Category: health care

Assorted Links

Seth Roberts3 Comments

Thanks to Steve Hansen and Gary Wolf.

“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.

Foot Fungus Revisited

Seth Roberts7 Comments

I described earlier my theory about foot fungus — that mine, at least, has been caused by socks. It recently got worse. Consistent with my theory, I had just gotten a dozen new pairs of socks of a new material. My theory suggested I buy new socks of a different material (I did), change socks more often (I did), and go sockless more often (I did). As soon as I made these changes, the fungus went away. More support for the theory. A few other people (see the comments to my earlier post) and a friend have had experiences that also support the theory.

My Berkeley doctor didn’t know this theory. He looked at my foot fungus and repeatedly suggested certain non-prescription medicines. I haven’t seen this point made elsewhere, although you can find a list of 20 things to do that includes “change your socks often”.

Sometimes doctors (and medical schools) are criticized for lack of emphasis on nutrition. Sometimes they are criticized for lack of emphasis on prevention. This was neither: it was cure and non-nutritional. Curing infection is one of the main things doctors try to do, which is why antibiotics are heavily-prescribed.

Suppose you bring a task to Programmer A. He has done a long education in programming followed by a long internship, and then passed a difficult screening test to become “board-certified”. To maintain his certification he takes “continuing education” classes. He returns with a 100-line program that fails to work. (The medicines my doctor recommended failed to work. He thought the failure was due to my not following the directions closely enough.) Then a 10-year-old boy gives you a 3-line program that works perfectly. You would realize your society is fond of make-believe — in particular, making believe that those who teach programmers understand their subject.

Positive Side Effects

Seth Roberts5 Comments

What happened to Brent Pottenger — when he improved his diet along ancestral lines, a serious health problem unexpectedly went away — also happened to Aaron Blaisdell. He improved his diet along ancestral lines and his sun sensitivity went away. A non-nutritional version happened to me: By adopting elements of Stone-Age life, I slept much better. And, at the same time, I stopped getting colds. Another example involves flaxseed oil. My discovery that flaxseed oil made my brain work much better implied that prehistoric diets contained more omega-3. A dosage that produced brain improvement also greatly improved gum health and recovery from injury.

This is the opposite of conventional medicine. As far as I know, every major drug has serious bad side effects. The drugs often help the problem for which they are prescribed, but your health has a good chance of becoming worse — sometimes much worse — in other ways. Against Medical Advice (2008) by James Patterson and Hal Friedman is the true story of a boy (Friedman’s son) with severe Tourette’s. (Recommended by Alexandra Carmichael.) In an epilogue, Friedman says, “Our family is convinced that his most extreme symptoms were caused by medicines prescribed but with unhappy results, almost without exception.” The cure was worse than the disease.

The phenomenon of positive side effects isn’t mysterious. Our bodies need certain inputs to work well. The whole body evolved with the same inputs. When something crucial is missing, several things break down. And when the missing thing is supplied, several things get better. We write all our words using the same 26 letters. If one letter is missing, many words will be misspelled. When the missing letter is supplied, many words will be spelled correctly. Fixing one word fixes many words. For example, suppose you lack “k”. Blink will be spelled “blin”, mark will be spelled “mar”, and so on. When you realize you need “k” to spell blink, at the same time you will improve the spelling of many other words.
The implication of positive side effects is profound. Finding the right inputs isn’t a new wrinkle on current health care, it’s a whole new way of being healthy. Public health officials haven’t had much luck selling prevention but maybe that was because their ideas about prevention have been poor — telling people to eat according to the Food Pyramid, for example. And if you are sick (as Brent was), you are highly motivated to do something about it. The old saying an ounce of prevention is worth a pound of cure should be revised: a ounce of the right cure is worth a pound of prevention. The dietary improvements that cured Brent’s migraines will prevent many other problems. Going from the old saying to the new saying is like going from thinking the sun revolves around the earth to realizing the earth revolves around the sun.

A great change is coming.

The Ancestral Health Symposium.

Brent Pottenger and the Benefits of an Ancestral Diet

Seth Roberts9 Comments

I read somewhere that Brent Pottenger (blog here) had benefited from adopting an ancestral diet. (Brent, Aaron Blaisdell and I are organizing the Ancestral Health Symposium.) I asked him for details. His answer:

I had debilitating migraines and chronic sinus infections for years, despite being a top-performing multi-sport athlete and following Conventional Wisdom (Food Pyramid, etc.) nutritional recommendations diligently. I’ve always been interested in living as healthy as possible, so I had made sure to do things like eat lots of whole grains. Essentially, components of my diet were causing chronic inflammation, but I did not know it. As a result, I had to take antibiotics (Z packs, erythromycin, amoxicillin, etc.) repeatedly for many years (a scary thing in light of the importance of gut flora), usually about 5 to 10 times per year for infections. My migraines got so bad that I had to go to the emergency room four times during a 1.5 year span to get pain medications because my prescription migraine drugs and painkillers (like Vicodin) did not work. The migraines were so painful that I would shut down and could not even take a nap to let them pass.

