Welcome, Healthy Skeptics!

Posted by on September 12, 2010 33 comments

One of my favorite blogs is Chris Kresser’s The Healthy Skeptic, so I was quite pleased a few weeks ago when he somehow discovered our blog and purchased a copy of our e-book. I’m even more pleased to see that he liked it:  He’s written a glowing review.

As Chris mentioned, everyone who buys the e-book will receive a free copy of the completed book, expected to be available in October. Simply email your address to paul@perfecthealthretreat.com and I will see that you receive your free copy as soon as it is available.

As he mentioned, the e-book, which is an early draft, has three sections. The final book will have a fourth, on healing and preventing disease.

The book is the fruit of five years of research and three years of writing. We began studying diet in 2005 in order to learn how to cure our own seemingly incurable chronic diseases. We began writing the book in 2008 partly because of the old axiom – “the best way to learn is to teach”; being forced to sift through the literature carefully would help us refine our ideas – and partly to share what we then knew with friends and family. By 2010 we had actually cured our own diseases, and had gained sufficient confidence in our ideas to bring them before the public. Indeed, we felt an obligation to do so. We know how many people suffer from “incurable” chronic diseases and premature aging. We believe that, with proper diet and appropriate antibiotics, nearly all diseases can be cured, and nearly everyone can become a healthy centenarian.

It will please us greatly if others find our book useful.  Thank you, Chris, for letting your readers know about it!

Saturday Night Fever

Posted by on September 11, 2010 4 comments

This cute couple looks like they’ve put in a lot of practice on the dance floor!

Is It Smart to Drink?

Posted by on September 9, 2010 66 comments

A surprising chart was posted by Razib Khan. In the General Social Survey, the higher Americans score on a vocabulary test, the more likely they are to drink alcohol:


Of course we know that correlation is not causality, so one should not immediately infer that reading drives one to drink, or that drinking improves memory (perhaps because, as the old joke argues, alcohol kills weaker brain cells, increasing the average quality of the brain).

It does, however, raise a serious question:  Is it smart to drink?

Epidemiology Recommends Moderate Drinking

Most people have read of the studies that show that moderate drinkers – who drink, say, a glass of wine or two with dinner – tend to have the best health, while teetotalers and alcoholics have the worst.

A recent prospective cohort study confirms this pattern and shows it to be surprisingly strong.

The study followed 1,824 adults, initially between ages 55 and 65, for 20 years.  Their conclusion: “even after adjusting for all covariates, abstainers and heavy drinkers continued to show increased mortality risks of 51 and 45%, respectively, compared to moderate drinkers.” [1]

This is a pretty large effect. Without their adjustments, heavy drinkers had a 70% higher mortality rate, abstainers 23% higher. Still large, although not so bad for abstainers. If the choice is alcoholism or abstention, go with abstention.

What About the Biology?

Epidemiological studies often mislead due to confounding factors.  It would be nice to learn from biology that alcohol is safe.

A primary safety concern with alcohol is its effect on the liver. Alcohol consumption can produce fatty liver disease and, eventually, a scarred and damaged liver (cirrhosis).

Interestingly, in animal studies the harmful effects of alcohol on the liver occur only when it is combined with polyunsaturated fats:

  • Researchers induced liver disease by feeding mice a combination of alcohol and omega-3-rich fish oil.  They then stopped the alcohol and split the mice into two groups, one fed fish oil plus glucose, the other palm oil plus glucose. (Palm oil consists predominantly of saturated fat, and is less than 10% polyunsaturated.) Livers of the fish oil group failed to recover, but the palm oil group “showed near normalization.” The researchers hailed saturated fat as “a novel treatment for liver disease.” [2]
  • Mice fed 27.5% of calories as alcohol developed severe liver disease and metabolic syndrome when given a corn oil diet, but no disease at all when given a cocoa butter diet. (Corn oil is 55% polyunsaturated, cocoa butter is predominantly saturated fat and is less than 3% polyunsaturated.) The first line of this paper begins, “The protective effect of dietary saturated fatty acids against the development of alcoholic liver disease has long been known.” [3]
  • Scientists induced liver disease in mice by feeding alcohol plus corn oil.  They then substituted a saturated-fat rich mix based on beef tallow and coconut oil for 20%, 45%, and 67% of the corn oil. The more saturated fat, the healthier the liver. [4]

This makes biological sense. Alcohol is metabolized in the liver just like fructose, a toxic sugar. Polyunsaturated fats are chemically fragile and quick to react with sugars; saturated fat, which lacks fragile carbon double bonds, does not.

