- In this short video about self-tracking and Crohn’s Disease, “tension” between doctor and patient (“Ari is a sensitive person. He let me know that he respected my knowledge and experience,” says Ari’s doctor, presumably in response to a question) receives more attention than the treatments Ari tried.
- Nature — the most prestigious scientific magazine in the world — makes a climate scientist look better than he actually is. “ Nature suppressed [Phil] Jones’ candid admission that he simply didn’t see why he should provide [climate] data to people that wanted to criticize him and substituted a fabricated explanation.”
- A talk critical of research universities, such as Berkeley. He criticizes careerism, for example.
- Melissa McEwen explains how SCD (the Specific Carbohydrate Diet) — very useful against Crohn’s disease and similar problems — can be improved. Via Perfect Health Diet.
Month: January 2012
Tonsillectomy Confidential
I wrote a piece for Boing Boing about tonsillectomies that has just been posted. It stemmed from a comment on this blog by a woman named Rachael. A doctor said her son should have a tonsillectomy. When Rachael did her own research, however, it seemed to her that the risks outweighed the benefits. I looked further into tonsillectomies and found that the risks were routinely greatly understated, even by advocates of evidence-based medicine.
More Here is a page on a doctor-run website called MedicineNet that grossly understates the risks of tonsillectomies. Compare their list of possible bad effects to mine.
Why We Touch Our Mouths So Much: Forewarned is Forearmed
When I taught Introductory Psychology, I came across a study in which researchers put people in a room with food and watched them. They were looking for cycles in eating and drinking. They noticed that their subjects spent a lot of time touching the face near their mouth — what they called “the snout area”. After I read that, I noticed the same thing countless times. Right now I am at an airport waiting for a flight. Looking around, I see three of about 50 people touching their mouth or nearby.
Why do we do this? I propose an evolutionary explanation: To expose our immune system to all the germs near us in small amounts. Mouth-touching is part of a larger sampling process: 1. We touch many things constantly. In particular, we shake hands, hug, and otherwise touch people near us. Germs that have managed to live in or on other people are the most dangerous. 2. We lick our lips often, moving germs on our lips inside our mouths. 3. When you eat, food transfers bacteria from the inside of your mouth to your tonsils, which circle your throat. Tonsils are full of lymphocytes, the immune-system cells that detect germs. Once we have developed antibodies to a microbe, of course, we are much less vulnerable to it. The whole sampling process is a kind of self-vaccination.
We need conventional vaccination when self-vaccination fails. Polio vaccination was the first big vaccination program, and it worked: polio was nearly wiped out. Before around 1900, polio was not a big problem. It became a big problem at roughly the same time that public health measures and the replacement of horses by cars caused cities to become much cleaner places. Others have theorized that this is why polio became a big problem. As recently as 1951, thousands of children died from polio.
This is related to but different than my ideas about our need for fermented food. (I believe we need to eat plenty of fermented food, day after day, to be healthy.) When we eat fermented food, we ingest large amounts of bacteria that are familiar and safe. The amount is large because the food has been fermented. The bacteria are familiar because we eat the same food repeatedly. They are safe because the insides of our bodies are dramatically different than what we eat (e.g., different temperature). The sampling system I am proposing here exposes us to small amounts of unfamiliar dangerous bacteria. However, this sampling system and the factors that push us to eat fermented food (our liking for complex, sour, and umami flavors) both act to produce the best environment for our immune system. Fermented food resembles exercise and practice; the mouth-touching system resembles information.
A similar sampling system is our love of gossip. We love to hear it, we love to spread it. Gossip spreads information about the dangers around us. Again, forewarned is forearmed.
I am in Tokyo (for a few more minutes), an admirably clean city. Public rest rooms, for example, are convenient, clean, and free. (Unlike New York, Los Angeles, San Francisco, Beijing . . . ) The practical point of this idea isn’t that there is something wrong with public health measures, it is that they can go too far.
Assorted Links
- Edward Jay Epstein on The Lessons of Le Carre (the spy novelist)
- Gary Taubes recommends five excellent books, including Weston Price.
- This article about the Marc Hauser case tells a brief story about a Harvard coverup in the 1960s. “In the late 1960s I was eating lunch in William James Hall with a few fellow assistant professors in the Harvard psychology department when a woman named Patricia Woolf sat down at our table. . . . She asked whether we had heard anything about the fabrication of data by one of our colleagues.”
