Category: General

Posit Science: Does It Help?

Seth Roberts5 Comments

Tim Lundeen pointed me to the website of Posit Science, which sells ($10/month) access to a bunch of exercises that supposedly improve various brain functions, such as memory, attention, and navigation. I first encountered Posit Science at a booth at a convention for psychologists about five years ago. They had reprints available. I looked at a study published in the Proceedings of the National Academy of Sciences. I was surprised how weak was the evidence that their exercises helped.

Maybe the evidence has improved. Under the heading “world class science” the Posit Science website emphasizes a few of the 20-odd published studies. First on their list of “peer-reviewed research” is “the IMPACT study”, which has its own web page.

With 524 participants, the IMPACT study is the largest clinical trial ever to examine whether a specially designed, widely available cognitive training program significantly improves cognitive abilities in adults. Led by distinguished scientists from Mayo Clinic and the University of Southern California, the IMPACT study proves that people can make statistically significant gains in memory and processing speed if they do the right kind of scientifically designed cognitive exercises.

The study compared a few hundred people who got the Posit Science exercises with a few hundred people who got an “active control” treatment that is poorly described. It is called “computer-based learning”. I couldn’t care less that people who spend an enormous amount of time doing laboratory brain tests (1 hour/day, 5 days/week, 8-10 weeks) thereby do better on other laboratory brain tests. I wanted to know if the laboratory training produced improvement in everyday life. This is what most people want to know, I’m sure. The study designers seem to agree. The procedure description says “to be of real value to users, improvement on a training program must generalize to improvement on real-world activities”.

On the all-important question of real-world improvement, the results page said very little. I looked for the published paper. I couldn’t find it on the website. Odd. I found it on Scribd.

Effect of the training on real-world activities was measured like this:

The CSRQ-25 consists of 25 statements about cognition and mood in everyday life over the past 2 weeks, answered using a 5-point Likert scale.

Mood? Why was that included? In any case, the training group started with an average score of 2.23 on the CSRQ-25. After training, they improved by 0.07. (Significantly more than the control group.) Not only is that a tiny improvement (percentage-wise) it is unclear what it means. The measurement scale is not well-described. Was the range of possible answers 1 to 5? Or 0 to 4? What does 2 mean? What does 3 mean? It is clear, however, that on a scale where the greatest possible improvement was either 1.23 (assuming 1 was the best possible score) or 2.23 (assuming 0 was the best possible score), the actual improvement was 0.07. Not much for 50-odd hours of practice. Although the website seems proud of the large sample size (“largest clinical trial ever”), it is now clear why it was so large: With a smaller sample the tiny real-world improvement would have been undetectable. Because the website treats this as the best evidence, I assume the other evidence is even less impressive. The questions about mood are irrelevant to the website claims, which are all about cognition. Why weren’t the mood questions removed from the analysis? It is entirely possible that, had the mood questions been removed, the training would have produced no improvement.

The first author of the IMPACT study is Glenn Smith, who works at the Mayo Clinic. I emailed him to ask (a) why the assessment of real-world effects included questions about mood and (b) what happens if the mood questions are removed. I predict he won’t answer. A friend predicts he will.

More questions for Posit Science

Vitamin D3 in Morning Improves Sleep After All (Story 26)

Seth Roberts13 Comments

Adam Clemans (28 years old, about 80 kg, pharmacist, lives in Shanghai) commented on a recent post that Vitamin D3 didn’t seem to improve his sleep (“I can’t say I noticed any improvement in my sleep from Vitamin D”). He took 4000 IU in drop form right after he woke up.

I wrote him for details. I said that since 4000 IU was the lowest dose I found effective, he might want to try a higher dose. Adam answered my questions and said he would try a higher dose. Two weeks later he wrote again:

I started taking 4 drops (8000 IU) of Vitamin D3 1st thing in the morning (up from 2 drops or 4000 IU); my sleep seemed to improve immediately and quite dramatically. I had been struggling with middle-of-the-night awakening for a week or so, but after the change I slept like a brick or a baby (pick your metaphor). I would like to experiment with this more before I say I am sold on it, but for now it seems to be working well.

