Seth's Blog

• More evidence that the SCD (Specific Carbohydrate Diet) diet really helps people with Crohn’s Disease. “Since starting this diet, I have had no pain. Some might attribute this to surgery, but I am convinced the diet has so much to do with it. My blood work is normal, and it hasn’t been in 8 years. The sed rate level in the blood is normal instead of elevated outrageously.”
• How to improve on lectures when teaching physics.
• More selenium, less risk of cancer. Contrary to what the researcher quoted in this article says, there is already substantial evidence that selenium reduces cancer risk. For example, in a county-by-county map of USA cancer rates, there is a clear rift in the north east. On one side of the rift rates are clearly higher than on the other side of the rift. The rift corresponds to geological fault line. On the low-cancer side of the rift, there is more selenium in the soil. There are also rat experiments. You certainly should take selenium supplements.
• American health care plays a surprisingly large role in an excellent story by Peter Hessler in The New Yorker about the Japanese yakuza (mafia). 1. From 2000 to 2004, four yakuza members got liver transplants at UCLA at a time when liver transplants were hard to get. A few months later they made large donations to UCLA. The money went into a general fund at the surgery department. According to a UCLA spokesperson, there was no connection between the transplants and the donations. According to a UCLA press release, “No money or donation was offered or paid to anyone at UCLA as a quid pro quo for getting a transplant or moving up on the list.” Because a general fund is not a person, this is literally true. 2. In the early 1990s, at a Columbia, Missouri hospital, a nurse was suspected of killing patients. Hospital administrators covered it up. “Everyone took part in the coverup was promoted, everybody who tried to expose it was punished,” said someone who tried to expose it.

Thanks to Alex Chernavsky.

• 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.

A blog called Adventures in Nutritional Therapy (started March 2011) is about what the author learned while trying to solve her health problems via nutrition and a few other things. She usually assumed her health problems were due to too much or too little of some nutrient. She puts it like this: “using mostly non-prescription, over-the-counter (OTC) supplements and treatments to address depression, brain fog, insomnia, migraines, hypothyroidism, restless legs, carpal tunnel syndrome, and a bunch of other annoyances.” In contrast to what “the American medical establishment” advises. Mostly it is nutritional self-experimentation about a wide range of health problems.

Interesting things I learned from the archives:

1. Question: Did Lance Armstrong take performance-enhancing drugs? I learned that LiveStrong (Armstrong’s site) is a content farm. Now answer that question again.

2. “If you return repeatedly to a conventional doctor with a problem they can’t solve, they will eventually suggest you need antidepressants.”

3.  “When I mentioned [to Dr. CFS] the mild success I’d had with zinc, he said it was in my mind: I wanted it to work and it did. When I pointed out that 70% of the things I tried didn’t work, he changed the subject. Dr. CFS’ lack of basic reasoning skills did nothing to rebuild my confidence in the health care system.” Quite right. I have had the same experience. Most things I tried failed. When something finally worked, it could hardly be a placebo effect. This line of reasoning has been difficult for some supposedly smart people to grasp.

4. A list of things that helped her with depression. “Quit gluten” is number one.

5. Pepsi caused her to get acne. Same here.

6. 100 mg/day of iron caused terrible acne that persisted for weeks after she stopped taking the iron.

7. “In September 2008 I started a journey that serves as a good example of the limits of the American health care system, where you can go through three months, 15 doctor visits, $7,000 in medical tests, three prescriptions and five over-the-counter medications trying to treat your abdominal pain, and after you lose ten pounds due to said pain, you are asked by the “specialists” if you have an eating disorder.” I agree. Also an example of the inability of people within the American health care system to see those limits.  If they recognized that people outside their belief system might have something valuable to contribute, apparently something awful would happen.

8. Acupuncture relieved her sciatica, but not for long. “By the time I left [the acupuncturist's office] the pain was gone, but it crept back during my 30-minute drive home.”

