Author: Seth Roberts

Diet and Acne (continued)

Seth Roberts5 Comments

I’ve blogged several times about environmental causes of acne, especially diet. Cynthia Graber, a science journalist, wrote a whole article about diet and acne, a link that dermatologists deny much more strongly than the evidence warranted. Why do they act so sure? I asked Graber. Because, low on the medical totem pole, they want to appear more scientific, she said. Genetics and drugs — that’s science. Diet — that isn’t science.

Here is more data on the subject, from two widely-different sources. The first is a comment on Dennis Mangan’s blog:

I had some acne when I was a teen. I was considered a very “pretty” teenager, but was painfully shy whenever my face “broke out”. I remember going to a dermatologist who put me on a sulfur cream and antibiotics for it. He emphasized over and over that diet “had absolutely nothing” to do with it, and that I should eat whatever I wanted and that “only by eating huge amounts of fish” could I actually aggravate it.

I still had some breakouts even until my twenties every so often. Because I was basically bodybuilding as a “hobby”, I switched to diet colas and started eating a great deal of tuna and canned chicken around this time. Guess what? The acne completely went away at about 21 and didn’t come back until about 26. At 26 I had some hard bumps under my chin like boils. The dermatologist said they were folliculitis and told me to make sure my razors were dry and my sink was super clean. But I noted that I had drifted back to a fast food diet and was drinking regular colas again–and kind of power-lifting a couple of days a week but not hitting it hard.

I got back into it at the gym, and wanted a six-pack again. I went back to diet cola and started dieting again. The result? The acne completely went away. This time I made a connection.

I have sworn up and down to some of my friends that I think our diets might lead to acne when we’re teens. One of my pals, Myron, took his kids (both teens) off cokes and instant soups and started cooking for them and making them drink orange juice and apple juice and tea. Their faces completely cleared up (they were 14 and 16) in about two months. No trips to the doctor, no anti-bacterial soaps, nothing. Just diet. They have had lovely clear skin ever since.

I have another friend at work whose teenage daughter “got off” colas and he started cooking for her (single parent). Her face cleared up. He mentioned it. She was a pretty girl but used to break out fairly badly. According to him, she’s on top of the world now that her skin is cleared up and is confident (and she should be because she really is a cutie).

I read a little bit about the study doctors cite about acne and diet. They fed a big chocolate bar to one group and fed another a CANDY bar that didn’t contain chocolate to another group. Since both groups had acne at the same levels, they declared that diet had nothing to do with acne. WHAT HOGWASH!!!!! If they were both drinking sodas, both eating tons of refined white flour, white pasta, and both eating a big candy bar (so what if one was toffee and one was chocolate) every day, they still were eating a “western diet”.

Anyway, I’ve read about the severe uptick in acne in newly “Westernized” populations. I’ve read about the rate of prostate difficulties of Asian-Americans versus rural Asians. Diets do INDEED affect much more about ourselves than we’d like to admit. I can guarantee you, because I’ve seen it on my own face and have friends who I trust who have seen it on the faces of their children, that diet does indeed influence acne and that high glycemic index foods and colas and sugars certainly worsen it at the least.

The thing that REALLY got me thinking this was a few years ago, I saw a couple of very Indian-looking Mexican teenagers. They didn’t look like they had a drop of European blood in them. They had BAD acne on their cheeks. Hell, I thought those people never broke out, yet there they were at a convenience store buying two colas and potato chips–looking like Oxy poster-children.

The second source is Arbor Clinical Nutrition Updates, an excellent Australian publication aimed at nutrition professionals. The latest update, which I cannot link to, is about acne and diet. From its conclusions:

For many years the conventional wisdom dispensed by physicians on the relationship between diet and acne vulgaris has been that there is none. In a recent study, the fact that nearly a half of a group of final year medical students believed that diet was an important factor in acne was held to be an unfortunate misconception “likely to perpetuate misinformation in the community.”

The “expert view” from doctors is in stark contrast to what their patients think. Many studies have shown that the average person is under the distinct impression that diet can indeed affect acne, particularly fatty foods and chocolate.

A careful look into this question reveals something rather fascinating — that although medical textbooks used to strongly support the idea of “acne diets”, in the last 50 years this has completely reversed. Yet experts’ current confidence that there is nothing to the diet-acne story is itself based on almost no evidence.

The update describes two studies. One found that a low-glycemic-index diet reduced acne. The other found that, in teenage boys, greater milk consumption was associated with slightly more acne.

