Category: ignorance

How to Avoid Infection: Something I Didn’t Know

Seth Roberts3 Comments

A book called Survival of the Cleanest (2005) by Jacob I. T. Van Der Merwe is about how to avoid infection. As far as I could tell from Google Books, it says nothing about how to boost your immune function. It is all about avoiding public bathrooms, frequent handwashing, and pointing out the many ways in which we can get infected (e.g., touching shopping carts). It is heartfelt but I didn’t find it persuasive. There was almost no data about the efficacy of the book’s thousands of suggestions.

Here is something I couldn’t find in the book. A few months ago, I noticed that my eyes itched. Apparently I had some sort of infection. My eyes almost never itch and this happened to coincide with something else very rare: I hadn’t changed the pillowcases on my bed in a few weeks. So I started changing my pillowcases more often. The itching went away and hasn’t returned. My explanation: The pillowcases were acting as staging areas for the bacteria. Ordinarily my immune system would fight them off but on the pillowcases they were safe. The pillowcases shifted the balance of power.

Survival of the Cleanest does say “correctly laundering clothes kills germs and drastically reduces the risk of infection” but since this particular bit of vague advice (what’s “correctly”?) is mixed with a thousand other bits of advice, such as avoiding doorknobs, it doesn’t get the attention it deserves. For what it’s worth, when I do laundry I do a second cycle without soap, in order to get a really good rinse. I’m less interested in killing germs than I am in washing them off.

Does Bad Medicine Drive Out Good? The Case of Eczema

Seth Roberts6 Comments

In an article on weight regulation I read this:

One subject . . . developed symptoms possible related to EFA [essential fatty acid] deficiency (ie, mild eczema relieved by the addition of fat to the diet).

In other words, the subject — in a metabolic ward at Rockefeller University where everything he ate was supplied by the researchers — developed eczema when fed a zero-fat diet. When fat was added, the eczema disappeared. The researchers understood that not enough fat in your food can cause eczema. This research was done around 1960. The conclusion is supported by dozens of reports from people doing the Shangri-La Diet who said that when they started drinking oil their skin improved. Dry areas disappeared. I found the same thing myself. (And judging by the large fraction of people who have dry skin, a lot of people aren’t eating enough fat.)

The notion that eczema can be cured by eating more fat — perhaps high in omega-3 — could hardly be simpler. Around 1960, at least some doctors understood this (in a situation, I admit, where it was easy to understand). Yet here is how eczema is treated today, according to Bottom Line/Women’s Health (April 2009, p. 9):

Eczema (dry, itchy, swollen skin) usually is treated with topical anti-inflammatory cream twice daily during flare-ups. Patients who applied tacrolimus (Protopic) twice weekly to lesion-prone areas even when no lesions were visible went 142 days between flare-ups, on average . . . versus 15 days for placebo users. Tacrolimus can cause nausea and muscle pain and may increase skin cancer risk — ask your doctor about the pros and cons of preventative eczema treatment.

The information comes from a study done by Sakari Reitamo, a professor of dermatology at University of Helsinki, and others published recently in Allergy.

The surface things — the things that impress many readers — appear good: large sample, big difference between groups, peer-reviewed journal, good university. Yet once you know that eczema can be cured by eating more fat, the whole thing sounds Orwellian.

Genes Or Environment . . . Or Environment?

Seth Roberts5 Comments

Forty or fifty years ago, psychologists and other scientists talked about “genes” determining this or that. (James Watson still talks this way.) A certain percentage of the variation of this or that (e.g., intelligence) was attributed to “genes”. Hardly anyone outside genetics or behavior genetics knew what this meant, but many people thought they did. In reaction to the huge misunderstanding (e.g., those who said intelligence was “80% genetic” but did not know what this meant), psychologists began to talk about gene-environment interaction. “Is the area of a rectangle determined by its height or its width?” they like to say.

But notice how fact-free this view is. A tiny number of studies have observed gene-environment interactions but they are very difficult. I think this has made it hard to realize something basic and important. Years ago, I heard a talk about squirrel circadian rhythms by Patricia DeCoursey, the scientist who introduced the concept of phase-response curves. At her talk, she showed results from about 15 squirrels. She tested each one — with an emphasis on individual results that resembles self-experimentation — to determine how much light it needed to become entrained to a 24-hour light/dark cycle. One squirrel needed much stronger light than the others.

