Seth's Blog

In this post Andrew Gelman comments on my recent post about acne self-experimentation. He makes an excellent point about drug-company studies:

How would you want to evaluate the risks and effectiveness of a new drug that was developed by a pharmaceutical company at the cost of millions of dollars? I’d be suspicious of an observational study: even if conducted by professionals, there just seem to be too many ways for things to be biased.

Right. And it’s not just observational studies. The data from any big study can be analyzed many ways. The more at stake, the greater the chance of what Andrew calls bias and I call making choices that favor the result you prefer. Independently of Andrew, Hal Pashler and I came up with what I call the Pashler-Roberts Law: The more expensive the research, the less likely the researchers will be honest about it.

You may remember that Robert Gallo, the AIDS researcher, did very expensive research. The deception (possibly self-deception) that accompanied very expensive fusion research is described in Charles Seife’s Sun in a Bottle: The Strange History of Fusion and the Science of Wishful Thinking (2008).

As Andrew says, this is a big virtue of self-experimentation. Because it’s free, it’s easy to be honest, especially about failure. The cheaper the better is a broad truth about science that’s hard to learn from books or classes or even talking to scientists.

From the SLD forums:

It has been two years since I started [SLD], and I just couldn’t think about changing this simple, natural way of life that has given me such peace and freedom.  I often think of a comedy skit I saw on t.v. some time ago where this guy was given a new electric sander as a gift, but kept using it without plugging it in.

To try to lose weight without SLD is like not plugging in an electric sander. Other weight-loss methods work; they’re just much harder, like a sander versus an electric sander.

In her sig file she describes her method and results:

48 years old, 5 feet 4 inches
March 7 160
May 8 119
May 9 116
1-2T OIL/day AND/OR N.CLIP 300-500 calories food.
CFF daily.
To sustain weight loss: Eat fewer calories; enjoy the food you eat; low G.I.; only highest quality.
Don’t assault your precious body with empty calories.

N.CLIP = noseclip. CFF = calorie-free flavor. See the SLD forums for more about them.

To lose 25% of your weight and go a year without regain is a huge accomplishment.

I just got a spam email from a company in China offering to sell me crystalline fructose. I have bought far more than my share of crystalline fructose (that’s how I originally did the Shangri-La Diet) and I live in China part of the year. How in the world did they know?

Someone who lives in the southwestern US posted this on a helmenthic therapy forum:

One [scorpion keeper] reported how a pain in his leg from a motorcycle accident that had been with him for years spontaneously resolved after getting stung by some fairly nasty [scorpion] . . . .  It’s fairly well-known that beekeepers don’t face the same risk from arthritis as the general public.

I haven’t managed to find support for this “fairly well-known” idea. But it’s quite plausible because bee stings are used to treat arthritis and multiple sclerosis. In this video, an Indonesian therapist says that 85 out of 100 sufferers are “cured” by the treatment.

“A therapy most of us would find taboo,” says the narrator of this video. I wonder. Here’s what Wikipedia says:

There is no known cure for [multiple sclerosis].  . . MS medications can have adverse effects or be poorly tolerated, and many patients pursue alternative treatments, despite the lack of supporting scientific study.

Multiple sclerosis and some forms of arthritis are autoimmune disorders. My “umami hypothesis” says that autoimmune disorders and other immune disorders, such as allergies, are deficiency diseases. They are caused by not enough immune-system stimulation — stimulation that long ago we got from bacteria-laden food. This suggests a new interpretation of what’s going on with bee-sting therapy. Their healing properties have been attributed, at least in these videos, to special properties of the venom. The umami hypothesis suggests that the foreign proteins in venom calm the immune system and that quite different foreign substances would do just as well. I don’t know of anyone treating arthritis or MS with fermented food — but before the Shangri-La Diet, I didn’t know of anyone drinking sugar water to lose weight. The fact that such hugely different agents as hookworms, bee stings, and fermented foods have similar effects is considerable support for the hypothesis. Without the hypothesis, no one would have grouped them together.

