Category: General

What to Do About Antibiotic Resistance? Improve Immune Function

Seth Roberts30 Comments

I recently got a flyer from my HMO. “Feel better soon . . . without antibiotics!” said the front page. “Antibiotics do not kill viruses” said the second page. Apparently the point of the flyer is to reduce antibiotic usage. I am surprised that doctors need protection from patients asking for antibiotics for viral diseases.

Antibiotic resistance is a problem, yes, but the bigger problem is how those who run our health care system ignore the immune system. Here are examples:

1. The historical solution to the problem of antibiotic resistance has been to develop new antibiotics. The problem has not stimulated research into how to strengthen the immune system. Here is a 1992 editorial in Science: “Mechanisms such as antibiotic control programs, better hygiene [= more handwashing], and synthesis of agents with improved antimicrobial activity need to be adopted in order to limit bacterial resistance.” Nothing about improving immune function. A 2012 World Health Organization report about the problem does not contain the word immune.

2. The idiocy of tonsillectomies. Forty years after researchers figured out that tonsils are part of the immune system, tonsillectomies remain common. Removing tonsils because of too many infections makes as much sense as removing part of the brain because of memory loss. I have never encountered a doctor who appears to understand this.

3. Epidemiologists have yet to systematically study what makes the immune system more or less powerful. For example, this epidemiology textbook does not contain the word immune. Nor does this review of 25 epidemiology textbooks.

4. A respected professor of pharmacology at the University College London named David Colquhoun left the following comment on this blog: “Talking of made up theories, the corniest of all has to be “stimulating the immune system”. There is [not], and never has been, any evidence that it happens — it is the eternal mantra of every quack who is trying to sell you their own brand of implausible therapy.” Here is an example of the evidence he says doesn’t exist. Professor Colquhoun is a Fellow of the Royal Society.

5. I know very little about the immune system. I barely know what a T cell is. My job (psychology professor) has nothing to do with it. Yet I have come up with three ideas related to it: 1. Tonsillectomies are idiotic. 2. We need regular intake of microbes to be healthy — in part to stimulate the immune system. 3. We need exposure in small amounts to the germs around us for our immune systems to best protect us. (So it’s not obvious that outside of hospitals more handwashing is a good thing.) Only because these ideas are obvious (#1 and #3) or semi-obvious (#2) was someone as ignorant as me able to think of them. That one ignorant outsider thought of three of these things before the hundreds of thousands of health researchers did suggests how little they think about the immune system.

Someday the people in charge of our health care — or the rest of us, ignoring them — will figure out how to make our immune systems work much better. We will sleep much better, eat much more fermented foods, take enough Vitamin D at the right time of day, and so on. Perhaps we will wash our hands less and kiss more. Antibiotic usage will go way down, selection for resistant microbes will become much less intense, and antibiotic-resistant microbes will become much less common. The problem will disappear.

Academic Politics, Alan Turing and Stanford

Seth Roberts6 Comments

This series of posts about a proposed Alan Turing conference at Stanford left me wondering about the best academic novels I had read. Pnin is good, but not very academic. Gone by Renata Adler is fantastic but about office politics. I didn’t like Changing Places nor Lucky Jim. I doubt a novel could be better than this:

A couple of days later we received a note from Lester Earnest to say he was withdrawing from the committee. Since Les was underwriting the event this was a blow; we had lost our funding.

I wrote to Les asking him what had happened, knowing that the exchange with [Jennifer] Widom [chair of the Stanford CS department] over the December holiday was surely sufficient to deter and depress anyone.

A few hours later Ed Feigenbaum wrote to the committee saying that he had not spoken to Les but that he would withdraw from the committee himself. This puzzled both me and Les because Les had just told me that Ed that had talked him out of supporting the conference.

Is there a blog about academic politics?

What Koreans Know About China That Many Chinese Don’t Know

Seth Roberts5 Comments

Everyone knows that Chinese media is heavily censored. I recently learned from my Chinese tutor, who is from Korea, that the South Korean media delights in spreading China-is-scary-and-weird stories, which tend to be censored in China. Here are examples:

1. A frozen dumpling made in China contained part of a cigarette. Someone took a picture and posted it. Someone from Korea noticed before it was censored. News of this spread all over South Korea.

