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Mikkipedia: Daily Summaries Delivered
by Mikki Williden
Mikkipedia is an exploration in all things health, well being, fitness, food and nutrition. I sit down with scientists, doctors, professors, practitioners and people who have a wealth of experience and have a conversation that takes a deep dive into their area of expertise. I love translating science into a language that people understand, so while some of the conversations will be pretty in-depth, you will come away with some practical tips that can be instigated into your everyday life.
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The most recent episodes — sign up to get AI-powered summaries of each one.
- 3 days ago50 min
Food Delivery Apps and the Digital Food Environment with Dr Sisi Jia
Sign up to my fatloss in the festive season webinar here. https://www.mikkiwilliden.com/fatloss-in-the-festive-season-2026Save 20% on all Nuzest Products WORLDWIDE with the code MIKKIPEDIA at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.comEpisode SummaryDr 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 TopicsSisi'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 habitsHow the food environment, including paid placement and commercial influence, shapes what we choose, and whether the same thing is happening on delivery appsWhy 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 teenagersNutrition 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 appsHow 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 cafesCommercial determinants of health and personal responsibility, and how community voice helped stop a proposed 24/7 McDonald's in RedfernSisi'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 afterwardsDark 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 BastedWhat 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 socialisePractical 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 groupsChapters00:00 Introduction03:22 From dietetics to public health07:22 Food delivery apps and young people11:03 Nutrition information and kilojoule labelling15:55 How delivery apps nudge our choices22:11 Personal responsibility and community action28:15 Transport hubs and planning policy32:41 Dark kitchens36:53 Regulating the digital food environment40:05 Young people, schools and food courts42:47 Practical tips and food inequities47:00 Youth Well Lab and wrap-upGuest / ResourcesDr Sisi Jia, Youth Well Lab, University of Sydney: youthwelllab.com. Sisi says the lab also shares its latest papers and presentations on LinkedInCassano 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/S1368980024000673Jia SS, Brown H, Moore HJ, Lake AA, Gibson AA, Partridge SR.
- 5 days ago20 min
Can Diet Fix Hot Flushes? What a New Review of Food Trials Found
Sign up to my fatloss in the festive season webinar here. https://www.mikkiwilliden.com/fatloss-in-the-festive-season-2026Episode SummaryIn 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 TopicsWhat the review included: randomised controlled trials of whole foods, dietary patterns or calorie restriction only, with no supplements, isoflavone capsules or extractsWhy most of the trials were in women already through menopause, which leaves perimenopause, when symptoms are often worst, with the least dataThe 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 trialsEquol: 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 othersSoy 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 dayWhy 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 tooWeight 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 differenceWhat the evidence says on mood and cognition, including the Mediterranean, DASH and MIND diets and a trial where exercise, not fasting, improved memoryLara 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 progesteroneA 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 lifeChapters00:00 Introduction: can diet fix hot flushes?02:52 Soy and the headline hot flush result05:00 Equol, soy safety and how much to eat07:10 Placebo, linseed and the weight loss link09:39 Mood, cognition and dietary patterns11:51 Lara Briden's practical recommendations16:04 Running your own n-of-1 experimentGuest / ResourcesO'Neill et al. (2026), Dietary interventions for menopausal symptoms: a systematic review, American Journal of Clinical NutritionViscardi et al. (2025), Effect of Soy Isoflavones on Measures of Estrogenicity: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, Advances in NutritionEffect 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, ClimactericDodin et al. (2005), flaxseed vs wheat germ placebo in menopausal women, Journal of Clinical Endocrinology & MetabolismBarnard et al. (2021), the WAVS trial of a low-fat vegan diet with daily soybeans, MenopauseImayama 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 ActivityEffects 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 ActivityHitchcock and Prior (2012), Oral micronized progestero
