I continue to find Attia deeply knowledgeable in some aspects of healthspan research, especially as related to pharmaceuticals and exercise. In contrast, though, the more I read, the more I see strands of dogmatism in his thinking that lead to his not being well informed. The worst, I suppose, was listening to a sometimes glib presentation on organic fruits and vegetables in which Attia was not only poorly informed but incorrect in places, such as when he repeatedly considered concerns about the “pesticide” glyphosate to be questionable science.
Yesterday, I happened to read an Attia newsletter in which he proclaimed the last nail to have been driven into the coffin of resveratrol as a healthspan supplement. This latest determinative “nail” in Attia’s judgment consists of five studies examining endpoints of resveratrol supplementation. Three studies were four weeks in duration, one was three months, and the last six months, at respective doses of 500, 150, 150, 150, and 250 mg/day.
In considering the implications of these three very short and two intermediate length studies, Attia noted, ". . . resveratrol activated a class of enzymes known as sirtuins, which were thought to mediate the well-documented health- and longevity-promoting effects of calorie restriction – effects which include reductions in oxidative damage and in chronic, systemic inflammation (italics mine).
My first concern went to the very short duration of three studies but I thought that we still might expect to see reductions in inflammatory markers in 28 days. My second concern went to the mostly low doses. It was beginning to look like the studies we see so often when a pharma-driven study examines the effects of an OTC nutritional supplement. Based on the research, I would think 250 mg/day of resveratrol might be a reasonable floor dosage and 500 mg/day might be a ceiling.
So, what were the endpoints of these studies? Well, inflammatory markers for sure, perhaps only those markers for the ultra short studies. Nope! Here are Attia’s own words that he found worthy of a coffin nail:
"Analyses of circulating triglycerides and insulin levels utilized data from all five studies (n=267), while four studies (n=177) were used for analysis of total cholesterol and three studies (n=87) supplied data for analysis of HbA1c and liver enzymes (AST and ALT). In their evaluation of plasma lipids, the authors reported that changes in both triglycerides and total cholesterol were statistically equivalent between resveratrol and placebo treatments, though resveratrol treatment was associated with a trend toward higher triglycerides than placebo (SMD=0.11; 95% CI: −0.14 to 0.35; P =0.39). No significant differences were observed between resveratrol treatment and placebo in effects on HbA1c, insulin, or the liver enzymes AST and ALT.
Given that the observed reductions in CRP, IL-6, and TNF-α with resveratrol are decently supported by the research (as well as IL-1β, monocyte chemoattractant protein-1, and NF-κB ), it is difficult to understand the endpoints in these five studies. It is even more difficult to understand why Attia considers them to boot resveratrol out of the healthspan game.
I don’t think anything else needs to be said as the main point is not about resveratrol.