I talked about it in part at BIL:PIL:

I did not set out to cure myself, but that’s what happened. I started down what turned out to be the right health path because I read Nassim Taleb’s The Black Swan. In that book, Nassim referenced Art DeVany. I read Art’s work on Evolutionary Fitness. Nassim and Art dovetail nicely, and the idea that evolution could inform health decisions made sense to me. That nudged me to cut grains (and other things) out of my diet. Art also tipped me to Mark Sisson, and I related really well to Mark’s personal story as an athlete with a passion for health, and I enjoyed the logic behind his Primal Blueprint framework. From there, I got actively involved in what I call the Ancestral Health epistemocracy that has emerged in the blogosphere–Mark, Art, Robb Wolf, Matt Metzgar, Tim Penn, and I actually co-authored an unpublished book together in 2007. At this point, though, I still did not know that I had resolved my health problems for good; I just knew that these ideas were working–I gained lean muscle mass, had more energy, felt great, etc.–as I tested them on my own body. Through this involvement as both an e-patient and a hobbyist blogger/essayist, I realized that a few years had passed and I had not experienced a migraine or a sinus infection. Now, after over three years without a migraine and having only been ill one time, I realize that I cured myself nutritionally, as a side-effect of tinkering with the aforementioned ideas. During this process, I also found out about your work from Nassim. For lots of reasons, your work on self-experimentation seemed really valuable to me. For example, my neurologist examined me and prescribed some drugs that were, looking back, quite dangerous to take for a problem that was caused by things like grains, legumes, processed vegetable oils, and Conventional Wisdom nutritional guidelines. My self-experimentation was, ironically, much safer and ultimately more sophisticated from a philosophy of science perspective because I could react to local feedback that my neurologist did not have access to: my own body. From there, I realized that we are all experts in our own body and that physicians must partner with us respectfully if they want to act as agents who help us find cures for health problems. I’ve written about my experiences in bits and pieces elsewhere, but this is a brief synopsis that captures most of the highlights in one place.

Basically, thanks to an inquiring mind and persistence that I owe to my mom’s mentorship, I transformed my physiology remarkably thanks to trial-and-error solution searching with things I learned from Nassim, Art, Mark, and you. From there, I’ve added more “maps” into my portfolio of health practices from Doug McGuff, Keith Norris, Kurt Harris, and many others (many are listed on the Symposium presenter list). As a result, I no longer consume health-care resources and these resources can go to treat real medical problems. How remarkable were the improvements? One way to capture that besides the disappearance of my health problems is to look at my weight changes: at the same waist size, I’ve gone from 135 lbs. in 2002 to ~145 lbs. in 2004 to ~170 in 2010. That says something.

He later added:

Things I did to relieve my migraines that didn’t work:

– prescription glasses (theory = eye strain)
– cutting out caffeine (theory = ? stress)
– napping more (theory = better sleep)

None of those experiments cured my health challenges. Only nutrition worked. Very few environmental factors have fluctuated much over the past ten years: I’ve lived in the same hours, slept in the same bed, been a student, played the same sports in the same places around town, etc.

His old diet and his new diet:

Pre-Ancestral Health diet: I followed the Food Pyramid and associated concepts closely, so I consumed lots of whole grains (breads, pastas, granola, bagels, etc.), fruits (whole and juiced), vegetables, non-fat milk, non-fat yogurt, some meat (all kinds), coffee, tea, beans (black, pinto, others), and some cheese (pasteurized) and nuts. I ate things like Cliff Bars, drank Odwalla smoothies, etc.

Ancestral Health diet: I follow a very carnivorous paradigm, so I consume lots of meats (from pork bellies to raw Ahi tuna) and eggs, lots of cultured butter, coconut butter & oil, full-lipid Greek Yogurt (highest saturated fat content of any yogurt on the market), some vegetables (onions, avocados, greens) and mushrooms (sauteed in butter with onions and meats), essentially no fruit (I’m in a ‘Fructose Detox’ self-experiment), a little raw cheese, coffee, tea, essentially no alcohol. I also supplement with some Vitamin D, which is anabolic I think as well. I take fish oil when I have not had fish for awhile. I’ve eaten fish my entire life, though.