- 1 weeks ago1h 36m
Brandon DaCruz - Protein Masterclass: How Much You Need for Muscle, Fat Loss and Ageing
Sign up to my fatloss in the festive season webinar here. https://www.mikkiwilliden.com/fatloss-in-the-festive-season-2026Save 20% on all Nuzest Products WORLDWIDE with the code MIKKIPEDIA at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.comCurranz 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.nzEpisode SummaryBrandon 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 TopicsWhy protein advice is still confusing: "proteinification" of food, lingering myths about kidney harm, and experts with similar authority saying very different thingsWhy training creates the signal for muscle growth and protein supports the response, and why adding protein without resistance training does little for muscleHow 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 womenThe 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 carbFat 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 athletesLean 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 muscleDon Layman's informal 100 g a day floor, and why both hosts increase protein in steps rather than all at onceProtein 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 foodProtein 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 athletesPer-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 mattersChapters00:00 Introducing Brandon and the protein masterclass03:13 Why protein still confuses people08:06 Protein, resistance training and muscle15:54 How much protein people actually eat22:28 The RDA versus an optimal intake27:50 Protein needs for endurance athletes30:15 Protein needs during fat loss39:50 Lean mass, excess body fat and GLP-1s47:45 A 100 gram floor and building up gradually52:35 Satiety and metabolic health1:02:14 Protein quality and plant versus animal sources1:17:21 Per-meal protein, distribution and timing1:26:10 Practical targets by goal and populationGuest / ResourcesBrandon DaCruzIns
- 1 weeks ago20 min
Up Two Kilos After a Big Weekend? Why Most of It Isn't Fat
Sign up to my fatloss in the festive season webinar here. https://www.mikkiwilliden.com/fatloss-in-the-festive-season-2026Episode SummaryIn 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 TopicsWhere 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 weightThe 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 caloriesWhy 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 gainWhat 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 expenditureHow NEAT (non-exercise activity thermogenesis) explained much of the tenfold difference in fat storage between people eating the same surplusThe 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 perimenopauseHow 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 statedWhy energy balance isn't static, and why the energy content of each kilo lost is lower early in a diet and in leaner peopleRerunning 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 surplusWhy the 7,700 rule creates false precision in both directions, from panic after a big weekend to disappointment after week one of a new planChapters00:00 Introduction: the Monday morning weigh-in02:52 Where the 7,700 calorie rule comes from05:17 Why extra food isn't all stored07:30 NEAT and the twin overfeeding study10:29 Glycogen, water and short-term weight gain13:00 Why energy balance isn't static16:15 What a kilo on the scales really means18:09 Big weekends, new diets and what to do nextGuest / ResourcesWishnofsky (1958), Caloric Equivalents of Gained or Lost Weight, American Journal of Clinical NutritionHorton et al. (1995), Fat and carbohydrate overfeeding in humans: different effects on energy storage, American Journal of Clinical NutritionAntonio 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 NutritionBray et al. (2012), Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating, JAMALevine, Eberhardt and Jensen (1999), Role of nonexercise activity thermogenesis in resistance to fat gain in humans, ScienceBouchard et al. (1990), The response to long-term overfeeding in identical twins, New England Journal of MedicineOlsson and Saltin (1970), Variation in total body water with muscle glycogen changes in man, Acta Physiologica ScandinavicaHall and Chow (2013), Why is the 3500 kcal per pound weight loss rule wrong?, International Journal of ObesityLeibel, Rosenbaum and Hirsch (1995), Changes in energy expenditure resulting from altered body weight, New England Journal of MedicineHeymsfield et al. (2012), Energy content of weight loss: kinetic features during voluntary caloric restriction, Metabolism Contact Mikki:https://mikkiwilliden.com/<br
- 2 weeks ago1h 1m
New Zealand Blackcurrant, Fat Oxidation and Recovery with Dr Matthew Cook
