All right, welcome back everybody to the Building Life on Athletes podcast. Thanks so much for stopping by. I really appreciate it. For those of you who haven't had a chance to meet me yet, my name is Jordan Renicki, and I'm a dual award certified physician in family and sports medicine. And the goal of this podcast is to keep you active and healthy for life. Through actual evidence-informed education. So, we kind of take a wide range of things and talk about it, whether it's exercise, rehabilitation, nutrition, all those fun things you talk about. Past couple weeks, we've been doing more specifically deep dives on videos that I find. So, kind of breakdowns of them, understanding the thought process behind the videos and looking at the claims in them. I've had a lot of things in my life that have made my life a little bit busier. And so I'm trying to do things that are streamlining a little bit. And sometimes this is a little easier than doing a ton of research for deep dies. I promise I won't get rid of those. I'll continue to do those intermittently. Right now, this is just how we're doing it. Today, we're going to kind of do a React video as well to a video that I found. So, we'll hop in here dual screen. For those of you who just listen to the audio version, this is a video here, but you'll hear the audio clips are the most important things. And so, we're going to kind of run through this and see what happens. But first of all, let's start off with the claim. A new randomized controlled trial finds that intermittent fasting increases human growth hormone by over 1500%. Okay, and that right there, this is the reason why I picked this video, right? I was scrolling. Every time I do a reaction video, it's from something that I've seen myself, right? So it's never like I go out looking for something, let's try to debunk something. I just find things interesting. Like when I see a number that's 1500, I'm like, dang, that's huge, right? That's a huge number, huge claim. Big claims require big evidence, and so I wanted to see what this is all about. And it's a big, important one, right? Talking about HGH, human growth hormone. Who doesn't want that to be increased, right? So, big, powerful claim here, huge magnitude, you know, talking about This is a randomized controlled trial. So there's just so many things that, like, right away clicked, like, oh, this is really, really important. And so, once again, we're going through this. This is just my thought process, how I look at things. This is not an attack ever on anybody or anything. We all make different interpretations of things. And that's the thing, like, I'm not a smart person. I'm really not. And so I wouldn't want someone coming looking through my stuff and be like, oh, here's where you messed up. So that's not what I'm trying to do at all. This is more just me kind of understanding, looking through there, what we're looking for, what the study shows. And so that's the first thing. So let's talk about it real quick and keep going. We're going to break down this fascinating analysis of a randomized controlled trial that involved, for the first four weeks of the protocol, there was a control arm that just did ad libidum feeding for the 26-week clinical trial. Whereas the intervention group, for the first four weeks of the 26-week trial, fasted for two days a week, a non-consecutive day, water-only fasting for 24 hours. Then, after the first four weeks, the first month, For the next 22 weeks of the 26-week humid clinical trial, the subjects just did a one-day-a-week water-only fast. And leading into the study, they looked at baseline levels of human growth hormone, HOMOIS score, metabolic health, insulin, C-reactive protein, blood sugar health, and so forth. And again, what they found that I think is. Okay, so we're just going to take a quick pause right there. So, first things first, he's saying, hey, we're looking at this randomized controlled trial. What he doesn't include is that he mentioned the whole title there. So, the big clip is actually, it's a, the whole study is a Randomized controlled trial looking at multiple things, it says it's secondary analysis. So, secondary analysis. So, the first thing that I want to mention is that that's a big deal, right? So, when he's saying, hey, this is a randomized controlled trial, looking at Human growth hormone, that's not what the outcome was at all that they're looking for. So, specifically, a secondary outcome is essentially something called an ad hoc analysis. So, when we talk about ad hoc, that essentially means after the fact, right? And so this data does come from an RCT, kind of, right? So he's not like completely off on that, but the original trial was something called the Wonderful Trial. So the paper he's citing. Here, though, is a secondary analysis of this earlier trial, right? The primary outcome of that original trial was to see if fasting could lower LDLC. And the original result, the study's primary goal, failed, right? There was no significant difference in LDL in the fasting groups. And so The first step, that was what they're looking for, this main goal, looking at LDL. They didn't look at it, but they also looked at secondary goals, looking at improving insulin resistance through something called a HOMA IR score. And that did succeed. It was helpful. And then this specific study here, the researchers did a new post hoc analysis exploring that HOMA IR finding more deeply. And so, once again, of the initial paper, the initial primary objective didn't really meet what they thought they were looking for. So then they went down, and they found the secondary outcome was positive. So, this secondary analysis, this ad hoc analysis, is looking further into that. And we have to remember as well: when you do a primary study, right? So, the primary randomness control trial. The entire study is built off of that and made