Eating Too Much Rice Almost Doomed Japan's Imperial Navy | Hacker News Reader

Eating Too Much Rice Almost Doomed Japan's Imperial Navy

nationalinterest.org

My favorite part was on the last page, which I’ll include below as I assume most won’t read to the end.

After 4,000 people died in the army from beriberi, the navy, which had eradicated the disease with better diet, criticized the army’s resistance to changing their diet. The article says:

‘Under attack by navy doctors, the Army Medical Bureau struck back with an article published under a pseudonym. “The army does not need traditional medicine, statistical speculation or 1,890-year-old theories to solve its beriberi problem,” the article stated. “It needs scientific knowledge based on experimental medicine.”’

After this, 26,000 more army men died from beriberi before the Emperor forced them to add barley to their rice...

As wonderful as scientific knowledge from experimental medicine is and has been, it seems this sort of belligerence towards pre-scientific human knowledge causes enormous damage that we’re still continuing to reckon with over a hundred years later. While ineffective traditional knowledge has caused plenty of unnecessary suffering too, it is often unwise to dismiss purely on the basis of having not yet been investigated with modern scientific rigor.

The two training ships seemed like pretty suggestive experimental evidence. Just not fully controlled laboratory evidence.

In purely philosophical terms, you could say it's "scientific." But... in practice science is an institution as much as it is a method. In that sense "unscientific" means that something doesn't come from the scientific institution/culture.. regardless of who is on what side of a Karl Popper test of science.

I would say that on very practical terms, one could call it scientific, taking advantage of a situation that made possible an trial that could not have been approved as a fully-controlled clinical experiment, given the official opposition to Takaki's ideas.

Takski's hypothesis also met Popper's criterion for falsifiability, and the Tsukuba could have suffered similar beri-beri rates as did the Ryujo.

There's a near identical tale behind scurvy. Scurvy, most of everybody now knows, is caused simply by a deficiency of vitamin C. But this is something that took thousands of years to grasp, with millions of people falling victim to it in the interim. During the age of sail losing large chunks of your crew, largely due to scurvy, was just part of life. Part of the reason the cure was so difficult to discover is because it sounds folksy or homeopathic. As scurvy is caused by a lack of vitamin C, a simple way of preventing it is eating fresh fruits or meats.

Imagine somebody told you you could prevent some terrible and frequently fatal disease, that's spread worldwide, by eating limes. And this was already well within the age of formalized science and medicine. This was also further confounded by the fact that the vitamin content of things such as lemon juice degrades over time in storage, and even more rapidly in certain types of storage. And so some scientific experiments to test its effectiveness were inadvertently hamstringing themselves. It's made even more fun by the fact that humans need external sources of vitamin c while some common lab animals such as mice and rats do not - and internally make their own. You can withhold external vitamin C from a mouse for years and you'll never see scurvy.

Its ironic that I think this particular tale has slowly been lost to many in society, even though we have so many direct references to it. For instance the slang for a Brit as a limey came from the fact that the British Navy was the first to start dosing their sailors with lime, with tremendously positive affects to show for it. Maybe the biggest one is vitamin C itself. Vitamin C is now called ascorbic acid. But when it was first discovered it was known as hexuronic acid. So huge was the effect of scurvy it was renamed for its discovered anti-scorbutic (against scurvy) effect. Ascorbic was just a shortening of anti-scorbutic. And this happened as recently as the 1930s!

https://idlewords.com/2010/03/scott_and_scurvy.htm which has been submitted here previously is an (as far as I know) great telling of that story, a real Science Is Hard parable.

A cocktail that I quite enjoy is the gimlet [0], it apparently was possibly invented to encourage sailors to drink lime juice.

[0] - https://en.wikipedia.org/wiki/Gimlet_(cocktail)#Etymology

>>A cocktail that I quite enjoy is the gimlet [0], it apparently was possibly invented to encourage sailors to drink lime juice.

...things people do to make sure they don't get scurvy ;)

But it's often made with Rose's Lime Juice, a concentrate, which AFAICT contains no vitamin C.