Save 20% on all Nuzest Products WORLDWIDE with the code MIKKIPEDIA at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.comCurranz 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.nzEpisode SummaryDr 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 TopicsMatt'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 WillemsWhat 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 effectsWhole 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 extractThe consistent finding that blackcurrant shifts fuel use towards fat at the same exercise intensity, and why that does not automatically equal glycogen sparingMatt'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 areA 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 repeatingResearch 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 womenResponders and non-responders: people burning more carbohydrate at baseline (a higher RER) had more room to respond, and why a smartwatch cannot measure RERA Liverpool John Moores University muscle biopsy study showing greater use of fat stored inside type 1 muscle fibres, and what that might mean beyond athletesPractical 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 recoveryChapters00:00 Introduction03:53 Matt's background and blackcurrant research09:53 Anthocyanins, metabolites and the gut18:20 Whole fruit versus extract24:28 Fat oxidation during exercise27:39 Putting the meta-analysis effect in context31:59 Men, women and body fat36:48 Responders and non-responders40:22 Baseline fuel use and RER43:18 Muscle fat use and metabolic health50:43 Dosing, timing and recovery54:29 Upcoming research and contact detailsGuest / Resources<l
- 2 weeks ago19 min
Live Blood Analysis, Skin Scanners and IgG Tests: What They Actually Measure
Episode SummaryIn 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 TopicsWhy 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 artefactBlood pH is tightly regulated at around 7.4, so a test claiming to show your blood is "acidic" isn't measuring anything realRobert 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 licenceSkin 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 statusThe conflict of interest when the scanner's manufacturer also sells the supplements that raise your scoreIgE versus IgG: why IgG to foods largely tracks what you eat, and why rising IgG4 signals tolerance rather than intoleranceWhy ASCIA, the European Academy of Allergy and Clinical Immunology and the American Academy of Allergy, Asthma and Immunology advise against IgG food testingWhat 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 panelThe costs of unnecessary restriction: avoiding 15–30 everyday foods, food fear in midlife, and months of delay before a proper diagnosisBetter 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 IBSChapters00:00 Introduction00:45 Live and dry blood analysis05:28 Skin carotenoid scanners07:54 IgG food intolerance panels11:02 The IgG-guided elimination diet trial14:28 The harms of unnecessary restriction16:13 Better ways to investigate symptomsGuest / ResourcesRobert O. Young, author of The pH MiracleDr Jim Faed, haematologist, University of Otago Medical School, quoted in the NZ Herald (April 2025) on clinics offering live blood analysisPharmanex BioPhotonic Scanner (S3), a Nu Skin skin carotenoid scannerVeggie Meter, a research-grade skin carotenoid deviceEuropean Academy of Allergy and Clinical Immunology (EAACI) task force report on IgG4 testing to foodsAmerican Academy of Allergy, Asthma and Immunology (AAAAI)ASCIA, the Australasian Society of Clinical Immunology and AllergySingh et al. (2025), A Novel, IBS-Specific IgG ELISA-Based Elimination Diet in Irritable Bowel Syndrome: A Randomized, Sham-Controlled Trial, GastroenterologyLow FODMAP diet (supervised, with reintroduction) Contact Mikki:https://mikkiwilliden.com/https://www.facebook.com/mikkiwillidennutritionhttps://www.instagram.com/mikkiwilliden/https://linktr.ee/mikkiwillidenNZ listeners - save 10% off Calocurb by using the code Mikkipedia10 at www.calocurb.co.nzSave 20% on all Nuzest Products WORLDWIDE with the code MIKKI at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.comCurranz supplement: MIKKI saves you 25% at www.curranz.co.nz or www.curranz.co.uk off your first order
- 3 weeks ago49 min
GLP-1 Medications in Practice: A New Zealand View with Dr Lara Courtenay
