Category: Politics of Health
'Low-Fat Diets Flub a Test' proclaims today's main editorial from the always peripatetic New York Times:
"The baffling results came from a $415 million study of almost 49,000 women age 50 to 79 who were tracked for eight years, with repeated exhortations to the low-fat dieters to stick to the regimen. In findings announced this week, the almost 20,000 women on low-fat diets had essentially the same incidence of breast cancer, colorectal cancer, heart disease and stroke as the 29,000 women who followed their normal eating patterns. The results clearly surprised the investigators and may sound the death knell for the belief that reducing the percentage of total fat in the diet is important for health."
Among other concerns, restricting fish, nuts, and seeds immediately cuts off any source of Essential Fatty Acids such as Omega-3. Low fat dieters are also more at risk of suicide.
Eat your rabbit food.
Not unexpected. There's huge amounts of money at stake: Grant money, book sales, you name it.
Although it took me the better part of my first two decades in practice to realize it, a truly resourceful approach to nutrition is not very complicated:
It is the foods that you identify as benefical for a specific person and which truly feed him, that make him more healthy. Telling a person what to avoid will sometime make him less sick, but only rarely more healthy.
I've never seen anyone improve on a diet of rice cakes and lemon water.
Future low fat gurus may want to ponder the wisdom of cajoling sick people into draconian dietary measures.
Now, before anyone thinks that this is the ultimate validation of all things Atkins, the study also found that an increased consumption of carbohydrates and grains is safe and healthy - contradicting the claims by proponents of low-carbohydrate diets such as the Atkins that high carbs increase the risk of diabetes. Those in the study "did not show any signs of diabetes, their triglycerides were normal and their blood glucose was normal," said Dr Elizabeth Nabel, director of the US's National Heart, Lung and Blood Institute, which sponsored the $415 million study.
So, now that we know who lost, when do we find out who won?
Not any time soon. That won't happen until researchers start incorporating specific markers of genetic individuality into their study designs: Polymorphisms (like ABO blood type and secretor status); single nucleotide polymorphisms (SNPs) and metabolomics (the study of genetic differences by analysis of metabolic end products).
Until then, we will constantly be left with conflicting results and confounding, competitive theories.
Could it be that the idea was right, but the execution wrong? That the cause of some cancers does have to do with fat, but not in a way that is addressed by a low fat diet?
In other words, suppose toxins and free radicals in fat tissue do cause breast cancer and cardiovascular disease, but (unfortunately) a low fat diet in and of itself does nothing to help eliminate them?
And perhaps paradoxically, in some people, actually concentrates them instead?
Then you have a reasonable experimental model for the case of the life-long vegan who gets breast cancer.
One of my teachers used to tell us that there were two types of medical students: The first type, who go through four years of medical school; and the second type, who go through the first year of medical school four times.
Sadly, we seem destined to go through this first phase of nutrition research a few more times.
Anyway, some other news:
Put up some new sound files in the Media Center. The first is an extract of a lecture I gave at the Ontario College of Naturopathic Medicine. The second is part one of the 'Century of Blood Type Science' lecture given as the keynote address at IfHI 2003. I hope you enjoy them.
You can access these sound clips by clicking this link.
I recently come across a study that seemed to show that repeated sauna therapy improves impaired vascular endothelial function in a patients with coronary risk factors. In the study, sauna therapy was performed with a 60 degrees C far infrared-ray dry sauna for 15 minutes and then bed rest with a blanket for 30 minutes once a day for two weeks. Systolic blood pressure and increased urinary 8-epi-prostaglandin F(2alpha) levels in the sauna group were significantly lower than those in the non-sauna group. These results suggest that repeated sauna therapy may protect against oxidative stress, which leads to the prevention of atherosclerosis.
Studies of other syndromes treated using far infrared sauna include chronic fatigue syndrome, anorexia, fibromyalgia and depression.
Although it has not been proved beyond all reasonable doubt, I tend to believe that far infrared saunas may help eliminate many of the industrial toxins that accumulate in our bodies over a lifetime.