Reminds me of how the British stationed in 19th century India used to use quinine to ward off malaria. Apparently in its raw form it's incredibly bitter so the soldiers started to mix it with water and sugar and voila - tonic water was born.

Some bright spark added gin and the rest is history...

Close, but it's really the gin and tonic that was born out of getting sailors to drink quinine in the tonic water:

https://en.wikipedia.org/wiki/Gin_and_tonic#History

And yes, having taken quinine pills for malaria it is very bitter and unpleasant.

It’s bitter because it’s actually quite poisonous, and your tongue is warming you about that. Dave Arnold’s excellent Liquid Intelligence has a section on making your own tonic with pure quinine powder, and he admonishes the reader to mix with a blender, because an ubcombined chunk of pure quinine could actually hospitalize someone if it ended up in their drink.

Tonic water made with actual quinine rather than the synthetic stuff is great. It seems preferable to the pills, though I suspect you’d have to drink a lot.

Edit: The WHO suggest treating severe drug resistant malaria with 500mg of quinine orally every 8 hours. A 1 litre bottle of tonic water should not contain more than 83mg according to the FDA. Drinking 6 litres every 8 hours is a bit much. https://apps.who.int/medicinedocs/en/d/Jh2922e/2.5.2.html#Jh...

https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/CFR...

https://en.m.wikipedia.org/wiki/Tonic_water

I prefer my mixed drinks with tonic over any other mixer. As you note, off the shelf tonic has very little quinine nowadays. When I had to take the pills I was headed to an area with a known malaria risk.

In general the Royal Navy added lime juice to whichever alcohol they issued to sailors as daily rations. Usually it was rum but could be other booze if the rum ran out. Officers would watch to ensure each man drank his dose instead of trading it away.

Was there no source of Vitamin C that was cheaper, less perishable, and more easily available in Northern Europe in all seasons, than citrus? I don't know how exotic lemons were at the time, but I'd guess loading up on lots of citrus in a Northern European port could be rather expensive?

For Northern Europe at that time I would think that kale would be the best source. You can harvest fresh kale for most of the year. No idea how the vitamin c holds up when you dry it. I'm unsure if sea buckthorn was growing in Northern Europe at that time, but if it was it would be a near perfect source, save for the trouble of picking them. Today you could eat Rosehip too, but that plant is so invasive that it needs to be seriously kept at bay.

Sauerkraut. Any kind of fermented vegetable would do but you really need something with relatively high vitamin c content and it’s really easy to destroy.

Yes, sauerkraut.

Remember that, without understanding the chemistry, running an experiment was difficult. Aside from the expense, I doubt people would be enthused about doing trials of alternative foods when people would get scurvy if the food turned out not to work as well.

> without understanding the chemistry, running an experiment was difficult

Also, without the scientific method, the concept of an experiment could look to an outsider like recklessness (or buffoonery).

Fermented cucumbers are used in winter as source of vitamine C all the way from river Oder to Kunming in China. As are other pickles like betrot.

https://en.m.wikipedia.org/wiki/Pickled_cucumber

In warmer climate like Mediteranian children were given wine in winter for that reason.

Raw (or lightly-cooked) meat also has a lot of vitamin C.

Scurvygrass (https://en.wikipedia.org/wiki/Cochlearia_officinalis)

Kept many people alive who had been marooned over the winter in Svalbard and other places in the Arctic. Also grows in cooler climates in Europe

Ironically limes have less vitamin C content than lemons so don't do as well at combating scurvy.

The British used limes as they had easier/controlled access to them than lemons.

Worse than this: they switched from lemons to limes, assuming that they were equivalent (and cheaper). And then came to doubt the theory that citrus prevented scurvy as some pre-modern pre-scientific relic.

Even more ironically, sargassum seaweed floats on the ocean, and is higher in vitamin C than citrus fruit.

And for both scurvy and beriberi, the cure was already known, but ignored because not scientific. From leoc's excellent link:

> But in the second half of the nineteenth century, the cure for scurvy was lost.