Now I wonder about acupuncture: Could it work, at least some of the time, because it injects foreign substances? Surely acupuncture needles put plenty of bacteria into the body. This line of thought explains why stabbing a knee with a scapel apparently helps arthritis (and involves a lot less hand-waving than calling that result a placebo effect). Keep in mind that this is the hallmark of deficiency diseases: They get a lot better, almost miraculously and without side effects, if you supply even a little of what’s missing. The cure rate can be very high.

People in power, by and large, are terrible problem-solvers. They like the status quo — it brought them where they are. They have a hard time seeing the benefits of change. The bigger the change, the less they like it. Thus self-experimentation, a new way of solving health problems, offends med school professors.

But sometimes people in power make a wise choice — possibly by accident. An example is how the City of San Francisco is encouraging solar power. They are giving huge subsidies to homeowners and renters who install electric power. The program is about a year old. If your income is low, the subsidy is so large that your power becomes almost free. This is a use of government money that encourages change and new solutions. It will help the local solar power industry grow. It might create a solar power hub near San Francisco the way defense department subsidies helped create Silicon Valley.

Why is this happening? Because the responsible department in San Francisco government gets $100 million/year by selling electricity from hydropower. (Which they don’t like to talk about, for obvious reasons.) The money can’t be transferred to other departments; it has to be spent in energy-related ways. On its face, the restriction seems cruel — why not use the money to help social services? But more money for social services is unlikely to improve the local economy. Whereas this use of the money helps poor people and the local economy. It does so in the basic way Jane Jacobs recommends: It empowers those who benefit from change — in this case, the solar power industry.

I completely agree with Ray Bradbury about libraries:

“Libraries raised me,” Mr. Bradbury said. “I don’t believe in colleges and universities. I believe in libraries because most students don’t have any money. When I graduated from high school, it was during the Depression and we had no money. I couldn’t go to college, so I went to the library three days a week for 10 years.”

Here’s what he says about a similar source of free knowledge:

“The Internet is a big distraction,” Mr. Bradbury barked . . . “Yahoo called me eight weeks ago,” he said, voice rising. “They wanted to put a book of mine on Yahoo! You know what I told them? ‘To hell with you. To hell with you and to hell with the Internet.’

“It’s distracting,” he continued. “It’s meaningless; it’s not real. It’s in the air somewhere.”

When I was in college (at Caltech), I didn’t find classes or books very helpful. I liked reading old New Yorker articles. Which then I got from the library but now I’d get online.

Michael Bowerman writes from Kenya:

First, I’ve made a point of eating yogurt daily and have had no stomach problems in a month of eating here. May be coincidence as I haven’t eaten at risker spots, but most others I know here have had some problem during their stay. I did drink one yogurt which tasted foul, and realised it was past expiration. I wonder if my perception that it was foul was culturally indoctrinated, or a useful rejection of spoiled food. What is the relationship between fermentation and true spoilage?

Second, reading Nelson Mandela’s autobiography he talks about a traditional drink of his tribe, the Xhosa, called amasi – feremented milk. He writes about how much he loves the taste during an anecdote where fermenting the milk on his window ledge while staying at a safehouse in a white neighbourhood draws the attention of passing Africans who are wondering why “their” milk is in the window. I wonder if he would have liked my “spoiled(?)” yogurt? I haven’t looked for commercial versions yet, but will.

Third, a Sudanese friend told me that the Sudanese have a drink made from cow’s blood, urine, and fermented milk. The only part I was incredulous about was the urine but it seems cow and camel urine have been drank by other cultures — there is a urine-based soft-drink being released in India called Gau Jai. I found this site which documents the extensive fermentation in Sudanese culture — meat, milk, urine — including “…mish, which is made by prolonged fermentation to the extent that maggots thrive in it. The product is consumed whole, with the maggots included. These two products are closely related to Egyptian mish (1).”

A year ago I told students at my friend’s Mohamed Ibrahim‘s school that a student of Allen Neuringer’s had gone on a camping trip and found that her acne went away. At first she thought it was the sunshine; but then, by self-experimentation, she discovered that the crucial change was that she had stopped using soap to wash her face.