Here was an interesting finding that another scientist might have missed. What did it mean? Because the squirrels lived under very similar conditions (e.g., identical diets), it was almost surely a genetic difference. Let’s assume it was. In nature, sunlight is plenty strong. The lab light was weaker. In nature, the genetic difference wouldn’t make an observable difference. Only under artificial conditions did it become visible. It only became visible when the artificial conditions didn’t supply enough of something important (sunlight). In other words, the newly-visible genetic difference implied there was something lacking in the artificial conditions. The genetic difference implied the environment mattered. The opposite of the usual interpretation.

I don’t know any reason to think this is an unusual case. Aaron Blaisdell told me a story that shows its relevance to human health. Aaron is unusually sensitive to sunlight. Until recently, he could only spend 5 or 10 minutes in the sun before it became unpleasant. The condition is genetic. His mother has it; her father had it. It’s called Erythropoietic Protoporphyria. It is autosomal-dominant. Scientists even know where the gene is. That’s where the understanding of most scientists stops. A genetic condition. Recently, however, Aaron drastically changed his diet with great results, as noted earlier. At the same time as the dietary changes, his sun sensitivity got much better. He can now stay in the sun for an hour or more without discomfort. This is a gene-environment interaction, of course, but of a particular sort: The genetic effect showed there was something wrong with the environment, just as it did in DeCoursey’s experiment.

Sure, there’s always genetic variation — it’s just usually hard to see. The wrong environment makes it much easier to see. It reveals a range of genotypes, all of which would be harmless in the right environment. So when you come across a “genetic disorder” such as Erythropoetic Protoporphyria, it is likely to imply an environmental problem. No one had ever told Aaron or his mother or her father that their condition suggested that environmental changes would help them.

Antibiotics and Debt: Sources of Weakness

Seth Roberts5 Comments

Alexander Fleming, the Scottish bacteriologist who discovered penicillin, the first antibiotic, served in the military during World War I. According to Happy Accidents (2007) by Morton Meyers, soldiers in that war often died from infections in relatively minor wounds. Rather than conclude that something was wrong with their immune systems, and wonder why, Fleming — unsurprisingly for a bacteriologist — began to think we needed more substances that killed bacteria. A hundred years later, the blind spot still exists. A few years ago I noticed that a wide-ranging course on epidemiology was being taught in the UC Berkeley School of Public Health. I knew the professor. I asked him, “Will the course cover what makes the immune system weak or strong?” “No,” he said. You will look in vain for that topic in any epidemiology text. To call it a blind spot is being nice. Half the subject — the more important half — is being ignored. And Schools of Public Health favor prevention. Medical schools are worse.

In an editorial in today’s Financial Times, Nassim Nicholas Taleb and Mark Spitznagel point out that debt is inherently destabilizing because it creates less room for error. Financial professionals and economists, including those at the very top, don’t realize this:

Alan Greenspan, former Federal Reserve chairman, tried playing with the business cycle to iron out bubbles, but it eventually got completely out of control. Bubbles and fads are part of cultural life. We need to do the opposite to what Mr Greenspan did: make the economy’s structure more robust to bubbles.

Taleb and Spitznagel note that the dotcom bubble, when it burst, had only minor consequences. That’s because it was an equity bubble rather than a debt bubble. The stimulus package is just more debt: public rather than private. It doesn’t reduce the source of the problem: A too-fragile system. A great point — fascinating how rarely I hear it.

Just as Greenspan failed to understand the problem and chose the wrong lever to pull, so did Fleming and a million doctors and medical/drug researchers. They have tried to deal with a too-fragile system by killing bacteria. Bacteria, like financial bubbles and fads, are part of life. We need to make our bodies more robust to them. Fermented foods do that. By killing off bacteria inside our bodies, antibiotics do the opposite: Make us even more fragile.

Progress Announced in Scurvy Research

Seth Roberts4 Comments

From here:

“Cure just around the corner”

WASHINGTON (Reuters) – Scientists from the National Scurvy Institute (NSI) recently convened a 5-day conference to assess progress in the War on Scurvy. . . .
A cure is just around the corner, announced a spokesman at the conference. Over the past 30 years NSI, NIH (National Institute of Health) and ASS (American Scurvy Society) have spent over $30 billion on scurvy research. Pharmaceutical companies have over 80 new drugs in development to combat scurvy according to the FDA.