What other folklore do we ignore at our peril? One is organ meats.

What about organ meats? That's piqued my interest

\piqued. Very high nutritional density, but these days everyone prefers lean muscle meat, and are put off by organ meats (sadly, myself included). People used to eat them routinely, e.g.: lambs fry, steak and kidney pie, lamb's brains, tripe (lungs), heart.

Tripe is stomach. Lung is not always consumed, but is sometimes. Scottish haggis and related scandi dishes are made from "the pluck" which means lungs, liver/fry and tongue.

Tripe isn't lung, but stomach.

As an aside: if you ever visit the Balkans (including Hungary and Romania), definitely try Tripe Soup. It's a local delicacy and it's fantastic.

Liver in particular used to be something of a comfort food staple in at least parts of the US. I'd encourage people to use fresh veal liver if available rather than the frozen beef liver that may be in the back of a freezer in a supermarket somewhere.

I also like veal kidneys and sweetbreads but rarely see them.

One way to try sweetbread is to see if your local Mexican market with a food court has "mollejas" tacos.

Otherwise I have no idea how the average American will encounter it. Seems super old timey.

I also love buying those large packs of chicken hearts and browning/carmelizing them in a pan.

Every now and then you'll see them on a restaurant menu and you can sometimes get them from a butcher (although TBH they're probably more prep work than is worth it for me). But, yeah, pretty hard to come by.

I in particular am interested in the vitamin K2, which comes almost exclusively from organ meats. If I had to bet on one nutrient that’ll get the “duh you should’ve been eating X” in a century or two, it’d be K2.

Thanks for the heads up. Clicky: https://en.wikipedia.org/wiki/Vitamin_K2

> You can withhold external vitamin C from a mouse for years and you'll never see scurvy.

Withholding vitamin C from a mouse's diet for a few years results in a 99% mortality rate. Although it's the same for the control group.

I’d argue that the health of the sailors, who were in a sense the lowest of the low was not a concern for a long time. Ships were disgusting — you could smell a military ship coming.

As early as Vasco de Gama people were aware of the power of citrus to stop scurvy — they may not have known why, but they were aware.

With the British, there was an ROI to consider as the supply of sailors were tight, and they had attrition due to things like malaria as well.

It seems to me that one of the early French expeditions to Canada was saved by the local showing them to make a drink with evergreen needles.

Quick side note.

Japanese army and navy in WW2 were famously, well how should I say this, antagonistic against each other. They didn't share information with each other. Army even had own aircraft carriers to transport planes to distant islands. They couldn't or didn't want to rely on the Japanese navy.

There were similar rivalries in Germany (e.g. Gestapo vs. SS vs. Wehrmacht) -- different state rackets competing with each other is a common feature of fascism.

The Allies were not immune to this either, especially the Soviets (NKVD vs military). In the democratic countries it was more on the individual level, with certain powerful people fighting to get their way (i.e. MacArthur).

From 1936 onwards, the Gestapo was entirely subordinate to the SS, as were most of the police organizations in Germany. There was no rivalry between it and the SS, nor with the Wehrmacht.

The Gestapo becoming subordinate to the SS was the result of said rivalry, so it's odd to present that as evidence that there was no rivalry.

The Gestapo was born of rivalry between the SS and the SA. The Gestapo WAS the police arm of the SS, just as the SD was a part of the SS.

Reminds me a little of this joke:

  A Marine and a sailor are taking a piss. The Marine goes to leave without washing up.

  Sailor says, "In the Navy... ...they teach us to wash our hands."

  The Marine turns to him and says: "In the Marines, they teach us not to piss on our hands."

It's funny, because it's true. We went weeks in the same clothes without much more than the wet wipes packaged with MREs. But the moral of the story is to wash up when you can.

That joke comes in many flavors doesn't it? I know a version with 3 Engineers, one from MS, one from Oracle and one from Intel. Essentially, this one: http://www.jokes.net/threeengineers.htm but with different companies.