- This sad and fascinating post tells how pediatricians encourage Vitamin D deficiency by warning parents to keep children out of the sun. Then, making things even worse, children with broken bones due to Vitamin D deficiency are assumed by pediatricians to be victims of child abuse. “Dr. Carole Jenny, head of the American Academy of Pediatrics Section on Child Abuse, implies such tragic miscarriages of justice simply don’t happen. She then claims, “We have been checking every child with multiple fractures for metabolic bone diseases for several years and have not identified a single child with vitamin D deficiency.” How can that statement be true if every other researcher is reporting infantile and early childhood vitamin D deficiency to be rampant in normal children? Furthermore, how can an infant beaten severely enough to cause multiple fractures not be bruised or in distress? Dr. Jenny cleverly avoids the question.”
Flaxseed Oil and Gum Disease: Still More Success
The following comment was left a few days ago:
I was doing SLD using flax seed oil for two weeks before my last dental appointment. My pockets that were 4′s and 5″s magically changed to 2′s and 3″s. I had my dentist print both the reports because I was so grateful that they stopped talking about some really painful sounding root work. My brushing and flossing were totally unchanged. I was expecting the result because of what I’ve read on the blog, but nothing this good. I am convinced that taking flax=reduction in gum inflammation, at the very least. [emphasis added]
Take that, “ decline effect” (big experimental effects, when the experiment is repeated, get smaller)!
The commenter sent me the records of the two cleanings. At the pre-flaxseed-oil cleaning (April 28, 2011), he had 24 sites (13 teeth) with pockets of depth 4 or 5. At the cleaning after he started flaxseed oil (July 28, 2011), he had no sites with pockets of depth 4 or 5.
You can find many similar reports here.
Tokyo Restaurant Recommendations — and Why They Might Be A Bad Idea
An earlier post asked for Tokyo recommendations. A kind reader (Andrew Clarke) provided the following recommendations of off-beat restaurants:
One place I always recommend is Andy’s Shinhinomoto, in Yurakucho: https://www.frommers.com/
destinations/tokyo/D61101.html . I have never seen a travel show that has covered the place, but it’s a best kept secret within the ex-pat community. Its menu is a standard Japanese Izakaya (pub) menu with some of the freshest sashimi (and fish in general) in Tokyo, and the strangest thing – it’s ran by a long-term British ex-pat, who is so renowned for his ability to pick good ingredients that he selects and delivers fish for several local sushi shops. Upstairs seating is best for atmosphere, but the food is the same downstairs. They have an English menu, and I’d also recommend the fish head and tempura. It’s also not super expensive, somehow I never manage to spend more than 7000Y with alcohol.Teyandei is another one that I would generally recommend: https://www.bento.com/rev/2133.
html . You’ll be lucky if you manage to find this one, most taxi drivers I have ever asked couldn’t find it even with GPS, it’s located in a residential area of the back of Roppongi. Great atmosphere, and again Izakaya style but not fish oriented, and not strictly traditional. The most memorable dish I had was a french baguette, vanilla ice cream and maple syrup slider – which was very good, but to be enjoyed occasionally. Outside of that they have many great dishes, with more of a meaty or stuff on sticks vibe.Last general recommendation is for sushi: https://tokyofood.blog128.fc2.
[follow-up:] The Moroccan place, I’m not sure why I didn’t include this the first time, as it is possibly the most strange and off-the-beaten-path: https://www.dalia58.com/d_map.com/blog-entry-52.html . I used to live in Tsukiji town and this place is a friendly joint that attracts many locals in the evening. Probably because it’s not super-expensive, but great quality and I particularly recommend the Uni if that is your thing. Their ‘aburi (blow torched)’ dishes are great too, and the Aji (mackerel) and the tsuki maguro (marinated tuna).html . Google Maps. The owner is a Japanese lady who spent 1 year in Morocco on a home stay. She loved the home cooked food and fastidiously learned to replicate them the way only Japanese people can. I learned about from a Moroccan co-worker who swears it’s the most authentic Moroccan food he has had out side his homeland. You definitely need to book ahead, there are only maybe 12 seats in the place and only 4 of those are not on the ground. The menu is fairly small and changes every once in a while as the owner travels back to Morocco regularly, but usually I have the meatball tagine (best), fish tagine, freshly baked wheat bread and vegetable couscous. I have never been there alone, you’d need at least two people to eat all that.