The 5-year survival rate after diagnosis of scurvy is over 50% up from 30% just 20 years ago although 500,000 Americans continue to die of the disease each year. . . .
Risk factors for scurvy include cigarette smoking, diets high in saturated fat, and long ocean voyages. Sailors are particularly at risk for the disease. A researcher at the University of Washington has speculated that there may be a substance in sea water that triggers the disease. . . .
Researchers at the University of Maryland, working on the Human Genome Project, have identified a “Scurvy gene.” From this it may be possible to develop a test to identify individuals at risk for the disease.

Scurvy doctors have long emphasized the importance of frequent screenings for scurvy in at-risk individuals. The disease can be effectively treated if detected early enough. Men and women over 40 should get regular checkups.

Conventional treatments for scurvy include frequent gum cleanings to combat the bleeding associated with the disease, surgical amputation of atrophied limbs that have been ravaged by the disease, and stimulants to combat the lassitude characteristic of the disease.

A pilot research program has been proposed to NSI that would study a possible connection between Vitamin C and scurvy. A study conducted on 20,000 Americans at the University of Florida showed a substantially higher rate of scurvy in people who don’t eat fruits and vegetables. Dr. Henry Jacobson, assistant director of NSI, was quick to point out that no such connection has ever been scientifically proven. Vitamin C as a treatment for scurvy remains on NSI’s “unproven remedies” list. Clinical trials conducted in the 70′s showed no effect of Vitamin C on scurvy, added an NSI spokesman.

In related news, officials at the American Pellagra Society (APS) have designated the month of May as “Pellagra Awareness Month”…

Teaching Kids to Cook

Seth Roberts1 Comment

Outside Berkeley Whole Foods I encountered this cooking camp in session — they teach kids 8-12 years old to cook in two-week sessions, 4 hours/day. I love the idea. I think childhood obesity is due to eating ditto foods (foods, usually factory-made, that taste exactly the same each time) — teaching someone how to cook is a good way to reduce that.

I asked if they included any fermented foods in the curriculum. “Tomorrow we’re making tofu,” said one of the counselors — a Nutrition major at UC Berkeley. Tofu is not a fermented food, I said. She wasn’t sure what a fermented food was.

Yes, Canker Sores Prevented (and Cured) by Omega-3

Seth Roberts21 Comments

Here is a comment left on my earlier canker-sore post by a reader named Ted:

I found out quite by accident WALNUTS get rid of [canker sores] quite quickly. The first sign of an ulcer I chew walnuts and leave the paste in my mouth for a little while (30 seconds or so).

The first time was by accident, my ulcers disappeared so quickly I knew it had to be something I ate. And the only thing I had eaten differently the past day was walnuts.

Flaxseed oil and walnuts differ in lots of ways but both are high in omega-3. My gums got much better around the time I started taking flaxseed oil. I neither noticed nor expected this; my dentist pointed it out. Several others have told me the same thing. Tyler Cowen’s gums got dramatically better. One reader started and stopped and restarted flaxseed oil, making it blindingly clear that the gum improvement is caused by flaxseed oil. There is plenty of reason to think the human diet was once much higher in omega-3. All this together convinces me that omega-3 can both prevent and cure canker sores. Not only that, I’m also convinced that canker sores are a sign of omega-3 deficiency. You shouldn’t just get rid of them with walnuts; you should change your diet. Omega-3 has other benefits (better brain function, less inflammation, probably others).

Let’s say I’m right about this — canker sores really are prevented and cured by omega-3. Then there are several things to notice.

1. Web facilitation. It was made possible by the internet. My initial interest in flaxseed oil came from reading the Shangri-La Diet forums. I didn’t have to read a single book about the Aquatic Ape theory; I could learn enough online. Tyler Cowen’s experience was in his blog. Eric Vlemmix contacted me by email. No special website was involved.

2. Value of self-experimentation. My flaxseed oil self-experimentation played a big part, although it had nothing to do with mouth health. These experiments showed dramatic benefits — so large and fast that something in flaxseed oil, presumably omega-3, had to be a necessary nutrient. Because of these results, I blogged about omega-3 a lot, which is why Eric emailed me about his experience.

