“A Great Change is Coming” (part 1 of 2)

Seth Roberts3 Comments

In an earlier post, I wrote “A great change is coming” — meaning a great improvement in health. It will be due to better ideas. Let’s call the new ideas evolutionary thinking. They will replace gatekeeper thinking. With gatekeeper thinking, which began with shamans, you need to extract payment from sick people. Remedies and associated ideas that don’t allow this are ignored. Gatekeeper thinking pervades not only mainstream medicine but also clinical psychology, alternative medicine, and a zillion advertisements. Everyone in those fields, like the rest of us, needs to make a living. The possibility that they are doing so at the expense of the rest of us — by suppressing innovation — is impolite to bring up. Perhaps the person you are speaking to has a brother who’s a doctor. And for an enormously long time there was no alternative. A sick person doesn’t have time to do research, even if that were possible. They are forced to rely on gatekeepers, who are interested only in certain types of remedies.

Now there is an alternative — now just a glimmer, but surely growing. It has several dimensions. One is the sort of research involved. At one extreme of that dimension is original research — for example, my discovery that breakfast caused my early awakening. Gatekeeper thinking had no interest in such ideas. You could not charge for something that simple. I wrote about my discovery, with plenty of data. Anyone with web access can read it. At the other extreme of that dimension is “library research” — usually web search. An example is Dennis Mangan searching for possible cures for his mom’s Restless Leg Syndrome (RLS) and discovering persuasive stories about niacin. Again, there was no mainstream research about niacin for RLS. Anyone with web access can read what Dennis found. So for these two disorders — early awakening and restless leg syndrome — there is now a practical alternative to consulting (and paying) an expert. This isn’t repackaged folk wisdom or home remedies or someone opining. There is clear-cut data and theory involved. In the case of breakfast and sleep, it makes evolutionary sense that food would cause anticipatory activity. Likewise, the case for megadose vitamins makes biochemical sense, as Bruce Ames and his colleagues explained. You can judge for yourself.

Another dimension of this emerging space is the simplicity of the treatment. In my breakfast example, I established cause and effect with just one change: stopping breakfast. Dennis’s example also involved a simple change: megadose niacin. In contrast, Aaron Blaisdell found his sun sensitivity went away after he made many dietary changes. If you have sun sensitivity you will find it harder to duplicate what Aaron did than what Dennis or I did, but you can still come close and in any case it is a big improvement over the previous best treatment, which was to avoid the sun.

In all three cases — early awakening, RLS, and sun sensitivity — there was no gatekeeper approval. (My article with my breakfast discovery was peer-reviewed but appeared in a psychology journal rather than a medical one). In all three cases, the solution was excellent — cheap, fast, highly effective, no side effects — compared to prescription drugs (e.g., for depression). The sort of solutions that gatekeeper thinking doesn’t find. In all three cases, you don’t need to go through a gatekeeper to learn about them.

In a later post I’ll describe why I think this emerging solution space will soon become far more important.

Butterfat Good?

Seth Roberts16 Comments

I eat a lot of butter because I believe it makes my brain work better. A new paper says it may help me in other ways. From the abstract:

Compared with those with the lowest intake of full-fat dairy [= “whole milk, cream, ice cream, yogurt, full-fat cheese and custard”], participants with the highest intake (median intake 339 g/day) had reduced death due to CVD (HR: 0.31; 95% confidence interval (CI): 0.12—0.79; P for trend = 0.04) after adjustment for calcium intake and other confounders.

70% reduction is huge — so large it makes the idea of direct causation (butterfat lowers CVD risk) more plausible. (However, there is a lot of uncertainty in the estimate.) The alternative is that butterfat intake is correlated with the true cause — a behavior difference, say. But that correlation would have to be very high, which isn’t terribly plausible. Measured differences between the high-fat group and the low-fat group were small.

Stephan Guyenet reviews other evidence that supports the idea that this reduction is no fluke. Other studies have found similar effects.