More Maybe Graber was too kind. Confidence that diet had nothing to do with acne allowed dermatologists to prescribe dangerous and expensive drugs. I wish I could be sure no payola was involved, but — given a horrifying story in today’s NY Times about several psychiatrists’ total and dishonest disregard of conflict-of-interest rules — I can’t. From the article:

From 2000 through 2006, Dr. [Charles] Nemeroff [of Emory University] earned more than $960,000 from GlaxoSmithKline but listed earnings of less than $35,000 for the period on his university disclosure forms, according to Congressional documents. Sarah Alspach, a GlaxoSmithKline spokeswoman, stated in an e-mail message that “Dr. Nemeroff is a recognized world leader in the field of psychiatry.”

What does that say about psychiatry?

Shannon Brownlee on the subject. A blog on the subject. A letter from Senator Charles Grassley to James Wagner, the president of Emory, describing Nemeroff’s behavior and asking for more information.

The Neglected Importance of Diversity

Seth Roberts3 Comments

In The Black Swan (2006), Nassim Taleb wrote:

Globalization creates interlocking fragility, while reducing volatility and giving the appearance of stability. In other words it creates devastating Black Swans. We have never lived before under the threat of a global collapse. Financial institutions have been merging into a smaller number of very large banks. Almost all banks are interrelated. So the financial ecology is swelling into gigantic, incestuous, bureaucratic banks — when one fails, they all fall. The increased concentration among banks seems to have the effect of making financial crisis less likely, but when they happen they are more global in scale and hit us very hard. We have moved from a diversified ecology of small banks, with varied lending policies, to a more homogeneous framework of firms that all resemble one another. True, we now have fewer failures, but when they occur ….I shiver at the thought.

To me, this sounds Jacobian. Jane Jacobs disliked calls for reduced family size (e.g., Bill McKibben) not merely because she was a third child but because she disliked reducing the diversity of family ecology. In public health, it’s called the dangers of monoculture. The Irish potato famine (which “dwells in my memory as one long night of sorrow” — William Butler) is a dietary example of Taleb’s point. When one (potato) crop failed, they all failed.

Self-experimentation is a more positive example of the broad point. Self-experimentation derives its power from two things: 1. Motivation. You are more motivated to solve your own problems than other people’s problems. 2. Diversity. The self-experimenter can do anything — change anything, measure anything. Other scientists cannot. For people with serious problems, such as depression, reduced diversity of the associated science (e.g., the science of what causes depression) is a long slow catastrophe when the associated science, because of its restricted nature, cannot find the best solutions (as I believe is the case with depression).

My animal-learning research also centers on this point. It is about what controls variation in behavior. Dave Stahlman (UCLA), Aaron Blaisdell (UCLA), and I will soon finish a paper about this. With too little variation, catastrophe is too likely, as Taleb says. So mechanisms to produce diversity have evolved. Just as the importance of diversity has been neglected by financiers, it has been neglected by research psychologists.

Proposed Book: How to Lie with Experimental Design

Seth Roberts1 Comment

From ABC News:

Angelo Tremblay [a professor at Laval University] noticed something odd every time he worked up a grant application for his research program in a Quebec university. He had a craving for chocolate chip cookies.

Professor Tremblay wondered if this meant that thinking makes you fat — which is curious, because it implies that the rest of his job didn’t involve thinking, or at least less of it. More likely is that anxiety makes you crave pleasure-producing food (such as chocolate-chip cookies) to dull the pain; there is a term for it, emotional eating. Grant writing is anxiety-producing, of course: You worry about not getting the grant. Yet — to his credit — Tremblay did experiments to test his idea. And these experiments, he believes, supported his idea that thinking alone can cause obesity, which I’m pretty sure is wrong. It makes me want to write a book: How to Lie With Experimental Design (although I’m sure Tremblay wasn’t trying to deceive anyone). Its predecessor, How to Lie with Statistics, was a big success.

Thanks to Dave Lull.

More From a documentary about Ranjit Chandra:

In the Nestle and Mead Johnson studies, Chandra concluded that those company’s products helped reduce the risk of allergies, while the Ross formula which was virtually the same did nothing.

Masor says he asked, “‘Dr. Chandra, how can you explain that we didn’t see anything with our study and you did with the Nestle study?’ And he said, ‘Well, the study really wasn’t designed right.’

“I said: ‘Dr. Chandra we designed the study with you. You designed it. That’s why we went to you, so you would be able to do it correctly.’ And he said, ’Well, you didn’t really pay me enough money to do it correctly.’”