Now Mohamed writes:

I told my classes about your friend who went camping without her face products only to discover that the face products were contributing to her acne, and that from that point on she only washed her face with water. It turns out that two of my students wash their faces with water! And their skin looks great! I started “washing” my face with water about a month ago, and [now] my face is acne free and soft as a pair of brand new UGG boots. [He had had acne for years.] The only additional thing I do is wipe my face with a napkin throughout the day to remove any excess oil.

So one cause of acne is using soap to wash your face.

Acne really matters. And it’s common. It now turns out that it has a pathetically easy solution, in at least some cases. Dermatologists don’t know this. Apparently hardly anyone knows it. Somehow the entire healthcare establishment, to whom we entrust our health in many ways, missed this. Dennis Mangan’s discovery that niacin can cure restless-leg syndrome is another example of a pathetically easy solution missed by experts. Likewise, the Shangri-La Diet is very different than anything an obesity expert has ever proposed.

What else has been missed?

More Imagine a med student in a dermatology class. The student raises his hand and asks a question. “I read in a blog that acne goes away if you stop using soap. What do you think about that?” What would the instructor say — after telling the student not to believe everything he reads on the Web?

From his blog:

Recently I lost my sense of smell thanks to, I assume, some allergy meds I’ve been snorting. . .  .My wife, Shelly, kept asking versions of the question “Do you smell that? It’s awful!” But I never smelled that. . .  I think I also gave up something in the food tasting department thanks to my lack of a functional sniffer, but I’m okay with that too. I’ve dropped about eight pounds in the last two months because lately I’m not attracted to the taste of food, just its utility.

Thanks to David Cramer

More In related news, a popular cold remedy causes anosmia. Thanks to Marian Lizzi.

Years ago I made yogurt using a recipe from Saul Sternberg. I still use the same ingredients — the basic point is to add about 1/2 cup powdered milk per quart of regular milk at the start — but I implement the temperature changes differently. Since I became interested in fermented foods, I’ve made yogurt a dozen times. Here’s what I’ve learned.

1. Makes a great condiment. I blogged about this. Store-bought yogurt, even the plain stuff, is too runny — not thick enough — nor sour enough to make this clear. The addition of powdered milk makes the yogurt thick enough to easily eat with anything, including meat. It improves the flavor of just about anything, especially if the yogurt is really sour. This might be the most important lesson since it means you can eat it at every meal and it makes cooking easier. I use spices much less now. The yogurt supplies complexity.

2. You can incubate it for days. I want it as strong as possible — not only because more sour (food writers euphemistically say tart) is better but also because the longer it ferments the more bacteria there will be. After a while it stops getting more sour and I stop. I routinely let it incubate one or two days, much longer than any recipe I’ve seen.

3. Preheating helps. Most recipes say you should heat the milk before you add the cultures. Some say this kills “bad” bacteria, which could compete with the bacteria you add. According to Harold McGee, the preheating denatures the milk proteins, which helps them trap liquid (whey). I did a little experiment in which I didn’t preheat some of the batches. Without preheating, the yogurt was much less solid. Supporting McGee.

4. Strauss yogurt better than Pavel yogurt. (Two popular Bay Area brands.) When I make a new batch I start it with store-bought yogurt; that works better than using what I have left. Side-by-side tasting showed that Strauss yogurt is more sour than Pavel yogurt. I made yogurt using each as the starter; the Strauss-started yogurt was clearly more sour than the Pavel-started yogurt.

5. Slow cooker works great. It is very easy to do the preheating via a crockpot (also called a slow cooker). I put it on high and wait 3-4 hours. This heats the milk to about 185 degrees F. Then I cool it down, add the cultures, and put the whole crockpot in the oven (set very low) to keep it warm for a few days. No spillage. I use a food thermometer to track the temperature. I got the idea from the Shangri-La Diet Forums.

6. Whole milk better than low-fat milk. Whole tasted better.

Harold McGee’s recommendations.