I attribute my health improvements directly (and completely) to diet. As my diet evolved, I also altered how I train, transitioning a bit from ‘some long-distance running and sports playing’ to ‘mainly high-intensity, short-duration training (more weights and sprinting) and still sports playing as my exercise approaches. This energy expenditure evolution has, in my opinion, contributed to my stark body composition changes (lean muscle mass gain), but I think that my health improvements are due to diet and that my body composition would be much worse off if my diet had not changed like it has.

I will comment on this in my next post.

Why Cory Doctorow Won’t Buy an iPad

Seth Roberts5 Comments

I loved this Boing Boing post by Cory Doctorow about why he won’t buy an iPad. One of his points:

Relying on incumbents to produce your revolutions is not a good strategy. They’re apt to take all the stuff that makes their products great and try to use technology to charge you extra for it, or prohibit it altogether.

Just as I believe that relying on the medical establishment to improve health care is not a good strategy. Those in power (incumbents) will resist change, especially revolutionary change. Science — connecting beliefs with reality — is surely the most revolutionary activity invented yet professional health researchers, simply because they have something to lose, now resist change.

One of Doctorow’s complaints:

Then there’s the device itself: clearly there’s a lot of thoughtfulness and smarts that went into the design. But there’s also a palpable contempt for the owner. I believe — really believe — in the stirring words of the Maker Manifesto: if you can’t open it, you don’t own it. Screws not glue.

Likewise, I believe it’s possible to do health research where everything is understandable. Where you can understand the data. Where you can understand the connection between the data and better health. The simple situations, treatments and measurements I use in my self-experimentation I judge to be an improvement over obscure health research, whereas I suspect most professional scientists instinctively think something must be wrong with it. Real science, they think, cannot be done by amateurs.

“My Porphyria Went Away”

Seth Roberts4 Comments

I asked Aaron Blaisdell what was most surprising about his experience with “ ancestral health” — adopting a evolutionarily reasonable diet. “That my porphyria went away,” he said. Aaron’s porphyria is/was a form of sun sensitivity. “My mother has it. Her father had it,” he said. It was obviously genetic. Scientists had located the genes involved. Aaron assumed that someday, not soon, it might be possible to fix the genes involved. Until then, he didn’t think anything would change. It was a rare and not particularly damaging disease — it wouldn’t attract a lot of research.

How reasonable the gene-fix idea sounds, in spite of being wrong. I’ve heard dozens of scientists, including Bruce Ames and James Watson, say that we are entering a new age where we will figure out the causes of diseases (their genetic causes) and fix them. A new age of rational medicine. To fix a car or dishwasher, you figure out the part at fault and repair or replace it. The metaphor is so convincing that nobody points out another possible metaphor: Your washing machine isn’t working because you haven’t plugged it in. You need to read the owner’s manual. Most health-care researchers, especially at medical schools, are studying the parts diagram of the washing machine, trying to figure out what part is at fault, when the problem is elsewhere: Not plugged in. Much easier to fix.

Optimal Daily Experience

Seth Roberts15 Comments

Everyone knows about RDAs (Recommended Daily Allowances) of various nutrients. In a speech to new University of Washington students, David Salesin, a computer scientist, advised them to “maintain balance” by getting certain experiences daily:

  • something intellectual [such as a computer science class] (not so hard in college);
  • something physical (like running, biking, a team sport);
  • something creative (like music, art, or writing); and
  • something social (like lunch with a friend).

This served him well in college, he said, and he continued it after college.

I think he’s right — we need certain experiences to be healthy just as we need certain nutrients. My rough draft of such a list would be this: 1. Social. 2. Physical. Nassim Taleb’s ideas about exercise seem as good as anyone’s. This is really several requirements, for different sorts of exercise. 3. Travel. About an hour per day. 4. Hunger. T he data behind the up-day-down-day diet suggest we should experience a substantial amount of hunger every week. 5. Face-to-face contact in the morning. About an hour. 6. Morning sunlight. An hour? 7. Being listened to. I suspect the therapeutic value of psychotherapy derives from this. I believe this is one reason blogging is popular — it provides a sense of being listened to. 8. Being helpful. 9. Being recognized as having value. Blogging helps here, too. 10. Being part of a group effort, something larger. Of course #1 (social) and #5 (morning faces) can come from the same experience, and so can #2 (physical) and #3 (travel). I wouldn’t say we need #7-#10 every day but perhaps several times per week.

