Stuart King writes:

I was very hungry today at dinner and the thought of sweet food wasn’t appealing at all, but after filling up on some rice, chicken and coconut cream curry I immediately had ice cream and chocolate slice [= what Americans call a brownie], which had had no appeal 15 minutes or so before!

An everyday observation that anyone can make. Studies have shown what Stuart noticed: When you are hungry sweet foods are unappealing. This is why dessert is eaten after the rest of the meal.

The main way that psychologists explain an experimental effect — choose between explanations — is by finding out what makes the effect larger or smaller. For example, discovery of what makes learning more or less (what increases or decreases the effect of one learning trial) is the main way psychologists have chosen among different theories of learning. Different theories predict different interactions.

Why do we like sweet foods? The usual answers are that sweet foods are a “good source of energy” and they provide “quick energy”. But these explanations do nothing to explain what Stuart noticed. If sugar is a good (= better than average) source of energy, we should eat it before other foods (average sources of energy) when we are hungry (hunger signals lack of energy). The opposite is true. You may not want to call it a “contradiction” but there is no doubt the conventional view does not explain what Stuart noticed. Of course many nutrition experts, such as Weston Price, are/were entirely sure sugar is unhealthy.

As a tool for choosing among theories, Stuart’s observation is especially good because (a) it is very large (sweets go from unappealing to appealing) and (b) paradoxical (eating calories should make all calorie sources less appealing).

If you have been reading this blog, you know I explain Stuart’s observation by assuming that we need sugar in the evening to sleep well. Sugar (sucrose, fructose, glucose) eaten in the evening increases blood glucose, which increases glycogen. During sleep, glycogen becomes glucose, which the brain needs to work properly. Evolution shaped us to like sweet foods after a meal so that we will eat them closer to when we sleep. (The value of replenishing glycogen close to bedtime also explains why we eat sweet foods after dinner more than after breakfast or lunch.)

I can’t think of another case where what experts say is so out of line with what’s easily observed. For example, I’m sure cholesterol doesn’t cause heart disease, but there is no everyday observation that supports my belief.

I can’t think of another case where what experts say is so out of line with what’s easily observed. For example, I’m sure cholesterol doesn’t cause heart disease, but there is no everyday observation that supports my belief.

If sugar is helpful for sleep, why is it associated with diabetes? My guess is that sugar is almost always consumed in foods that taste exactly the same each time — what in The Shangri-La Diet I called ditto foods. For example, soft drinks. Ditto foods with sugar, because they have a strong precise CS (smell) and a strong fast US (calorie signal), produce an especially strong smell-calorie association. Such an association raises the body fat set point, thus causing obesity. Obesity causes diabetes. It’s also possible that eating sugar during the day — at the wrong time — hurts sleep. Maybe sugar during the day raises insulin and thus reduces the conversion of sugar to glycogen. Less glycogen causes bad sleep, bad sleep causes diabetes. My blood sugar levels clearly improved when I started eating sweets in the evening — opposite to what the sugar-diabetes link would predict.

• American Physical Society expresses uncertainty about AGW (anthropogenic global warming).
• Kyoko Miyake, talented documentary maker. I really liked Brakeless.
• Interview with Renata Adler. “The following thirty-two pages, in place of my essay–my most “controversial” essay, in some ways, closely argued–were from a cookbook.”
• The modern diet, in graphs. Note the huge increase in soybean oil. Sugar isn’t the only foodstuff to have increased a lot over the last 50 years.
• Blame doctors for the heroin epidemic. “Until recently, the system was rigged to encourage doctors and dentists to give out opioids with reckless abandon.”

Thanks to Casey Manion.

• Why I am anti-Komen. “Do you think individuals who donated to Susan G. Komen foundation knew their money would be used to sue other charities who want to raise money like Prom was doing? . . . Once national news shone a spotlight on Komen’s bullshit move, they backed off.”
• Cardboard standing desk
• Alex Chernavsky finds no effect of soy on brain speed
• Probiotic helps children. Notice that the study was done in Mexico City.

Thanks to Melody McLaren.

Walmart sells a kit for home measurement of HbA1c (brand name ReliOn) that costs $9 and provides results by email. It’s sold only at Walmart. I have been paying $30 for the same measurement at a test center (about 30 minutes away). If you use insurance, copay might be $15. Without insurance, a doctor’s office test might cost $90. The reviews suggest the test has roughly the same variability and average as a lab test. A few people had trouble getting enough blood on the dots but at $9 there is plenty of room for repeat testing.