for that, right? So the number of people you have, the statistical methods you do, the power analysis that you do is all built towards that. And so, any other downstream event, like you pretty much can't tell any causality from that because the original study wasn't powered to look at that. So, specifically for this. Human growth home. We'll talk about why that's not actually what they're really even looking for in the study, but that this is not power for that. And so any outcome we get from here is just to like Create something to talk about to essentially produce a hypothesis or something along that line. That's what we're going for. And so that's just an important thing here. They say, hey, this is an RCT randomness control trial. Kind of, but not really. I mean, this was definitely not a randomized controlled trial in the sake of like, hey, that's the outcome we're looking for. It's a secondary look at this. So, once again. Kind of misleading right away, right there. So that's just something I did want to mention and kind of, yeah, just see that. So that's just number one here when he says this is a random control trial. No, that's pretty much not. So we'll dive in here. It's quite interesting, is this association with a 1500% increase in human growth hormone, particularly if subjects had low baseline levels of human growth hormone at the start? Of the protocol. We're looking at figure two here, part B. Now, I want to continue on, but first, thank you for being here. If you're enjoying it, all right. So, we'll break into this. So, he's saying, hey, looking at when you had a low baseline level of HDH. These people, after they fasted, had an enormous 1,500% increase. That's off the chart, right? That's huge. You can see the number here. The big red arrow is pointing the same: 1,500. And so. Let's dive in a little bit here. So, what I'm going to do is actually pull up the paper. So, you can see this is the same chart that he's looking at here. So, same thing right there, there, and there. He just blew it up. So, right here, we're looking at And you can see that yes, this does indeed exist. And it does say 1518. So 1518%. That is there. That doesn't indeed exist. But let's talk a little bit more. Let's dive into that. So, what he's saying is: hey, These results happen at, you know, when they faceted, we saw 100% increase. And if you look at a box plot here, This is just probably misinterpretation of the box plot. So, a box plot, if we kind of break it down here, there are a couple different things we look at. So, overall, you see there's a large rectangle. If you're on the audio version of this, I apologize, I'll kind of walk through it. There's a A large rectangle that is vertical. And from there, we have what we call whiskers off of that, which kind of indicate the uppermost level. Then down below, we have whiskers as well. And so If we start from the top way up here on the whiskers, that is what we're looking at. Those are like the biggest outliers, right? So that's the highest value that we found in the study. It's an outlier. They pretty much don't include. You go all the way down the bottom, the whiskers going out. That is also the same thing there. It's an outlier on the lower side there. And the box, though, the box is the main thing where the vast majority of the data kind of falls, and the vast majority of them go in there. What he's pointing to the top of the box, producing that box plot, is typically the 75th percentile value. So that means here that 75% of people in that group had a result less than or equal to that number. So by using this number, you're saying, hey, This is what people got in the study. That's not actually the case at all. This is a 75th percentile. This is representing an upper range value as if it were the main outcome. So, if you actually go down further than the block spot, so the bottom-bottom Part of the rectangle would be 25th percentile. And then this little black line here. So, this little black line, and you might or may not be able to see. If you're listening to audio, believe me, it's there. But this black line here is representing the median. So the median right there. So that's probably what most people actually want to see. So the median is the bold line. And if you look next to it, that says 45%. So, the median increase in HDH for those people at a lower baseline level after fasting was 45% and definitely not 1500%. So, I'm not saying once again, this is like malicious by any sense of the imagination. This is just, you know, we saw the data. I interpret stuff incorrectly literally all the time. I'm not worried about that at all. I just want to clarify there. There are some studies I have seen talking about, hey, fasting can produce increases acutely, shortly. Of like 1500% Aucasian people. And so it's not like insane that we would see that. And there's obviously going to be a lot of variability there. But to say on average, that's the case, that's just really not the case. But you can see huge variation, right? So we have people over 2,500, which seems to be an outlier. And then we have people way down here, which is like pretty much did nothing. And so big, big, big variability there. So on average, that's not it. And another thing worth mentioning that is actually. Very, very important to mention is that we talk about these results, hey, 1500 or 45%, but like ultimately the paper's conclusion was that for HGH, there was actually no statistically significant improvement. So it was like 0. 