2. Someone in China took a picture of the Yangtze River in Jiangsu Province full of pill containers (e.g., blue/green capsules) floating on the surface. Censored in China, the picture was publicized widely in South Korea. I saw it on my teacher’s cell phone.

Along similar lines, on May 2, a Korean journalist reported that she secretly entered a factory where medical pills were being made and found that among the ingredients were human baby parts. It sounds impossible, yes, but that is what was reported. (I wrote this several days ago, I should have posted it sooner.)

“I never take Chinese medicines,” said my teacher. I asked her why the Korean media like these stories so much. “They show that something impossible is happening in China,” she said.

Assorted Links

Seth Roberts6 Comments

Thanks to Melissa McEwen and Bryan Castañeda.

Interview with a Shangri-La Dieter

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A few days ago I asked Mark Qualls, a 59-year-old truck driver who lives in Longmont, Colorado, about his success with the Shangri-La Diet, which he posted about.

How did you learn about it?

Freakonomics. When I read about you in that book, it made sense to me. The whole idea of a setpoint. I used to be an accountant. I weighed 290 pounds. I’m 6′ 2″. I lost 25 pounds when I started driving a truck. I’ve been there for almost 12 years. Around 260. I get a lot of exercise delivering groceries. I can eat anything I want but the idea of going on a diet makes me hungry. My doctor said lose a bit of weight but I just couldn’t do it.

How do you do the diet?

I use canola oil. I tried flax seed oil but it has a horrible taste. I have no problem taking the oil. I feel like I could do the oil for the rest of my life. At least 4 tablespoons per day. I don’t measure it. I have a jar by a sink at home, another in my truck. I take a sip, what seems about a tablespoon. I figure I’m getting at least 4 tablespoons per day. Some days I may get only 3 tablespoons.

What effect has it had?

I feel like I’m in control. I stopped drinking sweet tea, used to drink tons of it. For 20 years. I’ve been able to stop. I couldn’t stand drinking water. Now that’s all I drink. That’s all I’ve had for two months. The most bizarre thing to me in the world. I deliver to convenience stores. All they have is soda pop and doughntuts and all that kind of stuff. I’d stop and have a doughnut and chocolate milk. Now I can go without it. I still think about it but now I can say no.

What about weight loss?

I’m down from 255 to 229 – a little over 2 months. I don’t really try that hard. I pretty much eat what I want. On two days per week I try to eat hardly anything. Unless I almost eat nothing, I stay at the same weight. It’s not hard to do it – to eat almost nothing. Almost any time of day or night I think “I could eat something”. But then it’s okay not to. It gives you willpower – that’s how I explain it to people. Find the book and read the whole thing, I tell them. They need to understand the whole concept before they start taking oil.

Any downsides?

Eating is enjoyable to me. My mom is a great cook. My wife is a great cook. I like to eat. It’s emotionally satisfying thing to eat stuff. But when I take the oil I can not eat. Now I eat slower. To try to enjoy the little bit of food you do it. You’re not going to eat 3 more times today. I tell myself, I’m going to enjoy every bite of this cottage cheese. Because that’s all I’m going to eat today. The social part I miss. It’s a social part of your life that you don’t have any more. Most of the time I’ve gone to eat with people since I started, I go ahead and eat something because I don’t want to be a jerk about it. I still lose weight. That will be a day where I don’t lose weight when I go out to eat. To lose weight I have to have a day when I don’t eat anything. Today is a day where I told myself I want to lose 1 more pound. I ate breakfast with a friend,. There’s nobody who expects me to eat with them. My wife’s away.

How do other people react?

My wife’s a skeptic about the whole thing. She doesn’t think I can’t keep the weight off. One lady at church, she got the book right away. She’d lost 50 pounds eating 1000 calories per day. She started the oil. She’s gung ho about it. We see each other Sunday: how much did you lose this week? we ask.