My guess, the joke is as old as time and there's variations of it with different nationalities instead of professions.

I heard it with universities. Harvard and Yale, I think.

Said by Churchill, Eton vs Harrow.

The version I always used is "Difference between a university and a tech school"

How do you tell a white collar worker from a blue collar worker?

The white collar worker washes his hands after going to the bathroom stall, the blue collar worker before.

I really don't think the problem was "belligerence towards pre-scientific human knowledge" - the problem was that the Army did not want that knowledge because it came from the navy, and used "it doesn't meet scientific standards" as an excuse to ignore it.

You see the same in lots of discussions, where people make a claim and, when presented with evidence to the contrary, reject it because it's too small a sample - without holding their own claim to the same standards.

Bad science is the same as bad pre-scientific knowledge. I don't think anyone is for the utter rejection of pre-scientific knowledge, we just want to know why and if it works. If it's found not to, I don't think it holds any intrinsic value simply because it's traditional. Keep the aspirin, reject the humors.

You can often read it on HN actually. Quite often you'll see people offering word-of-mouth solution to a problem, and the comments following will dismiss it for being pseudo-science, request "link to studies", etc.

Too much of good thing can be a bad thing.

I think that goes back to the "why and how it works". A home remedy has a neutral value to me until I have evidence, and my own anecdotal evidence doesn't have a lot of value to me - when I have a cold eating a gallon tub of ice cream would make me feel better for a time, but it doesn't actually help anything and is generally a bad idea.

Next time you have a cold, I recommend sleeping all day. It's worked great for me!

That's because word-of-mouth is very capable of transmitting abject nonsense and fantasy. If you're going to be taking some medicine, you should be sure it isn't, and the way to do that is with thorough study & evaluation.

Not the point. The point is that we are the opposite of the facebook mum. She believes anything that is posted without evidence, while we don't dare to even try something without 4 white papers.

It's especially funny given that meditation, psychedelic and open source software were all ridiculed concepts 30 years ago, and now we are promoting them in this very comment section.

I am not promoting them, nor would I. Obviously, this is a mixed community, and you cannot paint it with such a broad brush.

We also have too many "essential oils" and homeopathy from world-of-mouth. It cuts both ways.

Yes, and this Firefox things was not serious when it was called Phoenix. And meditation ? Hippie crap. Ah, this fasting stuff is dangerous grandma shenanigans.

We are going to much in the extreme, and missing on many very useful thing, just because the people introducing it to us are not scientific credible sources.

The question is - does meditation make your life better in the same ratio that bleach enemas and black tar treatments for cancer make your life worse?

I'm assuming the average HN reader can assess the risk of trying something unusual out. Since we are, after all, talking about this community.

Yes, but read up a bit:

> For thousands of years, diseases had been seen through the lens of kampo, traditional Chinese herbal medicine. In kampo, disease was caused by heat or evils and was treated with herbal remedies.

> Sometimes the medicine was hokey, but other times it worked—as was the case with azuki and barley supplements for beriberi.

We can find, using science, if some folk medicine is hokey or useful. That is the key. Ground rhino horn still doesn't cure squat. Science fights "pre-scientific human knowledge" here in an uphill battle that will probably result in extinction of rhinos before this "pre-scientific human knowledge" is countered by science and reason.

My favorite demonstration of the value of science is scurvy.

Before scurvy was lastingly solved, the cure was discovered at least three distinct times within a century. In every case, the discoverer found a cure (like oranges, lemons, or raw meat) then made an untested assumption about the active agent (like acid, or avoiding tainted meat). They never tested those theories, but simply relied on circumstantial evidence and logic. The resulting treatments like lime juice and better food hygiene conformed to their theories, but did nothing to prevent scurvy.

