COR’s Research Roots -- Selecting the Top Lifestyle Intervention Findings

COR’s Research Roots -- Selecting the Top Lifestyle Intervention Findings
Background To care about your nutrition and fitness choices today is to be inundated with competing arguments. Everyone has an opinion about what the ‘optimal’ lifestyle interventions are, and often these opinions are ‘supported’ by some kind of medical research. Unfortunately, the ‘big-wellness’ soundbites that reach the general public obscure as much as they reveal. This happens for two reasons. First, the research these soundbites are based off of hasn’t been filtered or ranked--not all studies are created equal or deliver equally persuasive evidence. Secondly, what most clinical trials of lifestyle interventions observe--but rarely reveal--is the range of responses that individuals have. There’s a big difference between knowing that a given fitness or nutrition practice produces a benefit, on average, and knowing that the practice will have a high positive impact on you, specifically. Step One At COR, we wanted to tackle both of these challenges, so that we could provide individuals with deep and evidence-based insight into what lifestyle practices are best for them. We understood that this was a multi-layered challenge, and that one of the first steps would be to find a way to surface all of the highest quality research. In simple terms, we needed to separate the scientific wheat from the soundbite chaff. As a group of scientists and data people, we came up with an ambitious question: what if we could create an expert ranking system for all the medical/scientific research studies around lifestyle interventions? We knew it would be challenging, but we also knew it was a critical first step. We began by wading through the research and building out an expert system that ranked studies on a scale of 1-3, with three being the highest score. The ranking system consisted of: What was the form of the study? (Randomized controlled study, observational study, meta-analysis, etc.) Was it a human or animal study? If human, how many subjects were involved? What was the duration of the study? What journal was the research published in? How many times was that paper cited by other researchers? We assessed hundreds of studies through this system: Figure 2: Top 5 of 330+ Studies Ranked and Reviewed by COR Experts Step Two Once we had figured out the highest ranking studies, we put them through a secondary round of vetting. We got this subset of studies on fitness and nutrition practices in front of other experts and looked for unanimous agreement on which findings had sufficient evidence in the medical and scientific world to be deemed beneficial. In other words, what met the standards for contemporary medical and scientific consensus? The lifestyle interventions that survived both of these rigorous rounds of screening then became the ingredients with which we built our own COR.RELATE study programs. We selected seven items per program, ran a research study, then normalized and scaled the responses so that they can be referenced by anyone with a COR console. Figure 3: 5 through 10 of 330+ Studies Ranked and Reviewed by COR Experts End Result Why go through all this work? Because individuals who want to know--not guess, but know--what food and fitness practices are best for them deserve to have access to that knowledge. It’s simply not feasible for an individual to read all of these studies, let alone take part in them. By providing programs that have been thoroughly vetted through three different stages and developing a laboratory-grade infrared spectrometer with high precision, COR is offering something entirely new. It enables individuals to see how their body responds in short cycle times. The information they receive is quick and individualized, rather than gambling on full commitment to an ‘average’ benefit. In 21 days, a user can see whether they had a low, average, or high response, and consequently make informed decisions about what is most impactful for them. We call that lifestyle science. - Thomas Quertermous MD, COR Medical Director & William G. Irwin Professor of Medicine, Stanford University References: Figure 1: Williams PT, Wood PD, Vranizan KM, Albers JJ, Garay SC, Taylor CB. Coffee intake and elevated cholesterol and apolipoprotein B levels in men. JAMA. 1985;253(10):1407-1411. Figure 2: Sabaté J, Fraser GE, Burke K, Knutsen SF, Bennett H, Lindsted KD. Effects of walnuts on serum lipid levels and blood pressure in normal men. N Engl J Med. 1993;328(9):603-607. doi:10.1056/NEJM199303043280902 Covas M-I, Nyyssönen K, Poulsen HE, et al. The effect of polyphenols in olive oil on heart disease risk factors: a randomized trial. Ann Intern Med. 2006;145(5):333-341. doi:10.7326/0003-4819-145-5-200609050-00006 López Ledesma R, Frati Munari AC, Hernández Domínguez BC, et al. Monounsaturated fatty acid (avocado) rich diet for mild hypercholesterolemia. Arch Med Res. 1996;27(4):519-523. Zhang W, Wang X, Liu Y, et al. Dietary flaxseed lignan extract lowers plasma cholesterol and glucose concentrations in hypercholesterolaemic subjects. Br J Nutr. 2008;99(6):1301-1309. doi:10.1017/S0007114507871649 Sari I, Baltaci Y, Bagci C, et al. Effect of pistachio diet on lipid parameters, endothelial function, inflammation, and oxidative status: a prospective study. Nutrition. 2010;26(4):399-404. doi:10.1016/j.nut.2009.05.023 Figure 3: Schenk S, Horowitz JF. Acute exercise increases triglyceride synthesis in skeletal muscle and prevents fatty acid-induced insulin resistance. J Clin Invest. 2007;117(6):1690-1698. doi:10.1172/JCI30566 Lloyd C, Smith J, Weinger K. Stress and Diabetes: A Review of the Links. Diabetes Spectrum. 2005;18(2):121-127. doi:10.2337/diaspect.18.2.121 Leifert WR, Abeywardena MY. Grape seed and red wine polyphenol extracts inhibit cellular cholesterol uptake, cell proliferation, and 5-lipoxygenase activity. Nutr Res. 2008;28(12):842-850. doi:10.1016/j.nutres.2008.09.001 O’Donovan G, Owen A, Bird SR, et al. Changes in cardiorespiratory fitness and coronary heart disease risk factors following 24 wk of moderate- or high-intensity exercise of equal energy cost. J Appl Physiol (1985). 2005;98(5):1619-1625. doi:10.1152/japplphysiol.01310.2004 Hartley L, Flowers N, Holmes J, et al. Green and black tea for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013;(6):CD009934. doi:10.1002/14651858.CD009934.pub2