9. Pointing out many wrongs does not equal a right. She praises a talk by Robert Lustig about evil fructose. I am quite sure that fructose (by itself) did not cause the obesity epidemic. For one thing, I lost a lot of weight by drinking it. (Here is an advanced discussion.) In other words, being a good critic of other people’s work (as Lustig may be) doesn’t get you very far. I think it is hard for non-scientists (and even some scientists) to understand that all scientific work has dozens of “flaws”. Pointing out the flaws in this or that is little help, unless those flaws haven’t been noticed. What usually helps isn’t seeing flaws, it is seeing what can be learned.

10. A list of what caused headaches and migraines. One was MSG. Another was Vitamin D3, because it made her Vitamin B1 level too low.

She is a good writer. Mostly I found support for my beliefs: 1. Of the two aspects of self-experimentation (measure, change),  change is more powerful. She does little or no self-tracking  (= keeping records) as far as I could tell, yet has made a lot of progress. She has done a huge amount of trying different things. 2. Nutritional deficiencies cause a lot of problems. 3. Fermented food is overlooked. She never tries it, in spite of major digestive problems. She does try probiotics. 4. American health care is exceedingly messed-up. As she puts it, “the American medical establishment has no interest in this approach [which often helped her] and, when they do deign to discuss it, don’t know what the #%@! they’re talking about.” 5. “Over the years I’ve found accounts of personal experiences to be very helpful.” I agree. Her blog and mine are full of them.

Thanks to Alexandra Carmichael.

More Her latest post mentions me (“The fella after my own heart is Seth Roberts, who after ten years of experimenting . . . “). I was unaware of that when I wrote the above.

• Comparing one elbow to the other. I have no idea what “clinical epidemiology” is. The level of self-deprecation is remarkable. From the BMJ Christmas issue.
• The value of cod liver oil. From the BMJ Christmas issue.
• More evidence for radiation hormesis (beneficial effects of small amounts of radiation).
• Evolutionary medicine reaches the BMJ. The word paleo does not appear.
• Medical journals: “information-laundering operations for drug companies”

Thanks to Robin Barooah and Mike Bowerman.

Alex Chernavsky, who often comments here, has updated his Shangri-La Diet (SLD) page. It now shows his weight over four years: two years before he started SLD and two years that he has been doing it.

Before he started SLD he was slowly gaining weight. After he started SLD, he went from 220 pounds (BMI = 32) to 193 pounds. He slowly gained a few pounds. Then (on my advice) he added a tablespoon of nose-clipped coconut butter and the steady climb stopped. Ffor about nine months has been steady at 195  pounds (BMI = 28). In other words, there is no sign that he is regaining the lost weight.

Because Alex has added a lot of omega-3 to his diet (via flaxseed oil), I’m sure his health has improved in other ways. Because he is a vegan, he had no interest in a conventional (Atkins) low-carb diet.

Alex reminded me that a doctor named Quigley left the following comment:

I’ve tried to find data that your diet works for SUSTAINED weight reduction in a study that would be applicable to a generalizable population. As you know, temporary weight loss is relatively easy. Sustained weight loss (wt loss > 2 yrs), is hard. If your diet can do it, I’d prescribe it every day.

 

A recent Cochrane Review summarizes several experiments that measured the effect of Vitamin D on mortality. Here is a summary:

This systematic review analysed the influence of different forms of vitamin D on mortality. In the 50 trials that provided data for our analyses a total of 94,148 participants were randomly assigned to either vitamin D or no treatment or a placebo. All trials came from high-income countries. The mean age of participants was 74 years. The mean proportion of women was 79%. The median duration of vitamin D administration was two years. Our analyses suggested that vitamin D₃ reduces mortality by about 6%,

Vitamin D3 helped; Vitamin D2 and other forms of Vitamin D did not. The doses of Vitamin D3 were usually low: less than 800 IU/day.

Stimulated by Primal Girl’s discovery, I have been taking Vitamin D3 at about 7 am in the morning, slowly increasing the dose to see if there are any clear effects on my sleep (or anything else). I am up to 4000 IU/day.

