Seth's Blog

A reader of this blog named PSB, who lives in New Jersey, told me the following:

I’m 52.  I happen to like walnuts and was snacking on them and noticed the pain from canker sores was lessened.  I kept eating [walnuts] the next couple days and found the sores healed quickly, painlessly and were gone within a few days. They usually take quite a while to go away. The walnut thing was accidental and just from observation noticing the change in the sores. The sores are still gone and although I haven’t been eating lots of walnuts, I usually grab them here and there.

Her daughter “has suffered from canker sores for years . . . [and] gets multiple at a time and they are usually very painful.” Her daughter is resistant to eating walnuts. I asked why. “Doesn’t listen to her mother, knows it all and I sometimes thinks she prefers to complain. Other than that, no real reason, hahaha,” said PSB.

I’ve blogged before (here and here) about canker sores cured by omega-3. Walnuts are high in omega-3, supporting what I said. The Mayo Clinic lists eight possible causes of canker sores, including “A diet lacking in Vitamin B-12, zinc, folate (folic acid) or iron”. Nothing about omega-3.

When I took flaxseed oil capsules for reasons connected with the Shangri-La Diet, I noticed, to my surprise, that my balance improved. The next time I saw my dentist, he told me that my gums were much better. A reader of this blog named Chuck Currie has noticed the same things.

I ran across a reference to your book again which led me to your website. And, like I said, from there to Mark Sisson and all the rest.

I had already ran across information about flax oil and cholesterol and heart health. So I started taking two tablespoons a day [of flaxseed oil] – morning and night. I noticed my balance improvement while doing yoga, but thought it was due to practice. After reading several paleo blogs, I switched to fish oil – one table spoon a day in the morning. Then after reading some other studies regarding possible negative effects of over-consumption of fish oil, I stopped that also.

During this time I really became a strict paleo/primal eater and exerciser. No carbs other than leafy greens and non-starchy vegs. No more chronic cardio. Stopped swimming due to shoulder issues. Started using kettlebells and body weight tabata exercise. Went back and forth on supplementation. My weight dropped to below 120. [He's 5 feet 8 inches tall.]

I was getting totally confused on what was legit and what was BS. Sure I lost weight, but I must have looked sick because people were asking if I was all right. I think they thought I had cancer or AIDS. I felt great though. No more 2 o’clock naps and I slept great. Then I read Kurt Harris’s 2.0 blog and that set me straight – and straight back to your blog.

It made me think, OK what works on the individual level, not the hypothesis level. I had also noticed that my balance had deteriorated (I thought it was because I stopped doing yoga) and my gums were bleeding again – I had forgotten that they had stopped bleeding. [After he switched from flaxseed oil to fish oil, his balance slowly got worse.] Sort of back to basics. Sun, lots of it, or D3 – 10,000 units (I am sitting in the sun as I type this on my iPhone). Omega 3 – your posts about flax oil made sense – [sudden release of short-chain omega-3 causes] slow release [of long-chain omega-3] – and is more sustainable than cold water fish and fish oil. Magnesium at night for better sleep and muscle cramps. (when I first went full paleo, I suffered from terrible leg cramps during the night until I found magnesium). And extra butter – beyond cooking with it.

I tested the flax/balance question by continuing to not practice yoga or any other balancing exercises and [measure my balance] just using my ability to wash my feet in the shower without leaning against the wall – which had been my normal habit before my first improvement and then again when it went away. After about a week – perfect balance – both washing and drying my feet. Also, no gum bleeding. So as some would say, “the shit works”.

[He added later:] I can definitely say, with a high degree of confidence, that my balance is not as good when taking fish oil as it is when taking flax oil. Fish oil does provide a small improvement over not supplementing any omega-3. But the big improvement comes with flax oil.

You have diverticulitis when “diverticula in your digestive tract become inflamed or infected. Diverticula are small, bulging pouches.” A man in his forties named Tuck had a serious case:

In my twenties I got really sick; lying in bed for 5 days, bleeding from the lower part of my digestive tract: not pretty. . . Delirious days later and ten pounds lighter and I was recovered, except for one problem: I had diarrhea for the subsequent 14 years. . . . Two years ago [2008] I passed out on the toilet on a ski weekend. The emergency room at Bennington Hospital [Vermont] told me it was a stomach flu.