Alexandra Harney, author of The China Price, who has spent years in Tokyo, recommended:
My favorite watering hole: Asahi Shokudo in Nogizaka, near Tokyo Midtown. Unless you speak Japanese, the best thing to do is probably to have someone call ahead, make a reservation (a very good idea) and fax you a map. Their tel: 03-3402-6797. GREAT food, very good atmosphere, sake good too. It’s not fancy, but authentic and creative.
Tyler Cowen’s forthcoming book (An Economist Gets Lunch: New Rules For Everyday Foodies) says a lot about Japanese food and restaurants. In an email he said “Pierre Gagnaire Tokyo was the best meal I’ve ever had…that is expensive, though.”
I am in Tokyo now. Last night I took a long walk around my hotel (Hotel Changtee), which is in Ikebukuro. I have stayed here three times before. On my walk, for the first time, I noticed a Spanish restaurant (Agalito) a few blocks from my hotel. In Beijing, I often have Japanese food, so I decided to try it. The menu (mostly tapas) looked good. It wasn’t expensive (Ikebukuro is full of relatively cheap restaurants).
I had seven dishes. Every one surprised me and tasted great. I had pickles, a vegetable terrine, deep-fried shrimp and avocado (the avocado was also deep-fried), mackerel, a dish of large mushrooms and bacon, marinated cherry tomatoes (skins removed), and baked/grilled cheese and tomatoes. Far better than the tapas I had in Barcelona (or anywhere else). Far better than the tapas at a Berkeley restaurant (Cesar) next to Chez Panisse owned by Alice Waters’ ex-husband. The pickles were a small dish of carrots, cucumber, cabbage, and red pepper. The best pickles I’ve ever had, and I’ve had pickles hundreds of times, as anyone who knows my passion for fermented food will understand. They are a staple of Japanese and Szechuan cuisine. I’ve had Japanese pickles at dozens of places. The carrot pickles were so good, such a great blend of sweet and sour, so perfectly crunchy, that I want to start trying to recreate them. I didn’t know carrot pickles could be that good.The tomato and cheese dish also opened my eyes. I never knew that cheese and tomatoes could go so well together. I want to get special equipment (the baking pan) just to make this one dish. I want to try many different cheeses and tomatoes to find the best pairing. No meal at Chez Panisse or anywhere else has pushed me to do two new things. A tiny number (five?) have pushed me to do one new thing.
This restaurant is a few blocks from my hotel. No one recommended it. The meal, with drink, cost $60. I’m told that if you ask a Tokyo resident what are your favorite restaurants? they look at you blankly. Now I see why. There are so many great restaurants it doesn’t matter. This meal also taught me that recommendations may be counter-productive. Recommended restaurants are often expensive. Expensive food is likely to require lots of labor, special tools, and expensive ingredients. Making it harder to copy and thus less inspiring. Whereas this “plain” meal, with cheap ingredients and relatively little labor, will continue to influence and teach me whenever I do stuff it has inspired me to do.
Why Language Began: Words Say What We Want
My theory of human evolution posits that many features of human nature began because they increased specialization and trade. One is language. Language began with single words, I assume. The use of single words began and grew because they helped the two sides of trade find each other. The first language, in other words, was the first advertising. Advertising has two sides: (a) saying what you have too much of and (b) saying what you have too little of.
Single words are still used this way. Stores are often adorned with single words that say what they sell. When you go to an unfamiliar store, you may use single words to find what you want (“thermometers?”). The use of single words to convey desires is clear in a paper by Alexander Graham Bell, which I learned about from Electric Universe by David Bodanis. Bell (the inventor of the telephone) was a teacher of the deaf and wrote a paper about teaching deaf children language. His method involved labeling objects around the house with their names. One of his students was a five-year-old boy:
One morning he came downstairs in high spirits, very anxious to play with his doll. He frantically beat his shoulder with his hands, but I could not understand what he meant. I produced a toy-horse; but that was not what he wanted. A table; still he was disappointed. . . . At last, in desperation, he went to the card-rack, and, after a moment’s consideration, pulled out the word “doll” and presented it to me.
For a different view of why language evolved, see this paper by Hauser, Chomsky and Fitch.
Is Epidemiology Worthless? The Case of Calcium
Epidemiology has lots of critics. In this article, for example, it is called “lying on a grand scale.” Every critique I have read has ignored history. Epidemiologists have been right about two major issues: 1. Heavy smoking causes lung cancer. 2. Folate deficiency causes birth defects. In both cases, the first evidence was epidemiological. Another example is John Snow’s conclusion about the value of clean water. In my experience, epidemiologists often overstate the strength of their evidence (as do most of us) but overstatement is quite different from having nothing worth saying.