To many dieticians and much of the general public, the similarity between butter and eggs is that both are bad for you. Butter: Fattening! Clogs arteries! Eggs: High in cholesterol! To me, it’s the opposite: both seem to be unusually good for us. Butter seems to make my brain work better and may have reduced my risk of heart attack. Eggs — at least, scrambled eggs — are especially well-liked by Mr. T, a rat. There are many similarities between rats and humans. Humans also like eggs. The foods we like are a guide (imperfect) to what foods are good for us.

Here’s another similarity between butter and eggs: Both must be complete — contain all necessary nutrients — much more than any other food. Butter is large part of milk. When mammalian offspring are very young, mother’s milk is their only food. Eggs, of course, must contain everything needed to become a baby chick (as a commenter named Rashad pointed out). No other foods — not fruits, not vegetables, not whatever other foods your great grandmother or other ancestors ate — have been under this sort of evolutionary pressure.

The evolution of lactose tolerance and my butter discoveries.

Two months ago I wrote that camelina oil might be a good source of omega-3. A few days ago, a reader named Evelyn Majidi commented as follows:

Based on this suggestion, I ordered camelina oil from the good farmers in Saskatchewan and began taking it using the same dose (3T/day) that I had been taking of flaxseed oil for relief of psoriasis and lichen planus. Unfortunately, the slow but sure improvement I had been experiencing over the past year with flaxseed oil stopped immediately and after a week my skin and mouth began to deteriorate. After using about 1/4 of a bottle of the new oil I went back to flaxseed and am delighted to report that I am [again] having good results with it. Since both of my conditions wax and wane without any reason identified by medical science I cannot state that it was simply the flaxseed oil that has led to this success. Based on my experience, however, I intend to continue taking the oil regularly and I recommend that others with psoriasis or lichen planus try it. For me, two tablespoons a day were not enough, I needed three tablespoons of the oil to see a change. I don’t think it advisable to take capsules, you’d need to take too many to equal 3T of oil.[emphasis added]

Psoriasis is a skin disease that usually involves “thick, red skin with flaky, silver-white patches called scales”. Lichen planus is “an itchy rash on the skin or in the mouth”. To give some idea of how common they are, psoriasis has 36 million Google hits; lichen planus 1-2 million. (“Heart disease” has 64 million.)

Eveyln’s experience provides four pieces of evidence that suggest flaxseed oil (FSO) improved her psoriasis and lichen planus:

1. When she started taking FSO at 3 T/day, they started improving. They did not improve with 2 T/day.
2. Over the first year of FSO, she saw steady improvement in both in place of the usual up and down.
3. When she replaced FSO with another oil, which she hoped would be better, the results were the opposite of what she wanted: The improvement stopped and the two conditions got worse.
4. When she switched back to FSO, the improvement resumed.

I can think of no plausible alternative to the conclusion that FSO helped. There is plenty of other evidence that supports this conclusion: the evidence that omega-3 is anti-inflammatory, FSO is high in omega-3, most of us don’t get enough omega-3, and so on, including my own experience. You could write a book about the evidence that supports it. (Evelyn tried flaxseed oil because of reports on this blog that it improved/cured bad gums.)

In any case, the conclusion that FSO reduces psoriasis and lichen planus is new, in the sense that FSO (or another source of omega-3) is not a popular treatment for either condition. Here are about 16 treatments for psoriasis, including topical corticosteroids. None includes omega-3. Here are eight “lifestyle and home remedies” for psoriasis, including “take daily baths” (seriously, Mayo Clinic Staff?). None includes omega-3. After going through about forty-odd treatments, I found a reference to fish oil: “Other research has suggested that taking oral fish oil supplements containing 1.8 to 3.6 grams of eicosapentaenoic acid (EPA) a day may bring improvement.”

Same thing for lichen planus. FSO is not a popular treatment.

If you take flaxseed oil or other omega-3 source to treat psoriasis or lichen planus, I hope you will let me know what happens.