He’d been doing the higher dose for two weeks. Hard to explain as a placebo effect.

“The Scale of the Scandal”: Tony Scott’s Suicide Quite Possibly Due to Antidepressant

Seth Roberts10 Comments

As pointed out by dearime, the columnist Peter Hitchens recently made the following comment in The Mail on Sunday:

When I read in August that the talented Hollywood film director Tony Scott had killed himself without any apparent good reason, I was fairly sure that pretty soon we would find that the poor man had been taking ‘antidepressants’. Well, a preliminary autopsy has found ‘therapeutic’ levels of an ‘antidepressant’ in his system. I take no pleasure in being right, but as the scale of this scandal has become clear to me, I have learned to look out for the words ‘antidepressant’ or ‘being treated for depression’ in almost any case of suicide and violent, bizarre behavior. And I generally find it. The science behind these pills is extremely dubious. Their risks are only just beginning to emerge. It is time for an inquiry.

“ Tony Scott Suicide Remains a Mystery After Autopsy,” wrote a Vanity Fair editor. The autopsy found that he had been taking the antidepressant Remeron, whose known side effects include suicide. SSRI’s, of which Remeron is an example, cause suicidal thinking in people who are not depressed.

The psychiatrist David Healy was the first to emphasize this point. In 2000, after he began this research, he was offered a job at the University of Toronto. In a very unusual move, the job offer was rescinded. Apparently psychiatry professors at the University of Toronto realized that Healy’s research made the psychiatric drug industry look bad.

I don’t think it’s wrong to sell drugs that improve this or that condition (e.g., depression), even if the improvement is slight. I do think it’s wrong to make false claims to induce people to buy the drugs. In the case of depression, the false claim is that depression is due to a “chemical imbalance.” No chemical difference has ever been shown between people who later become depressed and people who don’t later become depressed. This claim, repeated endlessly, makes it harder to do research into what causes depression. If you figured out what caused depression, you could treat it and prevent it much better. This false claim does enormous damage. It delays by many years discovery of effective treatment and prevention of depression, a disease from which hundreds of millions of people now suffer.

This happens in dozens of areas of medicine. Dermatologists say “ acne is caused by bacteria“. Most doctors appear to believe “ulcers are caused by bacteria”. Ear nose and throat surgeons claim that part of the immune system (the tonsils) causes illness. The “scale of the scandal” — medical school professors either (a) don’t understand causality or (b) deceive the rest of us — is great.

Quantified Self Utopia: What Would It Look Like?

Seth Roberts1 Comment

On the QS forums, Christian Kleineidam asked:

While doing Quantified Self public relations I lately meet the challenge of explaining how our lives are going to change if everything in QS goes the way we want. A lot of what I do in quantified self is about boring details. . . . Let’s imagine a day 20 years in the future and QS is successful. How will that day be different than [now]?

Self-measurement has helped me two ways. One is simple and clear. It has helped me be healthy. Via QS, I have found new ways to sleep better, lose weight, be in a better mood, have fewer colds (due to better immune function), reduce inflammation in my body, have better balance, have a better-functioning brain, have better blood sugar, and so on. I am not an expert in any of these areas — I am not a professional sleep researcher, for example. I believe that this will be a large part of the long-term importance of QS: it will help non-experts make useful discoveries about health and it will help spread those discoveries. Non-experts have important advantages over professional researchers. The non-experts (the personal scientists) are only concerned with helping themselves, not with pleasing their colleagues or winning grants, promotions, or prizes; they can take as long as necessary; and they can test “crazy” ideas. In a QS-successful world, many non-experts would make such discoveries and what they learned would reach a wide audience. Lots of people would know about them and take them seriously. As a result, people would be a lot healthier.