Four weeks later I got cramps at work. I had to lie on the floor until it passed. Then I drove to my doctor’s office, and he told me that I had diverticulitis, and I had to go to the emergency room. I drove myself, and barely made it. I was in agony; I nearly passed out again while they were interviewing me to see if it was “serious”. . . . I had a perforated colon. . . . I spent the next four days in the pre-operative ward, so if it got worse they could cut me open immediately. I lost 10 pounds. Then I started bleeding, and I realized these were all the same symptoms that I had had 14 years before. My blood pressure got so low that the automated blood-pressure machine wouldn’t work . . .

I mentioned to all three of the doctors I saw that I had had constant diarrhea for the last 14 years, since the first attack, and they shrugged. They told me to eat more fiber, and whole wheat, even though that was what I had been eating for the last 20 years. So I avoided surgery, started eating salad with salad dressing (containing industrial seed oils) and lots of whole wheat. . . . But the more salad and whole wheat I ate, the worse it got. I couldn’t understand why. Finally had to have eight inches of my colon removed. The diarrhea continued, so obviously the cause remained.

Then something happened that, before blogging, wasn’t possible: (more…)

A new study found that ground flaxseed powerfully lowers blood pressure:

A patient population with peripheral artery disease (PAD) was selected as ideal to benefit from dietary flaxseed. . . . Patients received 30g of milled flaxseed (or placebo) each day over 6 months. [I eat  50 g/day -- Seth] . . . No significant adverse events were associated with flaxseed ingestion. . . . SBP in the placebo group increased by ~3 mmHg and DBP remained the same over the experimental period. However, SBP levels were ~10 mmHg lower (P<0.04) and DBP was ~8 mmHg lower (P<0.004) in the flax group compared to placebo. In the flaxseed group, patients with a SBP <140 mmHg at baseline did not receive an anti-hypertensive effect but patients who entered the trial with a SBP > 140 mmHg at baseline obtained a sustained and significant 15 and 7 mmHg reduction in SBP and DBP, respectively, during the six months. . . . one of the most potent anti-hypertensive effects ever observed by a dietary intervention.

This supports my belief that we can improve our overall health by trying to improve our brains (which are more sensitive than the rest of the body). I have blogged about flaxseed oil many times. I became interested in it when I noticed it improved my balance. Balance measurements showed that the optimal dose  (2-4 T/day) was higher than flaxseed oil manufacturers suggested.  Then I and others noticed that taking this amount of flaxseed oil produced big improvements in gum health. Tyler Cowen, for example, no longer needed gum surgery. Go home, said the surgeon.

Thanks to Grace Liu.

• more black tea, less diabetes (cross-national comparison).Earlier research supports the idea that black tea reduces diabetes.
• Nassim Taleb praises an obscure French novel (translated into English) called The Opposing Shore. Says it is about “the antechamber of anticipation”.
• Natto consumption in different parts of Japan and correlation with Vitamin K levels and hip fracture risk. The correlation between natto consumption and hip fracture risk is weak but significant and cannot be explained by differences in wealth or overall soybean consumption. This is excellent epidemiology.
• Five reasons butter is a superfood. I was unaware that conjugated linoleic acid (of which butter is a good source) inhibits tumors.
• Fish oil and brain injury. Read this before you have a brain injury.

Thanks to Anne Weiss and Dave Lull.

A week ago I had my teeth cleaned. So dirty! said the dental hygienist. This wasn’t surprising. Because I am in China a lot, I get my teeth cleaned only twice per year. Long ago they got dirty so fast my dentist insisted on four cleanings per year. “But aren’t my gums okay?” I asked the hygienist. They felt okay. Not tender. They did’t bleed when I flossed (which wasn’t often). No, she said. You have pockets of 5 (= 5 mm depth). There is bleeding. Indeed, when I washed out my mouth with water at the end, there was some blood.

Yesterday I had my teeth examined. The hygienist was wrong. Almost all my pockets were 2′s, with a few 3s. That’s very good and a vast improvement from the 4s and 5s I had before I became a big fan of flaxseed oil. My gums improved exactly when I started drinking flaxseed oil, no doubt because the omega-3 in flaxseed oil reduces inflammation. My gums were fine in spite of all the plaque — which is supposed to make gums bad. Apparently the hygienist was so devoted to her theory (lots of plaque = bad gums) that she failed to see an exception she stared at for 30 minutes.