An extreme case.

My Pleasantly-Strange Trip to Beijing

Seth Roberts1 Comment

I am now in Beijing. On the way (12 hours nonstop from San Francisco):

  1. Without asking, my seat was switched to one of the best seats in economy: aisle of the bulkhead row.
  2. Boarding was last rows first. So rational, so easy, no special equipment or software required. I have never before encountered this. Good work, Air China.
  3. A riveting movie, which I’d never heard of, was shown: The Children of Huang Shi, which is a Chinese Schindler’s List. In both Chinese and English, with Chinese subtitles when the characters were speaking Chinese. The best movie I’ve seen on a plane.
  4. The plane was old. Well-maintained, yes, but the film was VHS, the headphone jacks were double-pronged, and my supplied headset was broken. Maybe this is why the price was surprisingly low (about 40% less than the competition).
  5. Midflight, a fly alighted on my book (Traffic by Tom Vanderbilt).
  6. Three times I did my one-legged standing. Seeing me, two others started stretching. For the first time on one of these long flights, I had no trouble sleeping in my seat. (In the past, I’ve been able to sleep well only on the floor.)
  7. The flight was 78 minutes early. I didn’t know such a thing was possible — like the fly.
  8. The Beijing terminal (Terminal 3 at the airport), which opened six months ago, must be the biggest in the world. Nicely decorated with bamboo plants. At debarkation, a sign said we were 10 minutes from Customs. No line at Customs. After Customs, we took a shuttle train to luggage pickup. The ride — within one terminal — seemed about a mile long. I look forward to spending more time there, to study the 72 restaurants, for example.
  9. The trunk of my taxi was perfectly clean.
  10. During the taxi ride, I saw a bike rider. He was about to go from the on-ramp onto the freeway, apparently to ride on the line between lanes. It was a normal unclogged highway, with cars going 60 or 70 mph. I didn’t know such a thing was possible.

Science in Action: Why Did I Sleep So Well? (part 16)

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A few days ago I spoke on the phone to someone who’d written me that one-legged standing improved his sleep. I mentioned this replication earlier but the new details are interesting.

He is a 35-year-old man with an office job. He now works in the Washington, D.C. area. Until about a year ago, his sleep was fine. He would sleep 7-7.5 hours no matter when he went to bed.

About a year ago he went through a tough time with a lot of stress and anxiety. After that he started waking up after only 6 hours of sleep. He’d wake up early in the morning, 3 or 4 am, still tired but unable to fall back asleep. This is exactly the problem I had when I started to self-experiment to try to sleep better.

He went to a doctor for help. (I considered seeing a doctor.)Â The doctor prescribed:

1. Ambien. It worked for 1 or 2 nights.

2. Lunesta. Like Ambien, it worked for only the first few nights.

After using these two drugs, the problem got worse. Now he awoke after only 4 hours of sleep. He tried non-prescription drugs:

3. Melatonin. It made him foggy during the day.

4. Tylenol PM. It worked okay, but he would still wake up after 6 hours.

Then he decided he didn’t want to take pills of any sort — even if they worked, he’d have to take them for the rest of his life. (This is why I didn’t go to a doctor and never tried pills.) He tried conventional alternative treatments:

5. Changed his attitude about the problem. Although he was waking up very early, he wasn’t tired during the day. He had four extra hours. After this change in attitude, he began to fall back asleep a few hours after waking up. Gradually the amount of time he was awake in the middle of the night got shorter.

6. He has cold feet. He can’t fall asleep when his feet are cold. He read somewhere that if you imagine your feet are warm, they will warm up. This gave him an idea. What if he imagined going into an MRI-like machine that induces sleep? He started doing this. When he’d wake up at 2 a.m., he’d imagine himself going into this machine. This enabled him to fall back asleep with a short latency.

In August he read my posts about this and started one-legged standing, often while watching TV. He does it without stretching the other foot: puts one foot on top of the other or behind the other. He might or might not balance. Usually stands on a pillow. He does it until it hurts, twice for each leg. In the beginning it took only 5-10 minutes but now it has gotten much longer and he has started doing other things, such as wearing a backpack with books, to shorten the time.

From my point of view the main points are these: 1. He had tried several other treatments. Some were awful, some were okay, but none sustainably solved the problem. Not only did one-legged standing help, it apparently helped more than six other plausible treatments, including two powerful and expensive drugs. 2. What he did differed from what I did — verbal descriptions are always inexact and omit a lot — but still worked well right away.

Directory.