Self-measurement has also helped me in a more subtle way. It made me believe I have more power over my health than I thought. This change began when I studied my acne. I did not begin with any agenda, any point I wanted to make, I just wanted to practice experimentation. I counted my pimples (the QS part) and did little experiments. My results showed that one of the drugs my dermatologist had prescribed (tetracycline, an antibiotic) didn’t work. My dermatologist hadn’t said this was possible. Either he had done nothing to learn if worked or he had reached the wrong answer. What stunned me was how easy it had been to find out something important a well-trained experienced expert didn’t know. My dermatologist was not an original thinker. He did what he was told to do by med school professors (antibiotics are a very common treatment for acne). It was the fact that I could improve on their advice that stunned me. I didn’t have a lab. I didn’t have a million-dollar grant. Yet I had learned something important about acne that dermatology professors with labs and grants had failed to learn (antibiotics may not work, be sure to check).

Skepticism about mainstream medicine is helpful, yes, but only a little bit. More useful is finding a better way. For example, it’s useful to point out that antidepressants don’t work well. It’s more useful to find new ways to combat depression. Two years ago, the psychiatrist Daniel Carlat came out with a book called Unhinged that criticized modern psychiatry: too much reliance on pills. No kidding. Carlat recommended more talk therapy, as if that worked so well. As far as I could tell, Carlat had no idea that you need better research to find better solutions and had no idea what better research might be. This is where QS comes in. By encouraging people to study themselves, it encourages study of a vast number of possible depression treatments that will never (or not any time soon) be studied by mainstream researchers. By providing a way to publicize what people learn by doing this, it helps spread encouraging results. In the case of depression, I found that seeing faces in the morning produced an oscillation in my mood (high during the day, low at night). This has obvious consequences for treating depression. This sort of thing will not be studied by mainstream researchers any time soon but it can easily be studied by someone tracking their mood.

In a QS-successful world, many people would have grasped the power that they have to improve their own health. (You can’t just measure yourself, you have to do experiments and choose your treatments wisely, but measuring yourself is a good start.) They would have also grasped the power they have to improve other people’s health because (a) they can test “crazy” solutions mainstream researchers will never test, (b) they can run more realistic tests than mainstream researchers, (c) they can run longer tests than mainstream researchers, and (d) no matter what the results, they can publicize them. In a QS-successful world, there will be a whole ecosystem that supports that sort of thing. Such an ecosystem is beginning to grow, no doubt about it.

Short-Term Effects of Fat, Protein and Carbohydrate on Cognition: Fat Best

Seth Roberts22 Comments

A German study published in 2001 measured the effect of starkly different breakfasts (all fat, all protein, or all carbohydrate) on cognition during the next hours. Participants (17 men in their 20s) ate the same packaged dinner at home and next morning came to the lab and ate different breakfasts. All of the breakfasts were “cream-like” and all contained 400 calories. The design was relatively sophisticated. Practice effects were reduced by giving considerable practice with the tests before the main measurements began. Brain tests included a simple reaction time task, a choice reaction time task, and a “combi-test” in which the subject does two things at once that provides six measures of performance. One set of tests took 15 minutes. The tests were done once/hour for 3 hours after the breakfast.

The simple reaction time test showed no difference between the breakfasts. The choice reaction time test and the combi-test did show differences: The all-fat breakfast was better. The improvement produced by the fat breakfast compared to the other two breakfasts was clearest about two hours after the breakfast.

EMG (brainwave) measurements showed no differences between the breakfasts.

These results agreed with previous work.

Cunliffe et al. (1997) reported that a pure fat meal did not increase reaction times in contrast to carbohydrate ingestion when measured hourly for 4 h after the meal. In our study, fat ingestion even improved reaction times compared with baseline. Our subjects scored best for all tasks of the combi-test after the fat meal. This finding is in line with the higher accuracy of a focused attention task after a high-fat meal compared with a low-fat meal reported by others (Smith et al. 1994).

The “fat” breakfast in this study was 25% soybean oil (high in omega-6), 25% palm oil (high in saturated fats) and 50% cream (high in saturated fats). I have not compared omega-6 to nothing but I suspect it would produce worse results, given that olive oil appears worse than nothing. So I suspect that the improvement due to fat was due to the palm oil and cream. I concluded, based on evidence that I and others collected, that butter (high in saturated fats) improves arithmetic speed. I usually ate 30 g (= 2 tablespoons = 270 calories) of butter twice/day. Close to the dosage of this experiment. The timing of the effects I saw (sharp improvement from one day to the next) is consistent with a change that happens within 2 hours.