3. Unconventional evidence. All the evidence here, not just the self-experimentation, is what advocates of evidence-based medicine and other evidence snobs criticize. Much of it is anecdotal. Yet the evidence snobs have, in this case, nothing to show for their snobbery. They missed this conclusion completely. Nor do you need a double-blind study to verify/test this conclusion. If you have canker sores, you simply drink flaxseed oil or eat walnuts and see if they go away. Maybe this omnipresent evidence snobbery is . . . completely wrong? Maybe this has something to do with the stagnation in health research?

4. Lack of credentials. No one involved with this conclusion is a nutrition professor or dentist or medical doctor, as far as I know. Apparently you don’t need proper credentials to figure out important things about health. Of course, we’ve been here before: Jane Jacobs, Elaine Morgan.

5. Failure of “trusted” health websites. Health websites you might think you could trust missed this completely. The Mayo Clinic website lists 15 possible causes — none of them involving omega-3. (Some of them, we can now see, are correlates of canker sores, also caused by lack of omega-3.) If canker sores can be cured with walnuts, the Mayo list of treatments reads like a list of scurvy cures from the Middle Ages. The Harvard Medical School health website is even worse. “Keep in mind that up to half of all adults have experienced canker sores at least once,” it says. This is supposed to reassure you. Surely something this common couldn’t be a serious problem.

6. Failure of the healthcare establishment. Even worse, the entire healthcare establishment, with its vast resources, hasn’t managed to figure this out. Canker sores are not considered a major health problem, no, but, if I’m right, that too is a mistake. They are certainly common. If they indicate an important nutritional deficiency (too little omega-3), they become very important and their high prevalence is a major health problem.

The Nutritional Wisdom of Young Chicks

Seth Roberts1 Comment

After I wrote that young children may be picky eaters because they are offered unhealthy food, some readers disagreed. But here is another example:

I myself have been amazed to see hungry young chicks refuse to touch a purified diet until we added thiamin, which we discovered to have been accidentally omitted from a published formula.

From Kenneth Carpenter’s excellent Beriberi, White Rice, and Vitamin B (2000), p. 193. If young chicks can better judge the nutritional quality of food than nutrition professors, perhaps young children can, in some situations, better judge the nutritional quality of food than their parents. And rightly decide that food their parents think is healthy isn’t so healthy.

The wisdom of the one-year-old picky eater.

What Causes Asthma? Not What the Tovars Think

Seth Roberts5 Comments

From Joyce Cohen’s The Hunt column:

For reasons unknown, Florida didn’t agree with little Noah Tovar. Since his toddler years, Noah, now 7, had suffered terribly from asthma. His parents, Jari and Selene Tovar, moved their family several times, trying to escape the mold or pollen or whatever it was that caused his breathing problems. Nothing helped much.

Noah’s parents didn’t know, I can tell, about a 1992 study of childhood asthma and allergies in Germany. Maybe childhood asthma is caused by air pollution, the researchers thought. Let’s test that idea by comparing a clean West German city (Munich) with a dirty East German one (Leipzig). Here’s one of the results:

The lifetime prevalence of asthma diagnosed by a doctor was 7.3% (72) in Leipzig and 9.3% (435) in Munich.

Less asthma in the dirty city! It wasn’t a significant difference but similar differences, such as hay fever and rhinitis (runny nose), were in the same direction and significant. Hay fever was much rarer in Leipzig.

Noah’s asthma cleared up, to his parents’ surprise, on a trip to New York. So the family moved to New York.

Even though “everyone was under the impression that New York would cause him more distress, it was just the opposite,” Mrs. Tovar said. “Not one doctor nor myself can explain what it is.”

Mrs. Tovar’s doctors are badly out of date. The hygiene hypothesis has been around since the 1990s, supported by plenty of data that, like the German study, shows that childhood allergies are better in dirtier environments. Noah is better in New York because New York air is dirtier than Florida air — that’s the obvious explanation.

In The Probiotic Revolution (2007) by Gary Huffnagle with Sarah Wernick, which I’ve mentioned earlier, Dr. Huffnagle, a professor of immunology at the University of Michigan, describes a self-experiment he did:

Could probiotics relieve something as tenacious as my lifelong allergies and asthma? I decided to take a probiotic supplement and make a few simple changes to my diet to my diet, just to see what happened. Yogurt became my new breakfast and my new bedtime snack. I also upped my intake of fruits and vegetables. Whenever possible, I substituted whole grains for processed ones. And I tried to cut back on sugar. [Why he made the non-probiotic changes is not explained. In another part of the book he says he also increased his spice intake.] No big deal.