 

 

Effect of Vitamin D3 on My Sleep

Seth Roberts23 Comments

I have blogged many times about biohacker Tara Grant’s discovery that she slept much better if she took Vitamin D3 in the morning rather than later. Many people reported similar experiences, with a few exceptions. Lots of professional research has studied Vitamin D3 but the researchers appear to have no idea of this effect. They don’t control the time of day that subjects take D3 and don’t measure sleep. If the time of day of Vitamin D3 makes a big difference, measuring Vitamin D3 status via blood levels makes no sense. Quite likely other benefits of Vitamin D3 require taking it at the right time of day. Taking Vitamin D3 at a bad time of day could easily produce the same blood level as taking it at a good time of day.

I too had no idea of the effect that Grant discovered. I had taken Vitamin D3 several times — never in the morning — but after noticing no change stopped. I tested Grant’s discovery by taking Vitamin D3 at 8 or 9 am. First, taking it at 8 am, I gradually increased the dose from 2000 IU to 8000 IU. Then I shifted the time to 9 am. The experiment ended earlier than I would have liked because I had to fly to San Francisco.

When I woke up in the morning I rated how rested I felt on a 0-100 scale, where 0 = not rested at all and 100 = completely rested. I’d been using this scale for years. Here are the results (means and standard errors):

Vitamin D3 had a clear effect, but the necessary dose was more than 2000 IU. If Vitamin D3 acts like sunlight, you might think that taking it in the morning would make me wake up earlier. Here are the results for the time I woke up:

There was no clear effect of dosage on when I got up. Shifting the time from 8 am to 9 am may have had an effect (I wish I had 3 more days at 9 am).

Many people have reported that taking Vitamin D3 in the morning gave them more energy during the day. I usually take a nap in the early afternoon so I measured its effect on the length of those naps:

Maybe my naps were shorter with 6000 and 8000 IU at 8 am. It’s interesting that 4000 IU seemed to be enough to improve how rested how I felt but not enough to shorten my naps.

What do these results add to what we already know? First, the large-enough dose was more than 2000 IU. (A $22 million study of Vitamin D3 is using a dose of 2000 IU.) The dose needed to get more afternoon energy may be more than 4000 IU. Second, careful experimentation and records helped, even though many people found the effect so large it was easy to notice without doing anything special. For example, these results suggest the minimum dose you need to get the effect. Three, these support the value of supplements. Many people say it is better to get necessary nutrients from food rather than supplements. However, supplements allow much better control of dosage and timing and these results suggest that small changes in both can matter. I cannot imagine this effect being discovered with Vitamin D3 in food.

The Feeding Tube Diet

Seth Roberts18 Comments

In The Shangri-La Diet I noted that hospital patients given intravenous feeding often lose a lot of weight without hunger. I said this supported my theory that the body fat set point is raised by the smell of food. Without smell, the set point goes down. When your set point goes down you lose weight without becoming hungry.

You should be able achieve the same effect by nose-clipping all your food. A new diet, however, makes smell avoidance considerably more difficult and expensive.

The K-E diet, which boasts promises of shedding 20 pounds in 10 days, is an increasingly popular alternative to ordinary calorie-counting programs. The program has dieters inserting a feeding tube into their nose that runs to the stomach. They’re fed a constant slow drip of protein and fat, mixed with water, which contains zero carbohydrates and totals 800 calories a day. Body fat is burned off through a process called ketosis, which leaves muscle intact, Dr. Oliver Di Pietro of Bay Harbor Islands, Fla., said.

It is a hunger-free, effective way of dieting,” Di Pietro said. “Within a few hours and your hunger and appetite go away completely, so patients are actually not hungry at all for the whole 10 days. That’s what is so amazing about this diet.”

Di Pietro says patients are under a doctor’s supervision, although they’re not hospitalized during the dieting process. Instead, they carry the food solution with them, in a bag, like a purse, keeping the tube in their nose for 10 days straight. . . .

Schnaider said she was never hungry throughout the 10 days she was on the K-E diet, but admits that it still wasn’t easy. “It was emotionally difficult, the 10 days of not eating,” Schnaider said. . . . Although the K-E diet is new to the United States, it has been around for years in Europe. Dr. Di Pietro charges $1,500 for the 10-day plan, and says the before-and-after pictures sell themselves.

I sympathize with the “emotionally difficult.” When I lost 30 pounds in 3 months drinking sugar water, I ate maybe 50% of my usual calorie intake. I was never hungry and that too was bad. The world seemed drab without hunger.

Thanks to Tom George.