I might add two more things: 11. Learning. After I started studying Chinese via Anki/treadmill, I started to sleep better. It wasn’t the treadmill; that wasn’t new. Several studies have found that people sleep more when they are learning intensely. After I became a professor, instances of concentrated learning — such as learning to use R — became rare. I remember how good they felt. How intense learning could go on throughout your life during the Stone Age isn’t obvious, however. Presumably all the experiences we need to be healthy were easily available then. 12. Foot stimulation. In a Beijing park, I came across a cobblestone track about a hundred yards long. Walking on it is supposed to be beneficial. I took off my shoes and socks and tried it. I was astonished how painful it felt — but day by day I could stand on it longer. This is a topic for another post but of course in the Stone Age people got a lot more foot stimulation than anyone reading this. Commercial cobblestone track. Thanks to Tim Lundeen for reawakening my interest in this.

Top and Bottom Versus Middle

Seth Roberts11 Comments

I liked many things about this talk by Jacqueline Edelberg, a Chicago artist and political science Ph.D., about how she and other moms transformed their local school. Edelberg has written a book about it called How to Walk to School: Blueprint for a Neighborhood Renaissance. The man who introduced her told a story: In a classroom, he noticed a girl drawing a picture. What are you drawing? he asked. I’m drawing God, she said. You can’t do that. No one knows what God looks like, he said. They will soon, she said.

Edelberg’s story did sound miraculous: Her crummy neighborhood public school, within a year, became an acceptable place for her children. The change had many elements, including an after-school program, a farmer’s market, and painted doors, but I think the most important piece — which Edelberg said little about — was this: Parents were allowed to attend every class. Within two years, said Edelberg, all the bad teachers left.

I call this way of governing top and bottom versus middle. In this case the top was the school’s principal (Susan Kurland, Edelberg’s co-author), the bottom was the parents, and the middle was the teachers. Acting alone, the principal couldn’t control the teachers — she couldn’t fire the bad ones, for example. With the parents’ help, she could control them.

It’s as old as Moses:

1. As I’ve blogged, the Ten Commandments was an agreement between Moses (top) and the preyed-upon men in his community (bottom) against the men who were preying upon them (middle) — stealing from them, for example.

There are other examples:

2. One reason surgical checklists — implemented by hospital administration (top) — work so well, I believe, is that they give nurses (bottom) power over doctors (middle). A nurse can tell a doctor to follow the checklist. The details of implementation also empower the lower-ranking members of the surgical team.

3. In China, what are called (in Chinese) human-flesh searches — a kind of cyber-vigilante-ism — go on with the approval of the central government (top). These searches, which are actually mini-crusades, allow ordinary citizens (bottom) to punish corrupt or otherwise misbehaving local government officials (middle).

I predict that someday someone in the American government (top) will realize that a way to greatly improve health care is to empower patients (bottom) against doctors (middle).

Widespread Loneliness

Seth Roberts19 Comments

I’m fond of arguing that the Ten Commandments was a very political document. Notice it’s aimed at men? Notice that women aren’t protected, much less children? That’s because men had all the power. No one has said they already knew this or that I was wrong.

I thought of the Ten Commandments when a friend from Amsterdam wrote me about a recent experience of hers:

A very old man asked me to come to his apartment, and he would donate a bike to the project. I went over to get it, and it was half a bike, and it was locked to a pole…had obviously been there for years. The temperature was well below zero.  It became clear that he was in fact super-lonely, and torn between usual Dutch suspicion of strangers… and desperation for human contact.  He finally pleaded with me to come up to his apartment (where he obviously lived alone) but not before we spent 15 minutes trying to saw that rusty old bike loose, with his World War II-vintage hacksaw with missing teeth.

You may know that Dutch people are the tallest in the world, reflecting a very high standard of living. But — if this old man is not unusual — alleviating the loneliness of old people isn’t part of the Dutch social contract, admirable as it may be.

I recently watched the Frontline program Sick Around the World. It suggested that that old man isn’t unusual. In England, where doctor visits are free, a doctor said he has several patients who come weekly, purely because they’re lonely. In Japan, some patients have their blood pressure measured very often — presumably for the same reason. In Taiwan, if you see a doctor 20 times in one month someone from the government will come to talk to you. Not about loneliness — about overuse of medical care. The Frontline program made nothing of any of these facts, which were included to show that access was easy. That’s not all they show. What if the British doctor had said that several patients visit him often because they need water? Then we’d be shocked. Yet the idea that everyone needs human contact isn’t mysterious or controversial.

My explanation is there’s a double whammy: Not only do lonely old people have little power, it’s also clear that their problem (loneliness) isn’t caused by a “chemical imbalance”. So no drugs can be sold to treat it. And there’s no diagnostic category. It’s another example of gatekeeper syndrome. When these lonely old people exert what little power they have by visiting their doctor, the doctor — I’m assuming — doesn’t do anything to get rid of the loneliness. Even if you visit 20 times in a month.