It seems that if you keep your liver clear of polyunsaturated fats, the alcohol will be disposed of safely.

What Does This Mean on the Perfect Health Diet?

Our diet is very low in polyunsaturated fats:  We eat as few omega-6 fats as possible, and purposely include only 1 lb of oily marine fish per week in order to get long omega-3 fats.

Thus, two dinners per week may have omega-3 fats, other meals will be largely polyunsaturated fat free.

Mice on a saturated fat (cocoa butter) diet can get 27.5% of calories as alcohol with no liver damage. In humans, that would correspond to a daily 350 ml (12 fluid ounce) bottle of 80-proof gin, rum, or vodka, or a liter (36 fluid ounces, 1.3 bottles) of red wine.

We don’t recommend such alcohol intakes! That said, it does seem to confirm that there is little risk in moderate alcohol consumption, if the rest of the diet is sound.

For Perfect Health Dieters, perhaps on salmon days alcohol should be limited to a single glass of wine. In general, however, moderate drinking should hold no concern.

Oh, and for you alcoholics, a little friendly advice: If you value your liver, remove polyunsaturated fats from your diet. The safest foods? Red meats and seafood; starches (rice, sweet potatoes, potatoes); vegetables; butter/cream and coconut oil.

References

[1] Holahan CJ et al. Late-Life Alcohol Consumption and 20-Year Mortality. Alcohol Clin Exp Res. 2010 Aug 24. [Epub ahead of print] http://pmid.us/20735372. Full text: http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.2010.01286.x/pdf. (Hat tip:  Robin Hanson, http://www.overcomingbias.com/2010/09/alcohol-is-healthy.html)

[2] Nanji AA et al. Dietary saturated fatty acids: a novel treatment for alcoholic liver disease. Gastroenterology. 1995 Aug;109(2):547-54. http://pmid.us/7615205.

[3] You M et al. Role of adiponectin in the protective action of dietary saturated fat against alcoholic fatty liver in mice. Hepatology. 2005 Sep;42(3):568-77. http://pmid.us/16108051.

[4] Ronis MJ et al. Dietary saturated fat reduces alcoholic hepatotoxicity in rats by altering fatty acid metabolism and membrane composition. J Nutr. 2004 Apr;134(4):904-12. http://pmid.us/15051845.

Has the Medical Profession Been Corrupted?

Posted by on September 7, 2010 23 comments

There seems to be more soul-searching in the medical profession lately. A few pieces caught my eye.

The Money Scramble Corrupts Diagnosis

First, an editorial in the British Medical Journal begins:

Who decides what constitutes a disease and what is normality? Over the centuries such decisions have been the preserve of the medical profession, aided more recently by modern medical science. But the profession has grown too close to those who profit from developing drugs for new diseases and is no longer fit to make these decisions. [1]

The idea is that researchers, doctors, and drug companies are highly motivated to expand the medical industry by inventing new “diseases” that provide new scope for drug treatment.

The recent suggestion that statins be distributed over the counter at McDonald’s restaurants is one example of such a push. The editorial cites new diagnostic categories created by drug-company affiliated scientist-doctors:

[P]rehypertension [is] a condition that along with preosteoporosis and prediabetes has the potential to transform most of the world’s adult population into patients….

Of the US guideline committee that first created the diagnostic category of prehypertension in 2003, 11 of 12 members eventually declared multiple ties to industry. [1]

These “pre-diseases” could be given a more accurate name:  “wheat and vegetable oil consumption syndrome.”

Another example of an emerging disease is sarcopenia, or muscle weakness in the elderly. The New York Times reports:

[G]eriatric specialists, in particular, are now trying to establish the age-related loss of muscles as a medical condition under the name sarcopenia, from the Greek for loss of flesh. Simply put, sarcopenia is to muscle what osteoporosis is to bone.

“In the future, sarcopenia will be known as much as osteoporosis is now,” said Dr. Bruno Vellas, president of the International Association of Gerontology and Geriatrics. [2]

FuturePundit comments: “[B]y all means, label every change we experience while aging as a vile disease. How about hair graying and hair loss? Surely diseases…. Don’t feel as flexible as you used to? That’s a disease. Don’t have the energy of a 17 year old? Disease, horrible malady. Needs a cure. Finding yourself needing reading glasses in your early 40s? Don’t kid yourself. That’s a disease. Demand a cure. Stem cells, gene therapy, nano repair bots, whatever it takes.”

