none of these should be chronically high.

[Steve Magness @stevemagness]

There’s a reason athletes have off seasons.

After intense stress, you need time to mentally and physically recover.

Periodize your life. Know when it's time to 'grind' and when you need to back off and recover.

[Alex Klintworth @alexklint]

Real-world results do carry weight, and most athletes do fuel primarily with carbs. Lab settings don't exactly mirror professional-level race settings.

However, there's been a lot of recent research around how exactly extremely high levels of carbohydrate intake might improve performance. This research can't seem to pinpoint the carbohydrate itself being a key factor in performance, once intake increases above a moderately low level of intake.

[Tom Coughlin @tecoughlin]

Is carbohydrate loading just placebo? 🧐

This new review examined findings from 14 carb loading studies to establish if it actually improves performance, outwith the placebo effect 🔍

Here are the key findings ⬇️

📚 Of 14 eligible carb loading studies, only 2 used double-blind, placebo-controlled designs

🥤 Only 4 of the 14 studies provided carbohydrate during the exercise test, limiting real-world relevance

⚠️ The 2 double-blind studies that did include appropriate in-exercise carbohydrate found no performance benefit from carb loading

🔍 Many older studies tested carb loading without pre- or during-exercise carbohydrate, which does not reflect current endurance fuelling practice

🧠 The positive effects seen in some unblinded studies may partly reflect belief, expectation, or placebo effects rather than carbohydrate loading alone

💭 The effect sizes from the unblinded studies with in-exercise carbohydrate were similar to reported placebo effects for nutritional interventions

The authors did not argue that glycogen is unimportant, they argued that the evidence for extra benefit from above-normal carbohydrate loading needs stronger testing ✅

Overall, current evidence is inconclusive on whether 24–48 h carbohydrate loading adds performance benefit when placebo effects are controlled and in-race fuelling is optimised 🔍

Even if effects are down to placebo, this shouldn’t be discounted in applied settings.

If there is a mechanism there to support employment of carb loading (“glycogen stores”), then placebo isn’t bad if it improves performance ⚙️

Or maybe I just like eating lots of pasta 🫣

Reference:

https://t.co/GxjhdOiHYh

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[Alex Klintworth @alexklint]

This was an extra fun conversation for us as so many of Brian's guests have been instrumental in our nutritional journey.

https://t.co/bduUA83R8R

@FoodLiesOrg

[Alex Klintworth @alexklint]

Basic logic suggests what you provide to build and fuel your brain is the core foundation for how it functions.

[Matthew Baszucki @matthewbaszucki]

Huge misconception: Food is just about weight loss. Physical health. Important for diabetes, obesity, stuff like that.

True, but only half the story! Food is about MENTAL HEALTH.

People have problems. Temper. Basket case. Poor memory. Anger.

What if your brain is broken because you're feeding it a bunch of garbage!!!!!

[Alex Klintworth @alexklint]

It makes absolutely no sense to think that what you eat doesn't have an effect on how your brain functions.

[Nick Norwitz MD PhD @nicknorwitz]

Your brain contains roughly 100 quintillion mitochondria.

Your daily activities influence how they function and, ultimately, the overall energy status of your brain, your mood, and your cognitive performance.

Treat them well.

[Alex Klintworth @alexklint]

Understanding a study's limitations is just as important as understanding the outcome itself. If somebody can't explain the limitations, you may want to question their interpretation of the study.

[Alex Klintworth @alexklint]

Absolutely 100%

[Gil Carvalho MD PhD🌈🇵🇸 @NutritionMadeS3]

Reminder that every study ever conducted has limitations.

If we think a study has none we´re probably not familiar with that study.

And if we think a study should be discarded because it has limitations we´re probably not familiar with any studies at all.

[Nick Jikomes @trikomes]

Yep.

This is why understanding methods and mechanisms is important.

Without that understanding, you’re handicapped in your ability to filter truth out of the never-ending slop stream.

Most health influencer types just wind up mindlessly regurgitating the headline results of studies that will capture people’s attention.

And for good reason.

Posting can be automated, and you’re shielded from responsibility for being wrong or spreading bad info because, hey, you’re citing SCIENTIFIC studies!

So anyone who is optimizing for engagement or sales rather than truth will naturally gravitate toward automated slop streams that regurgitate “the evidence.”

That’s the incentive, so that’s mostly what you get from most people.

Those who care about truth and rigor know that the published literature is a vast cacophony of sense, nonsense, fraud, mediocrity, and rigorous science.

Therefore, you can’t bank on things being true just because they’re published.

But Rhonda Patrick is optimizing for engagement and sales, not true understanding.

So methods don’t matter.

[Alex Klintworth @alexklint]

The inclusion criteria were only studies that included low and moderate dose nattokinase. And yet, in the discussion section the researchers noted,

"However, a recent clinical study of 1062 patients with hyperlipidemia showed that nattokinase supplementation at a dosage of 10,800 FU per day for 1 year significantly decreased blood total cholesterol, triglyceride, LDL-C and increased HDL-C [47]. Ren et al. [48] also found that high-dose nattokinase administration over a relatively long period of time (26 weeks, 6500 FU) was effective in inhibiting the progression of atherosclerotic plaques and hyperlipidemia. Noticeably, in the meta-analysis of relatively high total dosage of nattokinase supplementation, the increase in HDL-C and the decrease in LDL-C were detected among included participants."

and

"In general, our observations reflected those of Chen et al. [17] who also proposed that long-term and high-dose nattokinase supplementation seemed to have positive impacts on blood lipids."

@NutritionMadeS3 I'd appreciate in your review your thoughts on the differences between low and higher dose supplmentation.