There is a well-established correlation between gum disease and heart disease (more gum disease, more heart disease), probably because both are caused by inflammation. So good gums is very good news — it shows I am doing a good job of reducing inflammation throughout my body. These results also support two of my pet theories:

1. Studying what foods make the brain work best is a good way to improve overall health. I started studying flaxseed oil, and how much to take, because I discovered by accident that it improved my balance. Experiments (what is the effect of flaxseed oil on my balance?) soon showed the optimum amount/day was more than flaxseed oil makers recommended! Before I started eating lots of butter, the optimum for me was about 3 tablespoons/day. After I started eating lots of butter, the optimum seems to have gone down to 2 tablespoons/day. Gum improvement seems to be easy to notice at about 1 tablespoon/day.

2. Our health care system fails to get the simplest things right. Omega-3 is not a mysterious nutrient. It has been shown to improve health in thousands of studies. It is well-known that it is anti-inflammatory. It is also well-known that too much inflammation is a major problem. Even so, our health care system has failed to grasp that a large fraction of the population eats too little omega-3 and this has an easy fix. Other examples of failure to get the simplest things right include gastroenterologists not realizing that digestive problems may be caused by food, dermatologists not realizing that acne may be caused by food, and everyone not realizing that cutting off part of the immune system (tonsillectomies) is a terrible idea.

What other simple things does our health care system get wrong?

How much can you help yourself by getting your genome sequenced? A lot, a little, not at all? Scenario 1 (big help): You discover you have a greatly elevated risk of Disease X. You do various things to reduce that risk that actually reduce it. Scenario 2: (a little help): You discover you have a greatly elevated risk of Rare Disease X. You do various things to reduce that risk but they don’t help. At least, when Disease X starts, you will be less upset. Scenario 3 (no help): You discover that you have a greatly elevated risk for a common easily-noticed disease (such as obesity). You already watched your weight, this changes nothing. Scenario 4 (harm): You discover that you have a greatly elevated risk of Scary Disease X (e.g., bipolar disorder). It is depressing news. Later studies show that the gene/disease association was a mistake. (Many gene/disease associations have failed to replicate.)

A recent Wired article tries to answer this question for one person: Raymond McCauley, a bioinformatics scientist who had his genome sequenced four years ago and learned he was “four or five times more likely than most people to develop age-related macular degeneration (AMD)”. The article says “of all the ailments described in the 23andme profile, AMD has one of the strongest genetic associations”. If I found this in my genetic profile, I would want to know the confidence interval of the increased risk. Is it a factor of 4.5 plus or minus 1? Or 4.5 plus or minus 8? This isn’t easy to figure out. In addition to the question of variability, there can easily be bias (= estimate is too high). Let’s say I do 100 gene/disease association studies. Then I scan these studies to pick the one with the strongest gene/disease association. It should be obvious that this particular association is likely to be too high and, depending on the details, could plausibly be pure chance (i.e., true association is zero).  I have been unable to find out how replicable the gene/AMD association is. According to Wikipedia, “the lifetime risk of developing late-stage macular degeneration is 50% for people that have a relative with macular degeneration, versus 12% for people that do not have relatives with macular degeneration.” (Until it was eliminated via better diet, pellagra also ran in families.) The Wired article does not say whether any of McCauley’s relatives have/had AMD — a huge omission, given the uncertainty of gene/disease associations.

It wasn’t obvious what McCauley should do, according to the article:

McCauley read that there were a few preventative measures he could take to reduce the chances of AMD one day rendering him blind: don’t smoke and avoid ultraviolet light, for instance. Also, it seemed, he could try taking a special combination of vitamins, including B12 and lutein. But when he consulted the research, he could find little evidence to support the effectiveness of the regime, based on his genotype.

The article says nothing about quitting smoking but he does wear glasses that reduce ultraviolet light and takes certain vitamins. It is very hard for him to determine whether they help.