Let’s look at an example. Many people think osteoporosis is due to lack of calcium. Bones are made of calcium, right? The epidemiology of hip fractures is clear. In spite of the conventional idea, the rate of hip fracture has been highest in places where people eat a lot of calcium, such as Sweden, and lowest in places where they eat little, such as Hong Kong. (For example.) In other words, the epidemiology flatly contradicted the conventional idea. This was apparently ignored by nutrition experts (everyone knows correlation does not equal causation) who advised millions of people, especially women, to take calcium supplements to avoid osteoporosis. Millions of people followed (and follow) that advice.
Thanks to a recent meta-analysis we now know that experiments and better data firmly support the earlier epidemiology, which suggested that calcium supplements are dangerous. Here are its main conclusions:
In meta-analyses of placebo controlled trials of calcium or calcium and vitamin D, complete trial-level data were available for 28,072 participants from eight trials of calcium supplements and the WHI CaD participants not taking personal calcium supplements. . . .Calcium or calcium and vitamin D increased the risk of myocardial infarction (relative risk 1.24 (1.07 to 1.45), P = 0.004) and the composite of myocardial infarction or stroke (1.15 (1.03 to 1.27), P = 0.009). . . . A reassessment of the role of calcium supplements in osteoporosis management is warranted.
If the epidemiology had been taken more seriously, many heart attacks might have been avoided.
Is this an “anecdote” — a single example — proving nothing? Here’s how you can check. Randomly select a meta-analysis of epidemiological studies. Thousands have been done. Then ask if the results summarized in the meta-analysis appear random. Better yet, randomly pick two meta-analyses. Suppose the first summarizes 5 studies and the second summarizes 6. If the 11 results were shuffled together, how well could you assign them correctly?
Assorted Links
- More evidence that the SCD (Specific Carbohydrate Diet) diet really helps people with Crohn’s Disease. “Since starting this diet, I have had no pain. Some might attribute this to surgery, but I am convinced the diet has so much to do with it. My blood work is normal, and it hasn’t been in 8 years. The sed rate level in the blood is normal instead of elevated outrageously.”
- How to improve on lectures when teaching physics.
- More selenium, less risk of cancer. Contrary to what the researcher quoted in this article says, there is already substantial evidence that selenium reduces cancer risk. For example, in a county-by-county map of USA cancer rates, there is a clear rift in the north east. On one side of the rift rates are clearly higher than on the other side of the rift. The rift corresponds to geological fault line. On the low-cancer side of the rift, there is more selenium in the soil. There are also rat experiments. You certainly should take selenium supplements.
- American health care plays a surprisingly large role in an excellent story by Peter Hessler in The New Yorker about the Japanese yakuza (mafia). 1. From 2000 to 2004, four yakuza members got liver transplants at UCLA at a time when liver transplants were hard to get. A few months later they made large donations to UCLA. The money went into a general fund at the surgery department. According to a UCLA spokesperson, there was no connection between the transplants and the donations. According to a UCLA press release, “No money or donation was offered or paid to anyone at UCLA as a quid pro quo for getting a transplant or moving up on the list.” Because a general fund is not a person, this is literally true. 2. In the early 1990s, at a Columbia, Missouri hospital, a nurse was suspected of killing patients. Hospital administrators covered it up. “Everyone took part in the coverup was promoted, everybody who tried to expose it was punished,” said someone who tried to expose it.
Thanks to Alex Chernavsky.
Assorted Links
- omega-3 blood levels correlated with better mental performance in the elderly. “The team found that people who had higher blood levels of vitamins B, C, D and E and omega-3 fatty acids scored higher on the mental-function tests, including attention tasks and visual and spatial skills, than those with lower levels of these nutrients.”
- “ Inflammation, atherosclerosis, and coronary artery disease.” An influential New England Journal of Medicine article from 2005. The next time someone tells you that heart disease is due to high cholesterol, refer them to this article.
- Weak evidence that bacteria in food stimulate the immune system. Indian women who ate yogurt to which a probiotic had been added had more of an immune-related molecule in their feces than before and after that ingestion.
- Speaking of India, do medical students who gain admission by fraud become dangerous doctors? India has a problem.
Thanks to Tim Beneke.