Coconut Oil/Foot Fungus Update

Seth Roberts19 Comments

A month ago I wrote about Chuck Currie’s discovery that coconut oil cured his foot fungus and seems to be curing his toenail fungus. He put coconut oil on his foot, put it in a plastic bag, and put a sock on it. Then he could walk around or whatever — vastly more convenient than the soaking remedies (e.g., soak your feet in vinegar) many people recommend (which I tried) and incomparably better than the foot fungus and toenail fungus remedies you find in a drugstore (which I tried many times).

For some strange reason I had foot fungus on one foot but not the other — for ten years. I have been doing Chuck’s remedy for a month. Within a few days it was clear it worked. Now the “good” and “bad” foot are indistinguishable. I am writing this post because I discovered that the plastic bag is unnecessary, making it even more convenient. I put the coconut oil on my feet and then put on socks. It still works. Nothing bad happens to the socks, which I think are a cotton/polyester blend.

I’ve been using Whole Foods house brand (“365″) food grade (‘expeller pressed virgin organic”) coconut oil. A 16-oz jar cost about $8. Maybe it will last 4 months with daily application. (For toenail fungus. My foot fungus is completely gone.) All other commercial foot fungus remedies should quietly disappear…

Do Sonograms Cause Autism? New Evidence

Seth Roberts5 Comments

A female American engineer named Parrish Hirasaki has started a website devoted to the idea that prenatal ultrasound is a major cause of autism. It includes a long list of supporting research. In spite of all this research, “as of spring 2011, analyzing the ultrasound results was not among the 23 hypotheses [about the cause of autism] being tested by the National Children’s Survey”, says the website.

I first heard this idea from Caroline Rodgers, a science writer, and have blogged about it several times. Nevertheless, the website’s home page taught me several things I didn’t know:

1. “A recent major study of twins supports earlier studies in concluding that environmental exposures during or shortly after gestation cause a majority of autism cases.” This is inconsistent with many other explanations (e.g., vaccine, genetic).

2. “In a recent study, autistic children had reduced connectivity between the two sides of the brain.” Which supports the idea that neural misdevelopment is a cause of autism.

3. “Twenty years ago, the FDA increased the allowable intensity of prenatal ultrasound 8-fold to improve images. Autism rates have risen dramatically since that time.”

4. There is “widespread misunderstanding among ultrasound operators of the safety guidelines.”

5. “A fast-growing commercial business is keepsake ultrasound photos. Franchisers advertise that no medical background or certification is required.”

I asked Hirasaki a few questions.

How did you become interested in this?

My age and my profession led me to the theory that the rise in autism is caused by exposure to prenatal/neonatal ultrasound.
  1. When my last child was born in 1978, there was one ultrasound machine serving the entire population of Houston.
  2. My work experience in the industrial and aerospace industries was extensive in heat and vibration.
  3. For several decades, my work included industrial instrumentation in chemical plants and refineries. Most such instruments require routine calibration to stay accurate.
  4. In the space program, there are always redundant devices because mechanical and electrical equipment may malfunction.
  5. A first cousin died at age 6 of cancer caused by x-ray overdose in the 1940′s. I am old enough to remember getting my feet x-rayed at the shoe store.

Who else, in addition to Caroline Rodgers, has independently had this idea and written or posted about it?

Manuel Casanova, a neurologist. Nancy Evans, a science writer.

When you started looking into possible causes of autism, did you look into other possible explanations?

No. I asked myself what had changed about having a baby. Ultrasound seemed to be the obvious major change. Exposure to caffeine, smoking, alcohol and medications had all decreased.

Was there any particular evidence that you found especially persuasive?