32 was the Uh, p-value. So, there was actually no statistical improvement in HDH levels based off of that. You could see a huge variability right there. So, they say, hey, based off of that, we couldn't see it on top of that. What it doesn't worth mentioning is in this specific subgroup, there were eight participants. So, eight participants. So, you can have a huge skew because of just how small of a sample size you have. And so Overall, the study's own authors concluded there was no statistically significant increase in HGH. There was a huge range. There were eight participants. So, overall, we definitely can't say, hey, This is something. This is definitive. We can do that. That's definitely not what's happening at all. Things worth mentioning as well: overall, the secondary analysis here included a total in this entire paper of 68 people. So, one scan. I'm not complaining at all, but this had 68 people. And then, when we classified even further into that low HGH fasting group, it showed an N of eight, so eight samples. So that's a huge red flag, right? So basically, Saying that 1500% increased claim on just eight people is scientifically absurd, essentially. You know, with that small of a group, a single person with an unusual response can completely distort the entire result, right? And that's also probably why it wasn't significant, right? Because we had so much variability there. Going on there. So, the foundation for this claim initially is that 1500% is statistically non-significant. We really shouldn't be mentioning it. And that's not where we want to go. And as I mentioned, though, you can have big increases like this, right? 1500%. I've seen that in acute things that before. It's not unheard of to have that, but certainly this is not chronic as well, right? So he's going to say, hey, this is what's going on and go from there. So let's see where he continues on with this. From the content, please hit that like button. Be sure to share this video with a friend and let me know what you think in the comment section below because human growth hormone is really, really important for Obviously, fat loss for preserving muscle mass and helping to prevent muscle catabolism during intermittent fasting periods. But since we're talking about fasting, a tool that may help you is the novel Burberry. Nice, there it is. So, kind of interesting. Spoiler has, I have seen this before, right? It's not the first time I've seen that. But, you know, he's saying, hey. Human growth hormone is important. Like that, that's like a no-brainer. It is important. It is very important for what it does. Is it kind of as it increases when you're fasting, it helps mobilize fuel so that you're not breaking down muscles necessarily and that you have, yeah. Yeah, it's very, very helpful in lots of circumstances. It's good for growth, it's good for muscle growth, it's good for keeping on muscle, all those things. Very, very important. But then he says, Hey, fasting. Is really important. And then, hey, by the way, here's a supplement that may help you. I'll be honest with you. He does say, like, hey, if you're interested, it may help you. And so he's certainly not like shilling it in that, like, hey, this is going to cure everything. But it was a nice segue saying, hey, like. Look how important fasting is, by the way, if you want to fast. So, once again, these are just all things you think about. And when I watch things, say, hey, how does this fit in? Like, once again, I'm not questioning his academic integrity by any means. And I'm not saying you can't make money. I think everyone needs to make money, especially if you're providing quality education on YouTube. You deserve to make money. And that I'm totally fine with that. But you just have to understand, hey, where is this coming from? It's the same thing if you read a paper saying, hey, that X medication is the best medication in the world. It does, you know, X, Y, and Z, all these things. And you look in the funding, it's like. By the company that makes that drug, right? You just got to understand what is the source in this. And so I'm not saying you can't ever be fully unbiased, right? Like I have my biases, like as 100%. That's never going to be like, hey, I'm completely unbiased, but just understanding that, hey, Did we frame this and that? Hey, look how important that fasting was. And then you see this nice product placement there. To me, I kind of shrug my shoulders a little bit. I don't know necessarily, maybe this is just kind of he has a whole. A lot of things he talks about with fasting and whatnot. I mean, that's certainly something he talks about quite a bit. But I thought it was kind of intriguing that we talk about this: how important fasting is. Look at the huge Increase in HDH. By the way, I have a supplement that can help you do better with that. Once again, I don't think it was a hard sale by any means, but it definitely turned into a little bit of sales pitch and it was kind of interesting there. So, we're going to fast forward that and kind of talk about what else is going on, what HGH, what it's talking about. So, let's see what he talks about with the rest of the video. 100% increase in human growth remote. Now, why might that be? Well, it turns out that human growth hormone is released when we fast. Now, why is that? Well, When we fast, your body needs to create energy for your brain because free fatty acids don't directly or easily transport into across a blood-brain barrier. We need ketone bodies. There are transport proteins called the monocarboxylate transporter in the brain where pyruvating ketones can go into the brain. And how do you get ketones? Well, you get ketones. By breaking down fatty acids that are stored in your fat cells or adipocytes. Those fatty acids are packaged into ketones, namely beta-hydroxybutyrate, but also acetoacetate and others. In the liver. The liver is repackaging the broken-down fat from your fat cells when your glucose, insulin, are low and your glucagon is high. And glucagon and insulin are, of course, released by your pancreas. And that metabolic environment causes increased pulsatile secretions of human growth hormone, which serves two purposes. Number one, to help liberate those fatty acids from fat tissue to help make the