These results, which I didn’t know about until recently, support my earlier conclusions about butter. My measurements cost almost nothing whereas this experiment must have cost thousands of dollars ($400/subject?) plus hundreds of hours of researcher time. Maybe I should compare cream and butter. Cream has advantages. Mark Frauenfelder suggested using cream to make yogurt. Superfood!

A more recent study found saturated fat consumption correlated with cognitive decline. It was a survey, however, with many differences between the groups being compared. I trust experimental evidence much more than survey evidence.

The Reddit Protein Powder Tests

Seth Roberts2 Comments

A few months ago, a Redditer with access to a protein measurement device offered to measure the protein content of protein powders that readers sent him. He got about twenty samples, presumably from all over the United States. Most of them turned out to have reasonable amounts of protein but four had much less than expected.

The tester interpreted the results here. One of the tested brands, American Pure Whey, clearly has problems. Call it a positive control. By confirming those problems, the rest of the measurements gain credence. One company whose protein powder scored low is Gaspari. Unfortunately I cannot read their reply, which appears on my browser without text.

I look forward to more truth-in-advertising tests. It is really helpful that the data is public — in this case, via Google Docs. Jimmy Moore (of Livin’ La Vida Low Carb) has measured the effect of several supposedly low-carb-friendly products on his blood sugar. His results are here.

Thanks to Eric Meltzer.

New Product: Cascal Fermented Soda

Seth Roberts3 Comments

This low-calorie soda (60 to 80 calories in a 12-ounce can) falls somewhere between kombucha and less-sweet sodas such as the aptly named GUS (Grown Up Soda). Its hook is the use of fermented juices as its base, resulting in a more complex flavor than sodas and sparkling waters based on plain juice.

$1.25 at Whole Foods. I’m in.

My interest in fermented foods partly derives from learning about a similar product. At a Fancy Food Show a few years ago, I learned about someone who wanted to develop a high-end non-alcoholic alternative to wine. He found he couldn’t get enough complexity without fermentation. That emphasized to me how our food preferences — in this case, a desire for complexity — push us to eat fermented foods.

The 2012 Nobel Prize in Physiology or Medicine

Seth Roberts4 Comments

As usual, there is plenty of disease and disability in the world: depression, diabetes, heart disease, cancer, stroke, obesity, autoimmune disease, and so on. As usual, the Nobel Prize in Physiology or Medicine — supposed to be given for the most useful research — is given for research with no proven benefit to anyone (except career-wise). Once again implying that the world’s best biomedical researchers — judging by who wins Nobel Prizes — either don’t want to or don’t know how to do useful research.

Once again the press release tries to hide this. “From surprising discovery to medical use” reads one heading. If you read the text, however, you learn there is no actual “medical use”. Here’s what it says:

These discoveries have also provided new tools for scientists around the world and led to remarkable progress in many areas of medicine. iPS cells can also be prepared from human cells. For instance, skin cells can be obtained from patients with various diseases, reprogrammed, and examined in the laboratory to determine how they differ from cells of healthy individuals. Such cells constitute invaluable tools for understanding disease mechanisms and so provide new opportunities to develop medical therapies.

Apparently you can make “remarkable progress” in medicine without helping a single person, which says a lot about what passes for medical progress. Although iPS cells are supposedly “invaluable tools” for understanding disease mechanisms, we are not told a single disease that has thereby been understood or a single therapy that has been developed.

The Guardian printed a roundup of responses to the award. I read it eagerly. Maybe one of the comments will explain how the prize-winning work actually helped someone (besides career-wise). After all, Yamanaka, one of the winners, had previously won the Finland Prize, given to research that “significantly improves the quality of human life today and for future generations”. Paul Nurse says the prize-winning work did such-and-such, “paving the way for important developments in the diagnosis and treatment of disease” unfortunately not saying what those “important developments” are. Martin Evans says:

The practical outcome is that now we not only know that it might be theoretically possible to convert one cell type into another but it is also practically possible. These are very important foundation studies for future cellular therapies in medicine.