Over 100,000 xenobiotics ('man made' chemicals) now contaminate our food, water, and air --and there are another three new xenobiotics being created every day. Many of these xenobiotics are carcinogenic and quite a few also have estrogenic activity: a bad combination for the female breast.
Here is a woman naturopath's take on xenobiotics and breast tissue. Chilling.
Xenobiotics make their way into the body by ingestion, inhalation, or through the skin. Our detoxication systems are not always perfectly efficient, and some toxins do reach the circulation. The ones that are fat-soluble get stored in the fatty tissues and remain there pretty much indefinitely. For example, in 2005 the Associated Press reported that a toxic component of rocket fuel had been found in the breast milk of women in 18 states. The chemical, perchlorate, can impede adult metabolism and cause retardation in fetuses, among other things. It leaches into groundwater from various military facilities and from there into the body.
One of the most famous is dioxin, which is routinely the subject of a rather lame internet hoax about microwaving with saran wrap, but does enter our bodies through a variety of less questionable ways including, of all things, forest fires.
If you rob Peter to pay Paul, you've already got half the vote.'
'Many years have you have been snubbed and even mocked, your theories debased and reviled. People seem to offhandedly wave away the world of discovery you have achieved like an odd odor in the air. It would seem that tremendous psychological forces are interacting in peoples minds when it comes to change, specifically in terms of attaining concrete understanding of health. You scare people, they are not ready for the truth.
-Stephan (blog comment)
Truth be told, the last few years have been a painful, if eye-opening education in the reality of rent-seeking, the corruption (intellectual, spiritual and economic) that results when learning is wedded to bureaucratic authority and income. Competing with rent-seekers can be a wearying and scarifying experience and a note like Stephan's does a lot to reassure me, a least a wee bit, that I am not some type of evil lunatic.
Rent-seeking can take many forms. There was the time a major manufacturer of ephedra-driven diet pills, fronted by a sonambulent reality TV star, advised my via FAX that they had been awarded the patent for developing supplements based on blood type and unless I 'played ball' with them, they would issue a cease and desist order. Investigating the patent quickly disclosed that the source material used in their application was my first book. They were, in essence, using me again me. We rolled the patent back, but only at great expense. But what about people who can't afford to fight back against the well-heeled?
Rent seeking is nothing new. The philosopher Schopenhauer wrote of it almost 200 years ago:
'Now what in the world has such a philosophy as mine to do with that alma mater, the good, substantial university philosophy, which, burdened with a hundred intentions and a thousand considerations, proceeds on its course cautiously tacking, since at all times it has before its eyes the fear of the Lord, the will of the publsher, the encouragement of students, the goodwill of colleagues, the course of current politics, the momentary tendency of the public, and Heaven knows what else? Or what has my silent and serious search for truth in common with the yelling school disputations of the chairs and benches, whose most secret motives are always personal aims?'
The new USDA food guideline are a great example of rent-seeking. Witness how the major processed food manufacturers have pre-registered for the whole-grain bandwangon. The stuff was already produced, the advertising copy already written. And right behind them? The biggest rent seekers of them all, The American Dietetic Association.
Whole grain? Great! GMO? What's that? Oh, yeah. Don't worry! Junk food CAN be part of a balanced diet. Blood Type Diet? Dangerous! Unscientific! Read this pamphet on a REAL healthy diet (paid for by McDonalds Corp). Use our spokespeople in your magazine or TV show (funded by Kraft Foods, or Monsanto, or ADM).
The proposed Codex Alimentarius is another exercise in professional and corporate rent-seeking. Interesting dialectic going on there. As long as vitamins are medically useless and not very profitable, there's no need to regulate. As soon as a biological role or profit margin is discovered, they become a terrible threat to the public and must immediately be regulated. The difference to the public? A minimum three-fold increase in price, availability only through physicians (most of whom are not going to prescribe them), and sub-therapeutic doses.