Thanks to Paul Sas.

Ernst Wynder on the Nurses’ Health Study

Seth Roberts22 Comments

It says a lot about the Nobel Prize in Medicine that Ernst Wynder, co-discoverer that smoking causes cancer, never got one. Wynder was also one of the founders of modern epidemiology. Here’s what he believed about the Nurses’ Health Study:

He had a strong skepticism about methods of dietary assessment, and always felt that the failure of analytic studies such as the Nurses’ Health Study to report associations between cancer and diet were due to a combination of random misclassification related to the imprecision of food frequency questionnaires and the narrow range of nutrient intake within a given population. I feel certain that he would have criticized the recent negative findings from the Women’s Health Study on dietary fat and breast and colon cancer on similar grounds. This was one area where he felt that international comparisons at the ecological [country-by-country] level provided better etiologic support than [more] analytic studies, and he published many studies over a period of decades to make just that point.

For example,

He developed a friendship with Kunio Aoki at the Aichi Cancer Research Institute in Nagoya, Japan, which resulted in our study which found that Japanese men with smoking habits similar to American men had considerably lower lung cancer risks.

I didn’t know that. It suggests that either Americans eat something that promotes cancer or the Japanese eat something that protects against it. I suspect it’s the latter — specifically, the big consumption of fermented food in Japan and not in America. I’m sure the food-frequency questionnaires Wynder criticizes, written by Americans, are tone-deaf to fermented food. I doubt they ask about kimchi or kefir or miso consumption, or distinguish between pickles aged for a day and pickles aged for a year. In Japan, people eat fermented food in many forms: vinegar drinks, yogurt, other fermented milk drinks, and alcoholic beverages. Above all, they eat miso and long-fermented pickles daily. They also have the longest life expectancy in the world.

Assorted Links

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Thanks to Mark Griffiths.

The Foxconn Suicides

Seth Roberts7 Comments

Foxconn, located on the coast of China, is the largest electronics manufacturer in the world. They make iPhones, Wiis, and many other famous products. You may have read about the epidemic of suicide that has broken out among its employees. There were two in the last few days, for example. The count now stands at something like a dozen suicides in about a month. The factory complex involved is gigantic, with perhaps 300,000 workers, but no question this is a terrible thing. The victims are all or mostly men in their early twenties. The median length of employment at Foxconn might be about a year.

Foxconn has appealed to my university (Tsinghua) and in particular my department (Psychology) for help. I’m told their assembly line was designed at Tsinghua. In any case, several people from my department (faculty and graduate students) have gone to the factory and tried to do something.

At a department meeting we discussed our department’s involvement. I said it’s really hard to make progress on such problems for reasons that might not be obvious. When I had trouble waking up too early, I started to study the problem via self-experimentation. All I cared about was solving the problem. Any answer was acceptable. I would spend as long as it took to find it. It took me 10 years to make visible progress. The first thing I figured out was that the problem was partly due to eating breakfast — which sleep researchers had failed to discover.
Consider the Foxconn suicides. It would be incredibly helpful to figure out what’s causing them. But few professors want to study a problem that they have no idea if they can solve nor how long it will take. They don’t want to wait ten years to write a paper. By then their funding will have run out. If funding is assured regardless of progress, then how does the funder ensure they are actually doing something? And few professors have total academic freedom. Their graduate school advisor, their academic friends, the people who control their career have certain beliefs. About which theories are good and which are bad. About which methods are “correct”. If their results contradict these beliefs, if they use a “wrong” method, they will suffer, just as all heretics suffer. So there is pressure to come up with an acceptable answer using proper methods. This gets in the way of coming up with the actual answer.

This doesn’t mean academic research is useless, but it does mean that professors work in shackles that outsiders are, in my experience, unaware of. I wrote about this in my Medical Hypotheses paper. It is a big reason my self-experimentation found new and surprising answers to old questions: I had total freedom. All I cared about was finding the answer. I didn’t care about publications. I didn’t worry about funding. I had as much time as it took.

