Learning from Case Studies
by Kamal Patel
Case studies offer an interesting perspective on scientific observations. They describe a unique or abnormal event, unlike trials that propose a hypothesis and have an experiment done to test it. There’s no sample size calculation or control group, just one lone, solitary person. So what does this mean when it comes to collecting evidence?
Due to the nature of a case study, it cannot be used as strong scientific evidence, even if it is indexed in PubMed.
Still, case studies can provide valuable insight into potential patterns that should be studied further. For example, more than ten case studies note marijuana usage about one hour before a heart attack or similar cardiovascular event. As it turns out, marijuana can increase heart rate and diastolic blood pressure. Examining this series of case studies could prompt a researcher to dig deeper into the relationship between marijuana and the cardiovascular system.
Official dietary guidelines generally recommend that everyone should get between 10-20% of their daily energy from protein, and some health authorities even argue that high protein diets (>20%) have adverse effects on health. Even though people who are very physically active have higher protein needs, the recommendations still apply as these individuals usually consume more total calories. However, if we look at the human dietary patterns throughout our evolutionary history, it’s clear that the average protein intake in most countries today is on the low side. While this doesn’t mean that high protein diets are necessary optimal, the mismatch between the typical protein intake in the western diet and the average protein intake in ancestral diets, in combination with the scientific evidence showing the benefits of “high” protein diets for weight loss, muscle growth, and prevention of several types of chronic diseases, suggests that the official recommendations are lower than optimal for many people. This is especially true for strength trainees and other physically active people who want to maximize protein synthesis and gain muscle and strength.
“All disease begins in the gut”
About 2000 years after the father of medicine said these words, the emerging field of microbiome science and increased focus on the gastrointestinal tract in health and disease have revealed that Hippocrates was probably right all along. Of course, saying that all disease begins in the gut is clearly stretching the truth, but science shows that it’s definitely ground zero for a lot of the ills that run rampant in the modern world. Since around 70% of our immune system is located in and around the gastrointestinal tract, it’s clear that taking good care of the digestive machinery is a good idea if you want to live a long and healthy life. Also, besides the obvious impact on general health, good gut health is also of special interest to those who are interested in fitness, as it in many ways is a key to optimizing workout results.
Are we returning to our ancient ancestors way of eating? Internet search trends and the enormous traction the caveman diet has gained over the last decade (especially the last couple of years) might suggest so. The paleo diet was the most googled diet of 2013, and many strength trainees, athletes, fitness enthusiasts, and even housewives and folks who previously weren’t especially interested in nutrition and health now swear by the paleo diet as a way to build a strong, fit, and healthy body.
However, not everyone has jumped on the bandwagon; with the amount of mainstream attention and popularity of the paleo diet, criticism and controversy are also inevitable. This surge in negative press and articles out to debunk the paleo diet has been especially apparent over the last couple of months, and it even seems that we’re heading to a place where it’s cool to lash out against the very idea of eating like our hunter-gatherer ancestors. This criticism probably stems from the fact that the paleo diet goes against most conventional dietary wisdom, and that most people aren’t ready to give up grains, milk, and other common staple foods in the western diet and therefore rather mock the very idea of eating like our “simple-minded” prehistoric ancestors.