Those Quackbuster guys are another bunch of self-appointed public guardians who are in reality world class rent-seekers. Talk about double-speak: By definition alternative medicines don't work, since if they did, then they would then be conventional medicines.
So what chance does a guy like me, with a puny idea like the BTD, stand against a juggernaut like this?
A pretty good one, if you ask me.
They can only manipulate to achieve their ends.
We have the idea.
'Every truth passes through three stages before it is recognized. In the first it is ridiculed, in the second it is opposed, in the third it is regarded as self evident.'
I was going through the logs of the referrer program last night. This is the script that allows visitors to refer a friend to the website by just plunking in their email and a short message. How many of these messages were from dads concerned about a child (â€˜Hey Sweety, this may help. Look's interesting. Love Dad') or friends who found the site and knew of others on the program (â€˜Hey Ginnie, this is the diet Betty is on!')
I scrolled through pages and pages of these quick, helpful notes and perhaps because I have been re-reading Dawkin's The Selfish Gene I got to thinking about his concept of a meme.
For those who have never heard of the concept, at its simplest, a meme (rhymes with dream) is an idea. Any idea. It is simply something that gets stuck in the human mind.
Dawkins described memes thusly:
Examples of memes are tunes, ideas, catch-phrases, clothes fashions, ways of making pots or of building arches. Just as genes propagate themselves in the gene pool by leaping from body to body via sperms or eggs, so memes propagate themselves in the meme pool by leaping from brain to brain via a process which, in the broad sense, can be called imitation. If a scientist hears, or reads about, a good idea, he passed it on to his colleagues and students. He mentions it in his articles and his lectures. If the idea catches on, it can be said to propagate itself, spreading from brain to brain.
You can think of a meme as a sort of 'thought replicator' stored in our human brains and passed on by the imitation of others. Some memes are helpful, others can be harmful. For example if you pulled up to a man on the side of the road that looked like a policemen, you might expect directions to a particular location to be accurate. However, people can simply walk into a uniform store and buy a policeman's uniform.
Some people may see a connection with memes to brain washing or thought manipulation, but that would not the case in anything but a tiny fraction. Most memes are passed along as a desire to inform, assist, or make a special statement about ourselves.
Our minds are not a blank slate on which any idea can be impressed. To be understood, a new meme must connect to the values and process that are already available to the individual. In addition one must also be willing to believe it or to take it serious. For example, although you are likely to understand the proposition that cartoon animals can talk with each other, you are unlikely to accept the proposition that this occurs in the real world without very strong evidence. Therefore, you will not add it to your â€˜information base' on animal characteristics. The cartoon meme will not manage to change your view on the subject.
The columnists and bloggers have been effective meme vehicles for the Blood Type Diet. A great example of the meme effect is Cheryl Hendrix's blog First Do No Harm where she writes of an interaction which allowed her to instruct an uninformed individual on another diet board about the low quality of most internet reviews of the Blood Type Diet. Another is Suzanne Graham's blog about her difficulties with the food pyramid.
Some writers think there are two basic types of memes: procedural and propagative. For example, when I successfully communicate an idea or application of the Blood Type Diet to you, I've spread a 'BTD procedural meme.' The BTD procedural meme then becomes widespread if it provides some benefit, like increasing the diet's effectiveness, or explaining things better, etc. When you in turn recommend the diet of the website to a friend, or discuss it with a co-worker, you in turn spread the 'BTD propagational meme.'
A good meme, like a good virus, will have special characteristics that insure continued growth. Without them, they eventually die. I've included a few here, with special reference to the Blood Type Diet.
Fidelity: The ability to maintain accuracy and correct errors to maintain integrity. I think the BTD does a good job here, as it has continued to generate a reassuring richness and complexity of material, but is as changeable and adaptable as needed. A good example is the addition of the secretor information to the basic ABO types that occurred with the publication of Live Right 4 Your Type.