[Gil Carvalho MD PhD🌈🇵🇸 @NutritionMadeS3]

3 reasons I don´t take or recommend Nattokinase

1⃣ Iffy Biomarker data
Meta-analysis of RCTs: blood pressure lowered ~3points but glucose (& maybe cholesterol) raised

2⃣ Zero outcomes (heart attacks etc) trials

3⃣ Largest trial shows no effect on plaque
https://t.co/PBcQfyUVsP

[Alex Klintworth @alexklint]

It depends on how the workout is structured. Low-moderate intensity running isn't likely to make much of a difference compared to +5000 steps, and might increase appetite.

2-3 sprint workouts would, for most, be overall superior if they're already at 5000 steps.

Even better, I'd recommend 2-3 cycling workouts/week. Much superior muscle growth and lower body strength. It's even a great core workout depending on the bike.

[Alex Klintworth @alexklint]

It would be a great validation, but that is not what I'm commenting on. First, your response has nothing to do with Dave's.Second, we have evidence Cleerly's results are not reproducible.

Given the latter point, and the fact each of the other analyses are in much closer accordance, it's more reasonable to suspect that the non-Cleerly analyses in aggregate are closer to the actual results than Cleerly.

[Alex Klintworth @alexklint]

@theproof @reallyoptimized @realDaveFeldman That response didn't address what Dave was describing. And Cleerly doesn't appear reproducible against itself given that when participants independently submitted their scans to Cleerly, the results came back wildly different from the CTA submissions.

[Alex Klintworth @alexklint]

It's quite interesting that when simple, healthy eating makes you lose a lot of interest in highly processed foods, people think it takes a ton of willpower or call it an eating disorder.

[Sama Hoole @SamaHoole]

Them: I couldn't do what you do. Honestly, I don't have the willpower for it.

Me: Willpower for what?

Them: Eating like that. So strict. All that discipline, day in, day out.

Me: I eat beef, cheese, eggs and butter until I'm full, then I stop. There's no discipline in it.

Them: I could never give up bread, though.

Me: Nobody made me give up bread. I lost interest in it and that was that.

Them: See, that's willpower. I'd cave in a second.

Me: You weighed your breakfast this morning.

Them: Well, yeah.

Me: You weighed a banana yesterday, then weighed the skin and took it off the total.

Them: That's just being accurate.

Me: You ran in the rain at ten o'clock last night because you went over on your calories.

Them: I wasn't going to sleep on a surplus.

Me: I had a ribeye and didn't think about food again all day. You've made about nine decisions before lunch to avoid things you actually fancy. And you couldn't do what I'm doing.

Them: ...

Them: When you say it like that, it's a bit grim, isn't it.

[Alex Klintworth @alexklint]

'Chemicals provides lots of benefits, so it's stupid to mention that chemicals can cause lots of harm.'

- Brought to you by a scientist employed by a multinational corporation that synthesizes chemicals designed to kill living organisms.

[Simon Maechling @simonmaechling]

Imagine posting "Chemicals are contaminating our lives"

Sent from a chemical-powered device. Connected through chemical-engineered materials. Built inside a chemically engineered home.

The problem isn't chemistry. It's forgetting what made modern life possible.

[Alex Klintworth @alexklint]

Fantastic thread, absolutely worth a read!

[Bret Scher, MD @bschermd]

For decades we have been told saturated fat is bad and must be limited. All of it. Cap it at 10% of calories or less. The science is settled.

A new review suggests that framing is fundamentally wrong and misleading. And this changes how we think about food. 🧵

[Nick Norwitz MD PhD @nicknorwitz]

It’s not that LDL and ApoB don’t matter. It’s that somewhere along the way, they stopped being viewed as risk factors and started being treated as cardiovascular risk itself. The result is reductionism and tunnel vision, two major obstacles to true scientific progress.

[Alex Klintworth @alexklint]

@Tellit007 In the study you referenced, what were the characteristics of the participants included in the research?

[Alex Klintworth @alexklint]

Headline results like the information about station trials is indeed interesting. However @Tellit007 rarely provides contextual information, which is why I don’t take anything the account says at face values and instead like reading the actual research. You can glean information from population-level results, but that says nothing about the outcome of an individual whose context is not similar to the average population.

I do pantry walkthroughs with new clients on a weekly basis, and based on the contents of almost all of them, I’d absolutely expect an association between ApoB and plaque progression. Population level research is studying people with horrendous nutrition habits, because the vast majority of the population has horrendous nutrition habits. Those research outcomes can’t automatically be expected to hold for people with generally healthy nutrition and lifestyle habits.

[Tellit Likeitis @Tellit007]

A detractor just called this account "basically just a bot" that "references research that is sometimes interesting to read."

We will take it.

The research in question: 170,000 patients across statin trials showing dose-response cardiovascular event reduction.

FOURIER: 27,564 patients, PCSK9 inhibition, significant reduction in cardiovascular events. SELECT: 17,604 patients, 20% fewer heart attacks and strokes in people with obesity.

NATURE-CT: untreated adults with acceptable LDL and a zero calcium score watching their plaque double over five years.

If that is "sometimes interesting," the alternatives must be extraordinary.

Can't wait for them to show us those so we can finally all jump onto the keto bandwagon.

Stay awake my friends.

[Alex Klintworth @alexklint]

@Tellit007 I said I’m not surprised the dietary and lifestyle patterns of a vast majority of Americans lead to an association between ApoB and atherosclerosis.

That association cannot be automatically expected to hold within a different national and lifestyle context.

[Alex Klintworth @alexklint]

@HohlyMohly @tylerblack32 @Tellit007 Ha at least that account, which is basically just a bot, references research that is sometimes interesting to read.