In nature animals must choose a healthy diet based on what tastes good. This doesn’t work for modern humans — lots of people eat poor diets — but why it fails is a mystery. There are many possible reasons. Are the wrong (“unnatural”) foods available (e.g., too much sugar, too little omega-3, not enough fermented food)? Is something besides food causing trouble (e.g., too little exercise, too little attention to food)? Are bad cultural beliefs too powerful (e.g., “low-fat”, desire for thinness)? Is advertising too powerful? Is convenience too powerful? Lab animals are intermediate between animals in nature and modern humans. They are not affected by cultural beliefs, advertising, and convenience (the foods they are offered are equally convenient). Their choice of food may be better than ours.

Nutrition researchers understand the value of studying what lab animals choose to eat. In 1915, the first research paper about “dietary self-selection” was published, followed by hundreds more. The general finding is that in laboratory or research settings, animals choose a relatively healthy diet. There are two variations:

[1.] Cafeteria experiments with chemically defined [= synthesized] diets showed that some of these animals, when offered the separate, purified nutrient components of their usual diet, eat the nutrients in a balance that more or less resynthesizes the original diet and that is often superior to it. [2.] Other animals eat two or more natural foods in proportions that yield a more favorable balance of nutrients than will any one of these foods alone.

Both findings imply that housing an animal in a lab does not destroy the mechanism that tells it what to eat.

Which is why I was fascinated to recently learn what Mr. T (pictured above), the pet rat of Alexandra Harney, the author of The China Price, and her husband, liked to eat. It wasn’t obvious. “We tried so many foods with him and always thought it made a powerful statement that even a wild rat turned his nose up at potato chips,” says Alexandra. “He hated most processed food. He also hated carrots, though.” Here are his top three foods:

1. pate
2. salmon sashimi
3. scrambled eggs

Pate = protein, animal fat, complex flavors (which in nature would have been supplied by microbe-rich, i.e., fermented, food). Salmon sashimi = protein, omega=3. Scrambled eggs = ??

He liked beer in moderation, but not yogurt. “Owners of domestic rats say they love yogurt,” says Alexandra, “but Mr T only liked it briefly and then hated it, even lunging to bite a friend who brought him some. [Curious.] He loved cheese, stored bread for future consumption (but almost never ate it). Loved pesto sauce and coconut.” Note the absence of fruits and vegetables. Alexandra and her husband have no nutritional theories that I am aware of. They did not shape this list to make some point.

For me the message is: Why scrambled eggs? I too like eggs and eat them regularly and cannot explain why.

More Alex Tabarrok’s Thanksgiving post shows the connection between libertarian ideas (economies work better when more choice is allowed) and dietary self-selection.

I blogged earlier about what I called a “stunning discovery”: Primal Girl found her sleep got much better when she started taking Vitamin D first thing in the morning (= soon after she got up) rather than mid-afternoon. This suggested that Vitamin D acts on your circadian system similar to a blast of sunlight. (More evidence and discussion here.) In his blog, Joseph Buchignani reports another experience that supports the idea that you should take Vitamin D first thing in the morning:

I picked up a bottle of Vit-D and Calcium. Dosage of Vit-D per pill was 1.6ud. Per the instructions, I took 1 at morning and 1 at night. I began this regimin on the night of the 24th of November. It’s now the night of the 25th of November, and my circadian rhythm is completely fucked. . . .  I’m fully awake now (12:30 AM), and I probably took the last dose of Vit-D around 7-8 PM. . . . I woke up with dark eye rings on the morning of the 25th. My energy level did not rise as it should have, but sort of meandered in the middle, before finally tailing off. Stress levels and depression were both elevated. I got little productive done.

Yesterday I started taking Vitamin D first thing in the morning. I took 2000 IU of Vitamin D3 at 8 am. In the afternoon I felt more energetic than usual. The next morning (this morning) I woke up feeling more rested than usual. This also supports Primal Girl’s experience.

Let me repeat: first thing in morning. If you wake up before sunrise, take at sunrise (say, 7 am). Sunlight has a considerably different effect on your circadian system at 7 am than 10 am. (Look up circadian phase-response curve and especially the work of Patricia DeCoursey if you want to understand why three hours makes a big difference.) I have two bottles of Vitamin D. Neither mentions time of day. Both say take with meals.