Fecundity: The fertility of the idea. The ease by which an idea it spawns itself. At least to me, this appears to be by and large culturally dependent. For example, when I first began practicing in the early 1980's there was little to no public or media interest in nutrition. Until that began to change, ideas about diets had no real place in the daily dialogue. 'Cultural relevance' is probably a critical aspect of meme fecundity.
Longevity: To me, the longevity of an idea is related to how relevant it continues to be, as its meme is passed to newcomers and future generations. In the case of the BTD, one could argue that its best days are still ahead of it, since it will almost certainly benefit from the impending paradigm shift in nutrition that will occur over the next ten years --the nutrigenomics revolution-- and the growing frustration over one-size-fits-all diets. There are several good examples of the BTD's longevity. A simple capitalistic one is the fact that my first book, written almost ten years ago, is still in hardcover. Another is the belief of many on the program, that this is a diet for life. Individuals who have been on the diet for 5, 7 or 8 years -- a tremendous meme pool, are filling out prospective blogger applications. Consider the life cycle of the average low carb diet book. It usually takes off with a period of stupendous sales, and then slumps as a newer version takes its place. Remember Sugar Busters?
Co-adaption: Effective memes tend to thrive in the company of other replicators that compliment them. I'm not certain that we do well in this department. For example, the â€˜Blood Type Diet Meme' should be expected to do well with the â€˜Naturopathic Medicine Meme' since they both address issues of innate healing and individualized treatment. However, not all naturopaths see the BTD as being as â€˜naturopathic' per se as perhaps a universal vegetarian diet. Also since the diet suggests a place for both a plant based or animal based diet, it tends to be criticized by advocates of the exclusive use of one or the other.
Right after the Oprah article came out I was deluged with comments suggesting I write the magazine and address the mistakes that the panel of experts had made in their description of the diet. After putting this off for a few days, I finally sat at the computer and diligently tried to accomplish this task. It was then I remembered that I had never actually read the Oprah article (I've pretty much stopped reading popular depictions of my work). At that point writing the letter began to feel like a 200-pound weight around my neck. Plus the more I thought about it, the more bored I became with the whole exercise. Finally I just lost interest and gave up.
Not a great example of meme propagation, but I am trying to be honest about it.
Now as time passes I am coming to understand why this apparently simple task was so profoundly debilitating to me: The 'Write Oprah Magazine Meme*' is not my meme.
* The more analytical in the crowd may have noticed that this statement about who owns the 'Write Oprah Magazine Meme' is in itself a meme.
Image copyright 1984-2004 Apple Computer Corp. You can see the complete Macintosh '1984' clip at http://www.apple.com/hardware/ads/1984/1984_480.html
The Internet site The Edge recently asked a few hundred deep thinkers "What's your law?â€? I liked Eberhard Zangger's two laws.
Zangger's First Law
Most scientific breakthroughs are nothing else than the discovery of the obvious.
Zangger's Second Law
Truly great science is always ahead of its time.
As examples, he gives:
The Hungarian surgeon Ignaz Semmelweiss in 1847 reduced the death rate in his hospital from twelve to two percent, simply by washing hands between operations -- a concept that today would be advocated by a four year old child. When Semmelweiss urged his colleagues to introduce hygiene to the operating rooms, they had him committed to a mental hospital where he eventually died.
The German meteorologist Alfred Wegener discovered in 1913 what every ten year old looking at a globe will notice immediately: That the Atlantic coasts of the African and South American continents have matching contours and thus may have been locked together some time ago. The experts needed sixty more years to comprehend the concept.
Heinrich Schliemann's excavation of Bronze Age Mycenae and Tiryns in Greece was considered by English archaeologists in The Times' as the remains of some obscure barbarian tribe' from the Byzantine period. In particular, the so-called prehistoric palace in Tiryns was labelled "the most remarkable hallucination of an unscientific enthusiast that has ever appeared in literature."
The theories of the Austrian psychiatrist Sigmund Freud were called "a case for the police" during a neurologists' congress in Hamburg in 1910.
I know it is probably just auto-suggestion, but I take solace from this sort of stuff.