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cover of episode #340 - AMA #69: Scrutinizing supplements: creatine, fish oil, vitamin D, and more—a framework for understanding effectiveness, quality, and individual need

#340 - AMA #69: Scrutinizing supplements: creatine, fish oil, vitamin D, and more—a framework for understanding effectiveness, quality, and individual need

2025/3/17
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The Peter Attia Drive

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我提出了一个评估膳食补充剂有效性和与个人健康需求相关性的框架,而不是提供简单的推荐清单。这个框架适用于各种膳食补充剂,包括肌酸、鱼油、维生素D、维生素B和Ashwagandha。评估的关键在于:1. 是否为了纠正缺乏或达到超常水平?2. 是否为了改善寿命或健康?3. 是否有生物标志物可以追踪?4. 是否了解作用机制?5. 风险与回报的平衡如何?通过这个框架,我们可以更科学地评估膳食补充剂的价值,并根据个人情况做出明智的选择。 在肌酸方面,研究表明它能改善肌肉性能,可能对认知功能也有益处,女性可能受益更大。但目前没有可靠的生物标志物来追踪肌酸的有效性。肌酸风险低,益处适中,建议选择最纯净的肌酸一水合物补充剂。 在鱼油方面,(此处应补充鱼油部分的论述,与肌酸类似,需包含评估框架的五个问题,以及研究结果和风险评估) 在维生素D方面,(此处应补充维生素D部分的论述,与肌酸类似,需包含评估框架的五个问题,以及研究结果和风险评估) 在维生素B方面,(此处应补充维生素B部分的论述,与肌酸类似,需包含评估框架的五个问题,以及研究结果和风险评估) 在Ashwagandha方面,(此处应补充Ashwagandha部分的论述,与肌酸类似,需包含评估框架的五个问题,以及研究结果和风险评估)

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In this "Ask Me Anything" (AMA) episode, Peter explores the complex world of supplements by introducing a practical framework for evaluating their effectiveness and relevance to individual health needs. Rather than providing a simple list of recommendations, Peter aims to equip listeners with the tools to critically assess supplements on their own. He then applies this framework to discuss research on several popular supplements, including creatine, fish oil, vitamin D, B vitamins, and ashwagandha. Additionally, he covers key factors in assessing supplement quality, helping listeners develop a deeper understanding of how to make informed decisions based on their personal health goals.

If you’re not a subscriber and are listening on a podcast player, you’ll only be able to hear a preview of the AMA. If you’re a subscriber, you can now listen to this full episode on your private RSS feed )or our website at the AMA #69 show notes page). If you are not a subscriber, you can learn more about the subscriber benefits here).

We discuss:

  • Overview of episode topics [1:45];
  • How Peter evaluates patients’ supplement regimens, and common misconceptions about supplements vs. pharmaceuticals [3:00];
  • A framework for evaluating supplements [6:15];
  • Evaluating creatine: purpose of supplementation, dosing, and mechanism of action [10:00];
  • Creatine: proven benefits for muscle performance, potential cognitive benefits, and why women may benefit more [15:15];
  • Creatine: risk vs. reward, kidney concerns, and choosing the right supplement [18:45];
  • Evaluating fish oil: its primary purpose as a supplement and how to track levels [20:45];
  • Fish oil: how omega-3s impact inflammation, heart health, and brain function, and the strengths and limitations of current research [26:30];
  • Fish oil: the risks of supplementation, guidance on selecting high-quality products, and how to determine whether supplementation is appropriate [37:30];
  • Evaluating vitamin D: understanding deficiency and optimal levels [45:15];
  • Vitamin D: role in bone health, immune function, potential longevity impact, and biomarker limitations [51:15];
  • Vitamin D: efficacy, safety, and balancing risk vs. reward [58:15];
  • Evaluating B vitamins: function, consequences of deficiency, and key biomarkers to assess whether supplementation is necessary [1:02:15];
  • B vitamins: risks for CVD and dementia associated with deficiency, and limited evidence for general population supplementation [1:07:15];
  • Evaluating ashwagandha: background, uses, and mechanism of action [1:15:30];
  • Ashwagandha: current evidence for its effects on sleep, stress, and anxiety [1:19:15];
  • Ashwagandha: evaluating supplement quality, safety profile, and the risk-reward balance [1:22:15];
  • The importance of using a structured evaluation framework to assess any supplement [1:26:30]; and
  • More.

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