ketones and also help just utilize fatty acids for fuel and metabolic processes. But secondarily, and equally as important, human growth hormone helps prevent the catabolism of skeletal Muscle. So that's what's really interesting. And yeah, I think overall that's pretty spot on. I like that. I think he's it's important to say, hey, this is why we care about HCH, that's why we care about fasting, all these things. And yeah, he's pretty much spot on. The idea behind HGH in this setting, in a fasting setting, is to mobilize free fatty acids so you have fuel, right? You're not bringing anything in, you need to somehow make fuel. And once you burn through short-term reserves, you got to dip into the fat stores a little bit. So that's totally fine. And then maintaining muscle mass, right? So that's a big Really important thing, right? People talk about don't fast. I want to extend it fast, we're going to lose protein, and you will lose some muscle if you do extend it fast. But the question is, you know, for a single-day fast here in the study specifically, was like a day fast. They did it twice a week for a little while at the start and then did once a week. Does it have significant changes in muscle mass? There's kind of different studies showing varying things that you know, some short-term ones seem to be pretty fine, longer-term, you start to show a little bit of muscle breakdown, and so it's kind of That here and there, and obviously, every study is going to be different as well. But there's numerous benefits. So, overall, though, I think that's pretty much spot on in terms of why we care about this and why we care about fasting. And growth hormone does a lot of good things for cellular repair as well. And so, I've even seen people talk about. Hey, when you're doing a fast, it helps with your inflammation, and there's truth to that as well. It can decrease inflammation. There's lots of things it can do. I mean, so overall, I agree with that. I think that was good. You know, he kind of goes through the rest of the video and talks about hey, maybe helps with aging, uh, in HGH is increased with long-term risks. Let's listen to that section as well here. But this is a really interesting human clinical trial. And it turns out that low human growth hormone levels are linked with increased risk of cardiovascular disease, accelerated aging. Problems in the brain, memory loss, cognitive issues, and beyond. So it's important. And one way that you, or two ways that you can improve growth hormone, it turns out. Is by focusing and prioritizing your sleep and also periodic fasting. And so, I think a one sweet. So, yeah, as you mentioned, very important. And he did talk about loves this human trial. Like, this study is not a good study. Like, I'm going to say that right away. And I don't mean that disparagingly at all. Like, it is a secondary analysis, you know, post-hoc analysis with looking at it. I think it's great for discussion, but from this, I can't really determine anything. You know, it is worthwhile mentioning, though, that These results that we see, this fasting, are acute spikes, right? So acute spikes in hemogrowth hormone. Doing them repeatedly doesn't seem to show that It long term leads to an increase in HH. In fact, like the author of this study did another one looking at a 24-week study of intermittent fasting or kind of like a 24-hour fast. And did it chronically elevate HH? No, it didn't, but it acutely did. So you kind of have these spikes. And maybe that pulse health spike is helpful for people long term. That may be helpful, but it certainly isn't increasing your H. But I do like that he mentioned sleep, like that's super important. Pretty much everything shuts down if you sleep. It's like The bad stuff happens like that goes up, and the good stuff goes down, and so sleep is very, very important. And so, but yeah, fasting can play a role with health. I'll probably do a whole other podcast all about Fasting in benefits and whatnot, but he is right on that. But in terms of you are not chronically going to increase your HH. Like fasting is not like a technique you should use, like Don't go fasting for 10 days and expect your HDH to be like through the roof in a good way. It's gonna be there, just it's gonna be try to be helpful to hang on to stuff. So, yeah, will it be elevated if you're fasting? Yes, it will be elevated while you're fasting. But, like, chronically, if you keep doing this back and forth, like, it'll kind of be cyclical, right? It's not just all of a sudden find a new baseline, like, oh, it's just high now because I intermittently fast every once in a while. That doesn't seem to be the case, and we know that just like By viewing things. If you are not eating for 10 days, like, oh, your HDH is high, but like, your muscle mass is going to go down, right? Because your body's eating itself a little bit. And so it's one of those things: like, oh, just because my HDH is good. Who cares? There's obviously other outcomes, right? Some people say, oh, when I fast, I feel mental clarity, or my inflammation goes down, and all that stuff. I've personally seen that. Like, when I do fast, my joints tend to feel better. That's what happens. But understand there's different outcomes. But if you're looking for, like, hey, this is really important for. Muscle and hang on to that, definitely wouldn't recommend fasting for a long, long time because we might have some long-term stuff down the line that could be an issue. And so Overall, this is kind of an interesting one. I do think this was cool just to mention and talk about like the study. It's probably not one I would have picked to talk about specifically, but it was more of like, hey. On social media, we see these things, right? You're scrolling, you see this HDH by 1500. You say, Holy cow, that's crazy! And you look at it, and then you look at the video and you say, Hey, that