Here is a study that found greater omega-3 consumption associated with lower risk of AMD. Here is a study that found AMD associated with inflammation (too little omega-3 increases inflammation). Here is a study that found no association between vitamin and mineral intake and AMD. Based on this, if 23andme told me I had an increased risk of AMD, I would make sure to optimize my intake of flaxseed oil (or other omega-3 source) using some sort of brain test. I have documented in other posts that brain function is sensitive to omega-3 intake and (probably) most people don’t get enough. Of course, just as it is foolish to smoke (a lot) regardless of whether you have genetic risk of AMD, it is foolish to not optimize one’s omega-3 intake, whether or not you have genetic risk of AMD. In other words: everyone should optimize their omega-3 intake.  If the 23andme results cause McCauley to do something wise like this that he would otherwise not have done, they have helped him.

The omega-3 study appeared after the Wired article so I don’t know how McCauley reacted to it. A puzzle about the  story is that it isn’t even clear that the gene/AMD associations are true. Consider McCauley’s older relatives: parents, grandparents. Did/do any of them have AMD? If not, it is more plausible that all of them were at 12% risk of the disease than at 50% risk. Suppose all of them had, according to 23andme, the same increased risk as McCauley (at least some of them have the risk-bearing genes). Now it becomes more plausible that something is wrong with the 23andme risk estimate. If some of McCauley’s older relatives do have AMD, it is not clear why the 23andme results would make much difference. He should have already have known he was at increased risk of AMD.

The upshot is that in this particular case, I cannot even rule out Scenario 4 (does harm). All four scenarios strike me as plausible.  Based on this article, we are a long way from learning the value of personal genomics.

Previously I used the example of Aaron Blaisdell to make the possibly counter-intuitive point that if you have a genetic disease something is wrong with your environment. Well, I do not have any obvious genetic disease. But I discovered, via self-experimentation, that my environment was terrible — meaning it could be improved in all sorts of ways: stop eating breakfast, drink flaxseed oil, eat butter, look at faces in the morning, take Vitamin D in the morning, and so on, not to mention eat fermented foods (which I figured out via psychology, not self-experimentation). My findings about what is optimal are so different than the way anyone now lives (except people who read this blog) that I believe everyone‘s environment can be vastly improved. If so, the value of discovering you have a genetically elevated risk of this or that is not obvious — you should already be trying to improve your environment. At least that is what my data has taught me. On the other hand, maybe genetic info (even wrong genetic info!) will give you a kick in the pants. Maybe that has happened with McCauley.

• A “safe starch” lowers HDL.
• DIY clinical trials
• omega-3 content versus mercury content of fish: a handy guide.
• Predictions of climate models versus reality. I have only seen careful prediction-vs-reality comparisons made by AGW skeptics. Those who believe humans are dangerously warming the planet appear to be silent on this subject.
• UNESCO’s list of “intangible cultural heritage”. I like to think the items on the list are clues to human nature.

Thanks to David Cramer and Nadalal.

The following comment was left a few days ago:

I was doing SLD using flax seed oil for two weeks before my last dental appointment.  My pockets that were 4′s and 5″s magically changed to 2′s and 3″s.  I had my dentist print both the reports because I was so grateful that they stopped talking about some really painful sounding root work.  My brushing and flossing were totally unchanged.  I was expecting the result because of what I’ve read on the blog, but nothing this good.  I am convinced that taking flax=reduction in gum inflammation, at the very least. [emphasis added]

Take that, “decline effect” (big experimental effects, when the experiment is repeated, get smaller)!

The  commenter sent me the records of the two cleanings. At the pre-flaxseed-oil cleaning (April 28, 2011), he had 24 sites (13 teeth) with pockets of depth 4 or 5. At the cleaning after he started flaxseed oil (July 28, 2011), he had no sites with pockets of depth 4 or 5.

You can find many similar reports here.

• omega-3 blood levels correlated with better mental performance in the elderly. “The team found that people who had higher blood levels of vitamins B, C, D and E and omega-3 fatty acids scored higher on the mental-function tests, including attention tasks and visual and spatial skills, than those with lower levels of these nutrients.”
• “Inflammation, atherosclerosis, and coronary artery disease.” An influential New England Journal of Medicine article from 2005. The next time someone tells you that heart disease is due to high cholesterol, refer them to this article.
• Weak evidence that bacteria in food stimulate the immune system. Indian women who ate yogurt to which a probiotic had been added had more of an immune-related molecule in their feces than before and after that ingestion.
• Speaking of India, do medical students who gain admission by fraud become dangerous doctors? India has a problem.

Thanks to Tim Beneke.