Because I doubted this little experiment would work, I didn’t mention it to anyone, not even my wife. And I didn’t bother to record my allergy symptoms. . . My “aha” moment came after about a month: I’d spent the evening writing a grant proposal, a box of tissues at my side. After all these years, I knew to be prepared for the inevitable sneezing and runny nose caused by my mold allergies, which kicked up at night. But when I finished working and cleared the table, I realized I hadn’t touched the tissues. And as I looked back on the previous month, I could see other changes. This wasn’t my first sneeze-free evening; I hadn’t needed my asthma inhaler for several months. To my astonishment, the experiment had been a great success.

This is a great and helpful story. Only after I read it did I realize I’d had a similar experience. I’ve never had serious allergies but I used to sneeze now and then in my apartment and my nose would run a lot; I went through more than one box of Kleenex in a month. Maybe 4 in one morning. In January, I made just one change: I started to eat lots more fermented foods (yogurt, kimchi, kefir, etc.). My sneezing and Kleenex use are now almost zero.

The Tovars can live wherever they want, I’m sure, if they feed their son plenty of fermented food.

Previous post about childhood allergies and fermented food.

More After the column appeared, someone wrote to the Tovars:

Funny, same thing happened to me. I moved from England where I had chronic asthma, to New York City where I had none. Stayed in NY for twenty years asthma free, then moved back to England with my wife for the last ten years and my asthma has returned all the time I’ve been back.

The Experts Speak: Nutrition

Seth Roberts7 Comments

I have nothing against a paleolithic diet, but I think its advocates, like many experts, are overconfident. It’s not easy to know which features of a diet that varies in 20 ways from modern diets are the crucial ones. I came across this while reading about paleolithic diets:

The general gist of eating like a caveman—namely, focusing on foods in their whole, natural state, is not going to get much argument. “It comes down to the advice your mother gave you,” says Leonard [William Leonard, chair of the anthropology department at Northwestern University]. “Eat a balanced diet and a diversity of foods.”

I beg to differ.

1. Whole, natural state. I find flaxseed oil very helpful. It supplies omega-3 missing from my diet, but presumably present in diets that contained lots of seafood or vegetation-fed meat. Flaxseed oil is not food in a whole and natural state.

2. Whole, natural state . I find fermented food very helpful. Bacteria break down food, making it less whole. Modern food of all sorts is unnaturally low in bacteria (due to refrigeration, food safety laws, shelf-life requirements, etc.), just as modern meat is unnaturally low in omega-3. Fermented food is unnaturally high in bacteria, correcting the deficit.

3. The advice your mother gave you. Traditional diets, yes, what your mom thinks, no. When I was growing up we ate margarine instead of butter — poor choice. We had skim milk, not whole milk — poor choice. The absence of butter and whole milk is, if Weston Price is right, why my teeth are slightly crooked. We ate almost no fermented food — very poor choice. (Which I suspect is why I had mild allergies.) We rarely ate fish — poor choice. And yet we didn’t have a TV — very good, very unusual choice. Even my mom, who thought for herself far more than most moms, had serious misconceptions about nutrition. Given the epidemic of childhood obesity, not to mention less visible increases in autism, allergies, and ADHD, I am very skeptical that the average kid’s mom knows what to eat.

4. Eat a balanced diet. Plenty of communities in excellent health eat diets that American experts would describe as not balanced at all — no fruit for example, or too much dairy. Eskimos and the Swiss in isolated villages studied by Weston Price are two examples. Price found that a wide range of diets, most violating one or more popular nutritional precepts, produced excellent health.

5. A diversity of foods. Several healthy communities studied by Price did not eat a wide range of foods. The human diet became a lot more diverse around the time of the “ broad-spectrum revolution” — broad-spectrum meaning wider range of food. Around that time human height decreased. Apparently the new, more diverse diet was less healthy than the old diet. An anthropology professor might know this.

The title of this post comes from the book The Experts Speak which is full of examples of how experts were wildly wrong.