number's on there. Yeah, that's crazy. That's up. But if you don't actually take a look and go in, it's a lot harder. And this is something I see all the time, right? So And I dealt with this all the time, just through us as a physician, is what happened, right? Someone comes in with, you know, they heard something on social media and they say, hey, look at this. And you say, oh, okay, well, let me look at it. And you take the time and you look. You know, whether it's from family, friend, or patient, you take the time to look and say, Hey, let's critically look at this, and you say, Oh, that's that's not the case at all. It's actually very different. Sometimes it's nuanced, meaning, hey, you're kind of there, but it's a little different. Other times, it's like way off base, not even close. But the problem is, it takes me so much longer. What I had to do here, he didn't see the link in his description of where this paper was. So I had to, you know, take a screenshot of the video title, search it, find it, go through, look there, open that. So it took all these steps for me to do this. And for most people, they're just not going to do that, right? I'm a huge nerd, so I did it, right? That's what I do. It's my hobby. Here I am making videos on YouTube. But for most people, they're not going to do it. They're going to read the headline and say, Oh, that's crazy. That's cool. Let's go. But even the thing, but for me, is even if you read the headline, like Or the abstract, like that's not the headline here. Like, that's literally not the takeaway. It never was. And so, that's one of those things where it's just you really have to look into stuff that you're going to understand and believe, right? I know I'm selling a broken record, but I say pretty much like trust, but verify, trust but verify. Even me, like things I say, please verify what I say. And if I'm wrong, please let me know. That's the big thing for me. I never want to be wrong. Nobody wants to be wrong, right? And I don't ever try to maliciously be wrong in terms of, hey, I'm going to misinterpret something for my betterment. I just like, I just don't need that in my life. I'm in a place where I care more about having integrity, and that's a big thing. And once again, not throwing shades saying people don't have integrity online, they aren't trying to do anything. I'm no way saying that's what's happening. But some people might do that. And so I want you to be able to have the tools to look at something critically and understand: hey, is it going on? So, this paper, kind of interesting in just an example of just critical appraisal, how to read a chart, a box chart, how to look at the study. So, all those things. But I wouldn't say that. Because of fasting, you're going to increase up your HH 1500%. You might, you might, but that's based off of this data, that is not what we're looking at here. So, overall, Yeah, we kind of ignored some big real findings about the paper, but that's okay. But overall, short-term-wise, may increase fasting. I'm sorry, I may increase your HDH a little bit faster. And once again, that's not even what they looked about, so I don't really care. But once again, if you see something on social media that has an extraordinary claim, definitely be skeptical, right? So these results that seem to be too good to true require extraordinary proof, right? So huge claims require huge data. That's what I say all the time. Look for sample size here. We saw a tiny sample size of eight in that specific subgroup. So, like, pretty much right away, all you can do is go to look at that and say, oh, it's kind of interesting. And you can kind of move on from there. So, check in the sample size. Understanding, you know, is this acute? Is this chronic? Looking at all that stuff, and then ask the motives, right? Like, where's this coming from? Where's the funding coming from? Are there other conflicts of interests? All those things look for. Hopefully, by watching this, you can learn to ask some more questions, look through literature or videos, and kind of cut through the hype, focus on the real evidence, and make truly informed decisions about your own health, right? That's ultimately all I care about is you. Doing what's best for you. I don't care if you disagree with me. I don't care if you think I'm stupid. That's fine. Hopefully, do it in a respectful way. But I'm not hurt if you don't take my advice or think I disagree on something, disagree with something. That's totally fine. I just want you to be able to critically analyze things, think for yourself, and then make informed decisions. That's ultimately what it comes down to. I tell people all the time: you're an adult, you're an autonomous human being, you can do what you want. I just want you to be fully informed. And so that's kind of where we come from here. But I do appreciate you listening and stopping by for the whole way here. If you did find this helpful, it would mean the world if you shared it with someone, either a friend. Or on the internet, the interwebs, see what goes on there, or just either like it on YouTube or subscribe on your podcast platform of choice. That'd be very helpful. But that's going to be it for today. Thanks again. Now please get off your phone and get outside. Have a good rest of your day, and we'll see you next time. Disclaimer, this podcast is for entertainment, education, and informational purposes only. The topics discussed should not solely be used to diagnose, treat, or prevent any condition. The information presented here was created with an evidence-based approach, but please keep in mind that science is always changing, and at the time of listening to this, there may be some new data that makes this information incomplete or inaccurate. Always seek the advice of your personal physician or qualified healthcare provider for questions regarding any medical condition.