On my website, there are 37 papers pertinent to the topic. My primary theory is that overexposure is the cause. The most persuasive evidence that points to this is:

  1. The girls in the Kaiser-Permanente study who have the highest exposure to ultrasound during the second trimester have more than double the expected rate of autism.
  2. Interruption of the neural migration patterns in the brains of the overexposed mice in the Yale study.
  3. A known cause of autism is the mother having an infection. One theory is that as the mother’s body fights the infection with a fever, the rise in temperature of the fetal brain causes the damage. The temperature rises in tissue exposed to ultrasound are reported in a paper which calls for the FDA to examine the current allowable limits.
  4. The much higher rate of autism for children who weighed less than 4.5 pounds at birth. The medical and AIUM protocol for infants this small is an immediate head ultrasound.
What has made it difficult for the research community to find this?
  1. The researchers have education and experience [and funding — SR] in medicine, biology, genetics. This is where they look.
  2. In the 1950′s, the FDA turned the regulation of medical ultrasound over to the American Institute for Ultrasound in Medicine (AIUM) which is funded by the government and the manufacturers. In November 2011, I expressed my concerns via email to the AIUM Bioeffects Committee. The chair responded that the AIUM monitors the topic and has conducted a thorough search of existing literature (2008) and found no link except the “weak association” in the Kaiser-Permanente study. The report states that there are potential risks to administering ultrasound tests, which include “postnatal thermal effects, fetal thermal effects, postnatal mechanical effects, fetal mechanical effects, and bioeffects considerations for ultrasound contrast agents.” Another section says “the long-term effects of tissue heating and cavitation have shown decreases in the size of red blood cells in cattle when exposed to intensities higher than diagnostic levels. However, long-term effects due to ultrasound exposure at diagnostic intensity is still unknown.” In 1992, the AIUM and the FDA increased the allowable intensity of prenatal ultrasound 8-fold without knowing whether it was safe. Twenty years later, they still don’t know.
  3. Engineers who could do such research receive funding from the manufacturers. Such a researcher would be unlikely to propose research that could decimate the industry.
  4. This is the classic search for a needle in a haystack. Less than 1 in 300 ultrasounds is causing noticeable brain damage.

I would add that links between sonograms and left-handedness are more evidence that sonograms can cause important brain changes. Here is a doctor who does sonograms dismissing the connection but what I find important is that the connection has been found repeatedly.

Lack of Repeatability of Cancer Research: The Mystery

Seth Roberts14 Comments

In a recent editorial in Nature (gated), the research head of a drug company complained that scientists working for him could not repeat almost all of the “landmark” findings in cancer research that they tried to repeat. They wanted to use these findings as a basis for new drugs. An article in Reuters summarized it like this:

During a decade as head of global cancer research at Amgen, C. Glenn Begley identified 53 “landmark” publications — papers in top journals, from reputable labs — for his team to reproduce. Begley sought to double-check the findings before trying to build on them for drug development. Result: 47 of the 53 could not be replicated.

Yet these findings were cited, on average, about 200 times. The editorial goes on to make reasonable suggestions for improvement based on differences between the findings that could be repeated and those that could not. The Reuters article goes on to describe other examples of lack of reproducibility and includes a story about why this is happening:

Part way through his project to reproduce promising studies, Begley met for breakfast at a cancer conference with the lead scientist of one of the problematic studies. “We went through the paper line by line, figure by figure,” said Begley. “I explained that we re-did their experiment 50 times and never got their result. He said they’d done it six times and got this result once, but put it in the paper because it made the best story.

Okay, cancer research is less trustworthy than someone just barely outside it (Begley) ever guessed. Apparently careerism is one reason why. What is unexplained in both the Nature editorial and the Reuters summary is how research can ever succeed if things aren’t reproducible. Science has been compared to a game of Twenty Questions. Suppose you play Twenty Questions and 25% of the answers are wrong. It’s hopeless. In experimental research, you generally build on previous experimental results. The editorial points out that the non-reproducible results had been cited 200 times but what about how often they had been reproduced in other labs? The editorial says nothing about this.

I can think of several possibilities: (a) Current lab research is based on experimental findings of thirty years ago when (for unknown reasons) careerism was less of a problem. Standards were higher, there was less pressure to publish, whatever. (b) There is a silent invisible “survival of the reproducible”: Findings that can be reproduced live on because people do lab work based on them. The other findings are cited but are not the basis of new work. (c) There is lots of redundancy — different people approach the same question in different ways. Although each individual answer is not very trustworthy their average is considerably more trustworthy.

Leaving aside the mystery (how can science make any progress if so many results are not reproducible?), the lack of reproducibility interests me because it suggests that the pressure to publish faced by professional scientists has serious (bad) consequences. In contrast, personal scientists are under zero pressure to publish.

Thanks to Bryan Castañeda.