Save 20% on all Nuzest Products WORLDWIDE with the code MIKKIPEDIA at www.nuzest.co.nz, www.nuzest.com.au or www.nuzest.comCurranz 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.nzEpisode SummaryDr 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 TopicsWhy 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 prescribersHow Lara came into obesity medicine through gastric balloons in 2020, and a clinic model where patients could not get the medication without seeing a dietitianOlder 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 hypePerimenopausal women who exercise, eat well and still cannot lose fat, and Lara's explanation that the medication lets go of the handbrakePrescribing from a person's heaviest documented weight, taking ethnicity into account, and why both Lara and Mikki see BMI and the word "obesity" as flawedDose 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 barriersWhether 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 manageAppetite 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-ateWhy 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 moreThe 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 HRTChapters00:00 Introduction02:58 GLP-1 knowledge among New Zealand GPs05:31 From gastric balloons to obesity medicine08:24 Older drugs, newer drugs and support11:43 Perimenopause and releasing the handbrake13:39 Prescribing criteria, BMI and the scales18:03 Dose escalation and cost20:53 Coming off the medication25:59 Appetite, under-eating and food noise32:28 Why people plateau37:08 Regular eating and breakfast41:33 Exercise intensity and cortisol45:04 HRT and contacting the clinicGuest / ResourcesDr Lara Courtenay at the MacMurray Centre: macmurray.co.nz/doctors/lara-courtenayThe 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 prescribingThe
- 3 weeks ago25 min
Three Studies, Three Different Answers on Supplements and the Brain
Episode SummaryA 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 TopicsWhy 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 contradictoryObservational studies versus randomised controlled trials, and why observational work is hypothesis-producing rather than conclusiveHealthy 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 measuredThe 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 27Why 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 multivitaminThe 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 oneWhy that omega-3 analysis has been challenged in published letters, covering exposure classification, residual confounding, omega-3 formulation, and its inconsistency with previous evidenceWhat 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 harmThe 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 usersThe 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 replicatedChapters00:00 A headline about supplements and the brain02:11 Observational studies versus randomised trials05:18 Vitamin D and cognitive decline07:53 Small effects, big databases, real limitations11:11 Omega-3, fish oil and the ADNI study15:00 Why the omega-3 findings were challenged18:55 Glucosamine, mice and health records21:59 Bringing the three studies together23:55 Practical bottom lines for each supplementGuest / ResourcesThe article that prompted the episodeNZ 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 discussedVitamin D — "Association between vitamin D supplement use and cognitive functioning: a longitudinal cohort study", BMJ Open, January 2026. Used the US Heal
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About Mikkipedia
Mikkipedia is an exploration in all things health, well being, fitness, food and nutrition. I sit down with scientists, doctors, professors, practitioners and people who have a wealth of experience and have a conversation that takes a deep dive into their area of expertise. I love translating science into a language that people understand, so while some of the conversations will be pretty in-depth, you will come away with some practical tips that can be instigated into your everyday life.
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Frequently Asked Questions
What is Podzilla's Mikkipedia daily summary?
It's a free AI-powered email that summarizes new episodes of Mikkipedia as soon as they're published. You get the key takeaways, notable quotes, and links & mentions — all in a quick read.
How does the Mikkipedia podcast summary work?
When a new episode drops, our AI transcribes and analyzes it, then generates a personalized summary tailored to your interests and profession. It's delivered to your inbox every morning.
Is this an official Mikkipedia product?
No. Podzilla is an independent service that summarizes publicly available podcast content. We're not affiliated with or endorsed by Mikki Williden.
Can I get summaries of other podcasts too?
Absolutely! The free plan covers up to 3 podcasts, any in the catalog. Basic raises that to 15, Pro to 40 and Max to 100. Browse our full catalog at /podcasts.
How often does Mikkipedia release new episodes?
Mikkipedia publishes every few days. Our AI generates a summary within hours of each new episode.
What topics does Mikkipedia cover?
Mikkipedia covers topics including Science, Fitness, Health & Fitness, Life Sciences. Our AI identifies the specific themes in each episode and highlights what matters most to you.
Start getting Mikkipedia summaries tomorrow morning.
Free forever for up to 3 podcasts. No credit card required.
Free forever for up to 3 podcasts. No credit card required.