My blood sugar improved when I started to walk an hour per day and when I started intermittent fasting (eating about half as much as usual every other day). I noticed the effects with blood sugar tests but frequent HbA1c tests (say, once/week) would have been much better.

Diabetes has become an enormous problem in China, where 10% of adults have Type 2 diabetes, roughly the same as in America. Americans often think obesity causes diabetes but this doesn’t explain why smoking — which makes people thinner — is associated with diabetes. People get diabetes who don’t smoke and aren’t fat. Whether anyone who walks an hour/day gets diabetes is less clear.

Thanks to Shant Mesrobian.

A year ago, Eric Lander, who identified himself as “President and Founding Director of the Broad Institute of Harvard and MIT [and] one of the principal leaders of the Human Genome Project, directing the largest center in the international project” did a Reddit AMA (Ask Me Anything). One of the questions did not go as expected:

Question As an advisor to the President, what is being done or do you think will be done to increase the attractiveness of students finishing PhD programs in science?

Lander We need to shorten the time for getting a PhD and for a first faculty job. Young people should get out into the scientific world early, when they have lots of fresh ideas. We should encourage grants to young scientists and should encourage them to take big risks. When you’re taking big risks, science is amazingly fun.

The response to this answer was very negative.

With all due respect, this is a ludicrous statement. . . The true problem is the way in which you fund science. You fund projects and proposals. In order to get these projects funded, the preliminary data has to be essentially the whole project being done. Then you fund at a 6% percent line. It leads to cronyism in the peer review process and a general sense of despair in scientists. How about you radically change the funding system for PIs?

I too am disappointed with Dr. Lander’s response to possibly THE most important question here regarding training basic scientists.

Do you truly believe this? . . . There is no reason to encourage more students to go into science if there is not enough government funding to support their careers.

Alas, this is not important. It just pleased me that someone questioned Dr. Lander’s absurd claims, which he makes often. “We should encourage young scientists to take big risks”. Yes, I agree, does he really believe this? Do he really believe that someone coming up for tenure should take big risks?

A recent Bloomberg News article looked into why Mt. Sinai Hospital in New York did a very large number of heart procedures, making its cardiologists very well-paid. One reason, the journalists discovered, is that patients had been told to lie:

On a pair of representative Sundays in 2012, 10 patients told ER workers they’d been instructed to arrive there before their cath-lab appointments, according to internal hospital correspondence. Two of them said they’d been coached to say they were having acute symptoms of heart disease, according to the exchanges.

Even more remarkable, the journalists found, was that many patients had cardiology appointments before they showed up at the emergency room:

Certain patients who showed up at Mount Sinai Hospital’s emergency room on Sunday mornings stood out [because] they already had appointments. Each was scheduled for a procedure at Mount Sinai’s catheterization lab, where cardiologists thread wires and tubes into blood vessels to detect disease and insert cardiac stents. The New York hospital’s cath lab has regularly scheduled such emergencies-by-appointment, according to three doctors and another medical professional, all of whom said they had direct knowledge of the practice.

Larry Husten, a medical columnist at Forbes, argues that this is an example of a widespread problem.

I have blogged many times that bedtime honey improves sleep. I learned this from Stuart King, an Australian musician. He also pointed out we eat dessert with dinner more than with other meals. which others who have described the honey effect have not said. The dessert observation suggests that other sweets, not just honey, improve sleep. After I repeated the dessert observation, a friend said I of all people should know it isn’t universal. The Chinese don’t eat dessert, she said. Yes, I said, but where I lived in Beijing there seemed to be lots of sweets eaten in the evening, and lots of street vendors selling fruit in the evening.

The honey-sleep connection helped me improve my sleep in other ways. I found my sleep got better if in addition to bedtime honey I ate fruit (e.g., banana) an hour or so before bedtime. My sleep got even better if I ate something sweet, such as Yakult, an hour or so before that. Both observations implied that honey improved sleep because of the sugar. Nowadays I usually eat three sets of sweets: soon after dinner, mid-evening, and bedtime. I sleep very well every single night, better than ever before. These findings make sense if glycogen (stored glucose) is very important for sleep. My way of eating (three sets of sweets slightly spread out) may produce more glycogen at bedtime than similar ways of eating (e.g., eating the same sweets spread throughout the day).