Has the Medical Industry Become Parasitic Upon Its Patients?

Somehow or other, we have developed a government-industry-medical complex that extracts tremendous amounts of money from taxpayers and patients, but damages health. Subsidies for wheat and soybeans and corn make toxic foods cheap; junk science like the “lipid hypothesis” promotes their consumption; elite doctors appointed supreme authorities by government bureaucrats declare biomarkers of wheat, corn, and soybean oil consumption to be diseases requiring drug treatment; the drug industry sells tens of billions of dollars of drugs to the afflicted persons.

Qui bono? Elites do well – elite doctors on the review and funding panels, bureaucrats, politicians, and pharmaceutical companies. Public health suffers.

Bureaucratization of Medicine

Bruce Charlton, the former editor of Medical Hypotheses, argues that medical research has been failing at its mission of making health improving advances in knowledge:

When people are asked about the success of modernity, they usually refer first to medicine….

I have even heard the whole thing boiled down to immunization and antibiotics, or to ‘anaesthesia’ – the existence of which are said to justify modernity against history; as in ‘how would you like to live in a world without ‘*’….

I have previously written about the failure of medical progress from the mid-twentieth century, and that for half a century we have been living through a medical research bubble –

http://qjmed.oxfordjournals.org/cgi/content/full/98/1/53

Yet the failure of medical research, defined as above, is stark: in broad terms we have not discovered any new classes either of antibiotics or pain killers for many decades. [3]

Medical research is very focused on incremental progress in an established research paradigm. Since many established research paradigms are mis-conceived – are cul-de-sacs that lead nowhere – incremental progress down these blind alleys translates into “no progress.”

When stuck in a cul-de-sac, one should reverse course and try some new direction. But medicine is increasingly unable to do this, Dr. Charlton says, due to the bureaucratization of medicine, and consequent stifling of independent creative research:

The reason we have failed to sustain medical progress are doubtless manyfold, but in essence I think it is because modernity has chosen bureaucratic expansion above creative individual discovery.

http://medicalhypotheses.blogspot.com/2010/04/cancer-of-bureaucracy.html

We prefer process over results – consequently we have a truly massive and expanding medical research process with zero or negative results. [3]

Nothing stifles creativity like a monopoly. Concentration of decision-making power in a few hands gives those hands an overwhelming incentive to obstruct change: for innovation could undermine the established social structure and deprive the decision-makers of power, income, wealth, and status. There is no surer way to achieve stagnation than a centralization of funding and decision authority.

As power has spread from individual doctors and researchers to distant bureaucracies, the medical profession has been demoralized:

As I look around medicine it is my impression that doctors know less, can do less, have less spirit, less sense of vocation (or none at all), are less able, make fewer breakthroughs, suffer greater losses of knowledge, have poorer judgment, do worse science, are less honest and have more wrong ideas than they did a generation ago. [3]

Conclusion

I have previously argued that we need a democratization of biomedical funding. Each taxpayer should be able to donate, say, $300 to the research of his or her choice. Projects seeking funding should be displayed on a public web site. This would force scientists to serve real people with real (or anticipated) health problems. This would create competition for public trust, and reward creative approaches to successful healing. No longer would the “old boy network” or peer-review clique control everything; a researcher would need only “1000 true fans”.

Doctors need more freedom to follow their clinical judgment. Let patients, not juries or medical boards, review doctors’ competence. Fear of loss of career and income – of sanctions from juries or medical boards – prevents doctors from prescribing unconventional treatments and engaging with their patients in the cooperative clinical experimentation that in the past led to so many breakthroughs.

Dispersal of power would have major benefits: increases in conversation, and of knowledge. Needing to find true fans, scientists would engage the public in conversation. Provided with funding power, fans would be motivated to learn how to use that power.

The medical profession is suffering from institutional centralization and stifling of individuals by elite authorities.  It needs a healthy dose of creative destruction.

References

[1] Fiona Godlee, “Are we at risk of being at risk?” BMJ 2010; 341:c4766. http://www.bmj.com/content/341/bmj.c4766.full.

[2] Andrew Pollack, “Doctors Seek Way to Treat Muscle Loss,” New York Times, August 30, 2010, http://www.nytimes.com/2010/08/31/health/research/31muscle.html.

[3] Bruce Charlton, “The decline of medicine refutes modernity,” http://charltonteaching.blogspot.com/2010/09/decline-of-medicine-refutes-modernity.html.