Thanks to Robin Barooah and Mike Bowerman.
I wrote recently about how our health care system resembles a protection racket. In a protection racket, you or someone else threatens people so that you can make money protecting them. Modern health care, especially in America, ignores prevention. It says let them get sick. Let the general public get sick so that we (health care providers) can make money treating them.
The profitability of let them get sick is illustrated by some numbers in Run Barefoot Run Healthy, a new book by Ashish Mukharji (who gave me a copy). Ashish has run several marathons. Before he started running barefoot, running caused all sorts of problems. To deal with them was costly:
Since he started barefoot running (3 years and 2 marathons ago), he has incurred no (zero) running-injury expenses. Interviews with other barefoot runners convince him this is typical. Long ago a runner friend of mine told me everyone who runs eventually hurts themselves. The truth of this was confirmed many times by runners I met after she said this. Now it appears she was right because all the runners she and I knew wore shoes.
I started barefoot running/walking on my treadmill a year ago. I have never had running injuries (probably because I walk — uphill fast — much more than run). Going barefoot saved time. During the first few months, I got four or five cuts (actually, splits) on the sides of my feet. The skin was split by downward pressure. The cuts made ordinary walking (in shoes) a little unpleasant. I did nothing about them. They healed and have not recurred.
A better health care system would have discovered the damage caused by running shoes long ago. We are lucky to live when personal scientists such as Ashish can figure out the truth themselves and tell others.
Thanks to Anne Weiss.
Thanks to Tucker Max, Melissa McEwen, Peter Couvares, Edward Jay Epstein, and Alexandra Carmichael.
Lots of people think it’s obvious: vegetarians are healthier than omnivores in Study X. Therefore vegetarianism is healthy. This is such a common line of argument that I draw your attention to Denise Minger’s slides for her talk at the Ancestral Health Symposium, which I have already blogged about. The slides make clearer than I did what she said. It’s all excellent but the best part is at the beginning where she points out the many confounds in the studies of Dean Ornish, Neal Barnard, Caldwell Esselstyn, and John McDougall. They change many things but — as Denise put it — What caused the benefits? It must be the vegetarianism! Paleo humor.
There are lots of other interesting things in Denise’s talk, as you will see, such as the health of religious vegetarians.
Yesterday I was telling a relative about the Ancestral Health Symposium and I mentioned the emphasis on meat eating — for example, two vendors gave out samples of beef jerky. To most people, I think paleo means eating lots of meat. I told my relative I disagreed with this. I find nothing wonderful about meat protein; I would happily get my protein from plants. I eat meat almost only for the associated fat. Which I can get from butter. A lot of meat I am served, such as in fancy restaurants, strikes me as too low in fat. Yesterday I requested butter at a sushi restaurant. The waitress was unsure if they had some.
Today I see Melissa McEwen said the same thing much better:
It was interesting to observe that [at the Ancestral Health Symposium] among the low-carbers, there seemed to be an epidemic of puffy red skin, particularly in older men. I’m sure the pictures, when they are posted, will make obvious who these people are. The ones who had healthy complexions like the Eades and Nora are those espousing a high-fat diet. It goes very well with some of the anthropological stuff I’ve been working on showing that almost all cultures that eat meaty diets are doing so because they have access to high-fat game.
My explanation of the Ten Commandments is that someone at the top (Moses) was trying to convince people at the bottom to join him. People at the bottom were being preyed upon. “Thou shalt not steal” meant, to Moses’s audience, “no one will steal from you — or at least we, your leaders, will discourage it.” At the very beginning of the Code of Hammarabi, another ancient set of rules, it says one purpose of the rules is “so that the strong will not harm the weak”.
I keep seeing this pattern — people at or near the top of the hierarchy making common cause with people on the bottom against people in the middle. I was reminded of it by this story:
One anecdote described a Hu Yaobang [top Chinese leader] visit that Mr. Wen arranged with Guizhou Province villagers — secretly, he wrote, because Hu Yaobang did not trust local leaders to let them speak freely.
In the 1960s, the U.S. civil rights movement gained considerable force and accomplishment when the very top of the government (first, President Kennedy and Attorney General Robert Kennedy, later President Johnson) weighed in on the side of the protesters (bottom) against the various state governments (middle).
The practical value of this alignment of forces is illustrated by How to Walk to School, a book about school reform (which I reviewed here). Two mothers of young children, Jacqueline Edelberg and another woman, wanted to improve their neighborhood schools before it was too late for their own children to benefit. On the face of it, this was impossible. But they found common cause with the principal of a local school (Susan Kurland). It goes unmentioned in the book but my impression, reading between the lines, is that the main thing that happened is that the worst teachers were shamed into leaving, above all by parents sitting in their classrooms. The principal alone could do nothing about terrible teachers; the parents alone could do nothing; together they did a lot. I spoke to Edelberg about this and she agreed with me.
I point out this pattern because it works. Judaism (Moses) still exists; people still read the Old Testament. Even more powerfully, all governments have lists of laws (Hammurabi). Jacqueline Edelberg’s neighborhood school is much better. The next big revolution in human affairs, I believe, will be health care. The current system, in which people pay vast amounts for drugs that barely work, have awful side effects, and leave intact the root cause (e.g., too little dietary omega-3), will be replaced by a much better system. The much better system will be some version of paleo. As Woody Allen predicted, people will come to believe that butter is health food.
How will it happen? I suspect this pattern will be the driving force. People at the top and people at the bottom will put pressure on people in the middle. Self-experimentation, self-quantification, and personal science (which overlap greatly) are tools of people at the bottom. They cost nothing, they are available to all. When you track (quantify and record) your health problem, and show your doctor, via numbers and graphs, that the drug he prescribed didn’t work, that puts pressure on him. When you bring your doctor numbers and graphs that show a paleo solution did work, that puts even more pressure on him. The point, if it isn’t obvious, is that numbers and graphs, based on carefully collected day-after-day data, amplify what one person can do. Not just what they can learn, not just how healthy they can be, but how much they can influence others. And this amplification of influence, which I never discuss, may ultimately be the most important.
I’m beginning to think Andreas Eenfeldt, a Swedish doctor, gave the very best talk at the just-finished Ancestral Health Symposium. (Which was full of excellent talks.) And I missed it. Well, that’s what the Internet is for. His talk was about the spread of paleo ideas in Sweden. Apparently not all establishments are hostile to all new ideas. Someone told me that sales of butter in Sweden have recently increased 40%.
Eenfeldt has written a great series of posts about the Symposium.
Denise Minger started her presentation at the Ancestral Health Symposium (titled “How to win an argument with a vegetarian”) with a comparison of number of Google hits:
“how to win an argument with a meat-eater”: 53,700 hits
“how to win an argument with a vegetarian”: 7 hits
Why all this concern with winning arguments? Sure, vegetarians are outnumbered, but shouldn’t the results speak for themselves?
Denise went on to make the excellent point that some of the most popular proponents of less meat and low-fat diets, such as Dean Ornish, base their claims on experiments with complex treatments. Group A (no meat, low fat) turns out to be more healthy than Group B (baseline) but the two groups differ in twenty other ways. Group A eats less sugar, gets more exercise, eats less processed food, and so on. But, as Denise said, it must be the vegetarianism.