Recently I realized that Stuart’s observation about dinner and dessert made a prediction: the word dessert should be better associated with the word dinner than the words breakfast and lunch. (A lot of talking/writing consists of describing reality.) I used Google to test this prediction. I counted the hits returned when I searched “dessert dinner”, “dessert breakfast”, and “dessert lunch”. The prediction turned out to be true: “dessert dinner” had a lot more hits than the other two combinations, even though breakfast, lunch and dinner are almost equally common.

I checked about forty other food words: Were they more associated with one meal than others? I found several interesting things.

1. It wasn’t just dessert. Honey and fruit were associated with dinner more than breakfast or lunch. The size of the association was very similar in the three cases. For almost all other food words I tested there was little or no association.

Here are examples of little or no association.

2. There were some surprising associations, shown here.

No surprise that tea is associated with breakfast but why is potato associated with lunch? French fries? Why is nuts associated with dinner? Do nuts contain something that improves sleep?

For each food I computed a “dinner effect” meaning the log(dinner count) minus the average of log(breakfast count) and log(lunch count). Here is a kind of histogram of those values.

The outlier status of nuts, fruit, honey and dessert is clear.

These findings support (a) the original idea (because the original idea led to them), (b) the importance of the original idea (because the association is so clear) and (c) use of Google to learn what people do. Word associations are influenced by many things, no doubt; these results suggest actual behavior is a strong influence. Use of Google to study behavior is free, public, fast, and convenient.

I was surprised the results were so clear. I suspect the explanation is that sweets taste better closer to bedtime. Dessert, honey and fruit differ in many ways; the similarity of size of association suggests that the association is due to what they share (sugar).

I hereby give you permission to eat dessert with dinner.

• Magnesium associated with reduced arterial calcification
• Sarno method for treating muscle pain compared to other methods. “My surgeon who had been an NBA team physician assured me I had a 90% plus chance of returning to my life as it had been. However, eight weeks after the surgery I was WORSE.”
• Are old people in Great Britain living shorter lives because of prescribed drugs?
• Some cancers detected by mammograms apparently disappear without treatment.

Thanks to Steve Hansen.

According to the headline of a Yahoo News article, “the dawning of the age of genomic medicine” is upon us. There has been little impact of genomics but “that is finally changing,” says Julie Steenhuysen, the author of the article.

I was curious how this would be argued. Here’s how:

Sambrookes had been very athletic as a young teen, but as she matured, she noticed a heaviness in her legs. By age 20, running left her tired. At 40, she needed a pacemaker, just like her mother did at that age.

“I started thinking there is something to this,” said Sambrookes, now 56, who lives in Michigan City, Indiana.

After some dead ends, she found McNally, who cast a wide net, testing for more than two dozen genes that could account for Sambrookes’ heart and muscle problems.

The culprit turned out to be a mutation in a gene called Lamin that causes Limb-girdle muscular dystrophy. The disease can cause weakness and wasting of the muscles between the shoulders and knees. The mutation can also cause electrical disturbances of the heart.

McNally recommended Sambrookes replace her pacemaker with an implantable cardiac defibrillator that could protect against sudden cardiac death.

That proved to be the right call. Last August, Sambrookes’ heart stopped three times. Each time, the defibrillator shocked her back to life.

“She literally tried to die three times,” McNally recalls of her patient. “It still takes my breath away.”

Because someone recommended a pacemaker be replaced with a defibrillator, genomic medicine is a good idea. The benefits of genomic medicine must remain elusive if you have to use such a poor example to support it.

• progress on narcolepsy. It is an auto-immune disease. A vaccine against the H1N1 (swine flu) virus apparently caused narcolepsy in France.
• Was Angleton right? New book by Edward J Epstein.
• Vivaldi’s business plan. “It ­doesn’t depend on pity; it doesn’t begin with scarcity. It starts with people’s talents and promise, not their neediness and suffering. It doesn’t assume that the people with money have the answers and the solutions while the people without money have the problems and the tragedy.” Another excellent post by the same author (Samuel Wells).
• Is the problem gluten or something sprayed on wheat? (Here is a unconvincing rebuttal.)

Thanks to Patrick Vlaskovits.