The Unreasonable Effectiveness of My Self-Experimentation

Seth Roberts7 Comments

A good way to have new ideas, it’s said, is to talk about the ideas you already have. After I posted about advantages of self-experimentation, Bruce Charlton, the editor of Medical Hypotheses, invited me to write an editorial about it. Wondering what I thought gave me some new ideas and the editorial turned into a full-length article called “ The unreasonable effectiveness of my self-experimentation.” For 20 years I’d been mystified by this. I’m not exaggerating, I had no idea what I was doing right. I wanted to know — so I could do more of, or at least continue to do, whatever it was — but I just couldn’t figure it out.

Four Transitions: Population, Forests, Obesity, and Fast Food

Seth Roberts8 Comments

Long ago Paul Ehrlich, a Stanford professor, wrote The Population Bomb. Yet you probably know about the demographic transition: A sharp decrease in family size when countries reach a certain level of wealth. Which implies a big problem with Ehrlich’s forecasts. You probably don’t know about three related transitions:

1. Forests. For a long time humans destroyed forests and forest area decreased. More recently, however, forests have been regrowing as people leave rural areas for cities.

2. Obesity. In poor countries, rich people are fatter than poor people. In rich countries, the opposite is true: the poor are fatter than the rich, presumably because the rich eat less factory food.

3. Fast food. On a recent visit to Tokyo, I was told that the number of fast food restaurants in Tokyo is declining.

Excellent Jonathan Franzen Story

Seth Roberts7 Comments

The current issue of The New Yorker has an excellent story by Jonathan Franzen. I enjoyed reading it (unlike most recent New Yorker fiction, unfortunately) and it’s closely related to stuff I blog about.

It tells what happens after a girl is raped by a boy with powerful parents. Her coach wants her to report it but her parents dissuade her. They are afraid of what the boy’s parents would do to them. The mother is active in the local Democratic Party and says “I wish it had been anyone else.” They have three other children — this one, they seem to decide, is disposable.

The story is so wrenching because the parent-child bond is usually so strong. But smaller abandonments happen all the time. When I was a graduate student at Brown, I was a teaching assistant. One of the papers I graded turned out to be plagiarized. I told the professor about it; he did nothing. I’m sure I know why: It would have been costly for him. Time-consuming, for example. He abandoned the student. Teachers, like parents, should teach right and wrong.

I posted yesterday about a Columbia University valedictorian named Brian Corman who plagiarized part of his speech. Was this the first time he’s plagiarized? Of course not. It’s merely the first time he’s been punished for it. I believe he’s plagiarized many times and in some cases the teacher noticed. The teacher did nothing — thereby abandoning the student — because to do something would have been costly for the teacher. Had Corman been punished earlier, he would (a) not have been valedictorian (it would have gone to someone more deserving) and (b) not face ridicule for the rest of his life, since this episode will be preserved by Google. Likewise, Adam Wheeler — a flagrant liar who almost graduated from Harvard without being caught — will be ridiculed the rest of his life. He too was abandoned by his professors, who surely noticed before now that he plagiarized.

That Brown, Columbia, and Harvard professors put their own comfort ahead of doing right by their students is unsurprising, given the examples set by countless university presidents and underlings. (Examples here.) Why did Columbia University President Lee Bollinger show a shocking lack of understanding of the purpose of free speech? (He’s a law professor whose specialty is freedom of speech.) Because he thought it would be crowd-pleasing — and it was.

Restaurant With No Menu

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Today I had lunch at a Beijing restaurant with no menu. You choose dishes in discussion with your waiter. The restaurant’s theme is kung fu. Somehow having no menu is kung-fu-like. A sword hung on the wall and there were other martial-arts decorations. As we left, the wait staff said an ancient Chinese good-bye loudly in unison. It meant “the mountain and river will still be here [a metaphor for enduring friendship], let’s make a concrete date to meet again.” Only one of our two dishes was really good but I’ll go back.