Emphasis added. Another comment: “These breakthroughs will ultimately lead to new and better treatments for conditions like Parkinson’s and improve the lives of millions of people around the world.” A bold prediction, given that they have not yet improved the life of even one person. Julian Savescu, an ethicist at Oxford, says “This is as significant as the discovery of antibiotics. Given the millions, or more lives, which could be saved, this is a truly momentous award.”

Year after year, the Nobel Prize in Physiology or Medicine is given for research that, we are told by biologists with huge conflicts of interest, will — no doubt! — be incredibly valuable in the future. Indicating there was no research that might be honored that had already been useful. It is as if you have a baseball award for best hitter but all hitters all over the world strike out all the time so you end up giving the award to people who strike out best. They are the best hitters, you tell credulous sportswriters. They receive the prestigious award for best hitter at an elaborate ceremony, with toasts all around. Nobody says they cannot hit.

 

Vitamin D3 Eliminated Colds and Improved Sleep When Taken in the Morning (Stories 24 and 25)

Seth Roberts12 Comments

A year and a half ago, the father of a friend of mine started taking Vitamin D3, 5000 IU/day at around 7 am — soon after getting up. That his regimen is exactly what I’d recommend (good dose, good time of day) is a coincidence — he doesn’t read this blog. He used to get 3 or 4 terrible colds every year, year after year. Since he started the Vitamin D3, he hasn’t gotten any. “A huge lifestyle improvement,” said my friend. His dad studied engineering at Caltech and is a considerable skeptic about new this and that.

Much more recently his mother changed the time of day she took her usual dose of Vitamin D3. For years she had been taking half in the morning (with a calcium supplement) and half at night. Two weeks ago she started taking the whole dose in the morning. Immediately — the first night — her sleep improved. She used to wake up every 2 hours. Since taking the Vitamin D3 in the morning, she has been waking up only every 3-6 hours. A few days ago, my friend reports she had “her best sleep in years”.

Sleep and immune function are linked in many ways beyond the fact that we sleep more when we’re sick. A molecule that promotes sleep turned out to be very close to a molecule that produces fever, for example. I found that when I did two things to improve my sleep (more standing, more morning light) I stopped getting colds. So it makes sense that a treatment that improves one (sleep or immune function) would also improve the other (immune function or sleep).

A few days ago I posted a link about a recent Vitamin D study that found no effect of Vitamin D on colds. The study completely neglected importance of time of day by giving one large injection of Vitamin D (100,000 IU) per month at unspecified time. I commented: “One more Vitamin D experiment that failed to have subjects take the Vitamin D early in the morning — the time it appears most likely to have a good effect.” These two stories, which I learned about after that post, support my comment. What’s interesting is that the researchers who do Vitamin D studies keep failing to take time of day into account and keep failing to find an effect and keep failing to figure out why. I have gathered 23 anecdotes that suggest that their studies are failing because they are failing to make sure their subjects take their Vitamin D early in the morning. Yet these researchers, if they resemble most medical researchers, disparage anecdotes. (Disparagement of anecdotes reaches its apotheosis in “evidence-based medicine”.) The same anecdotes that, I believe, contain the information they need to do a successful Vitamin D clinical trial. Could there be a serious problem with how Vitamin D researchers are trained to do research? A better approach would be to study anecdotes to get ideas about causation and then test those ideas. This isn’t complicated or hard to understand, but I haven’t heard of it being taught. If you understand this method, you treasure anecdotes rather than dismiss them (“anecdotal evidence”).

 

Five Most Important Rules of Nature Photography

Seth Roberts2 Comments

A friend sent me some photos taken on a mountain hike. They seemed to derive from the following rules:

1. Carry a small camera in a big bag.

2. Always take a picture of a flower.

3. Change clothes from one picture to the next. (For example, wear pants in one picture and shorts in another picture, or a blue shirt in one picture and a white shirt in another picture.)

4. Make a funny face (for example, press finger into cheek).

5. Wear a funny shirt.