From the present, it's easy to underestimate the power of the scientific method. We tend to think of it as what happens at universities, or as a format for writing a paper with a hypothesis, data, conclusions, and so on. The mere concept of testing one's theories seems too obvious to be a modern breakthrough. But that simple idea - that a theory shouldn't be accepted until its specific claim has been tested - was regularly ignored as late as World War One. It's hard to blame the Army for insisting on experimental evidence when "traditional medicine" and "statistical speculation" had been leaving soldiers with easily-curable scurvy only 20 years earlier.

A great write up on part of that history:

https://idlewords.com/2010/03/scott_and_scurvy.htm

I find it fascinating that at the time, a holistic diet-based solution was considered flakey and rooted in ignorant traditions.

And yet here we are almost 200 years later and many common illnesses are still closely related to diet, and many still feel as though treatment through diet is flakey or inferior to modern drugs or surgery.

It turns out one of the best things we can do for ourselves is eat well and strive to prevent disease before it occurs. If I recall correctly, this is a core tenant of many traditional medicines including traditional Chinese medicine.

I'm not saying we should all start practicing traditional medicine. I just find it fascinating that we have and still often discount traditional knowledge, even after it's been virtually proven for milennia. It's like we throw out the baby with the bathwater.

I hope modern science can find more concrete conclusions around health and diet such that more people might have faith in food as a preventative medicine. To many of us it seems obvious, but to much of the world I suspect it isn't... Just like it wasn't in the Japanese Navy.

> many still feel as though treatment through diet is flakey or inferior to modern drugs or surgery.

This advice literally (using the word in the correct sense) kills people.

> I just find it fascinating that we have and still often discount traditional knowledge, even after it's been virtually proven for milennia

Check out the infant mortality rates for milennia.

I agree prevention is better than cure. That is why I and my family are up to date on all our vaccines.

Meanwhile a holistic diet will do nothing to prevent most infectious diseases. The reason we have the luxury to entertain wellness bloggers, traditional medicine and faith healers is that we discovered antibiotics and vaccines.

Traditional medicines that work get incorporated into modern medicine. For example if you have a dietary deficiency you will be given supplements and told to eat better. If you have a headache you may take a compound first derived from Willow bark.

Modern medicine has even resulted in flour being fortified with vitamin B1 preventing the disease the article refers too!

Even modern understanding of healthy eating is derived from modern medicine not traditional 'healing'...

Antibiotics, vaccines and a well-balanced diet are not mutually exclusive, nor did GP imply so.

Having a good diet isn't in any way competitive with being up to date on your vaccines.

And a good diet absolutely will do something to prevent most infectious diseases - if your immune system is stressed/compromised due to a shit diet, you're much more likely to be infected when you're exposed. You're exposed to infectious disease constantly, and the reason you don't get sick the vast majority of the time is because you're successfully fighting those off.

I don't think he is arguing against vaccination or using modern medicine just that people see things like obesity and type-2 diabetes as issues that need to and maybe even should be cured with medicine or surgery while the actual answer is radical change in diet.

While I remain skeptical about long term effects of the new fad carnivore diet there is no doubt it has helped a lot of people with inflammation to regain control of their lives. You can look up Mikhaila Peterson's blog or interviews about the subject.

Why is this the actual answer? Most RCTs show the best obesity cure we currently have is surgery, and it wildly outperforms diet on an intention to treat basis.

Diets do terribly in long term RCTs.

Treating the symptoms and not the cause.

What diet are they following? For how long? How is the adherence measured? Who has commissioned the study?

If you compare something like "the food pyramid" diet, but with less calories to surgery I have no doubt the surgery will keep more people at lighter weight after five years. However that doesn't seem like a fair comparison. For one the usual diet that gets pushed to fat people isn't a good diet to being with. Next one requires much more dedication than the other, meaning if you are going through a surgery to alter your body so you can't eat as much, then obviously the adherence will be higher.

Also people who result into surgery are usually on their last legs. Doctors won't give you the surgery unless it is your only option. So if you had to loose weight or die in next year, obviously the adherence will be a lot higher than with loose weight or in 10 years you will have to have a surgery.

All diet rct studies everywhere. There are no long term studies for diet that show weight loss in the same range as surgery.

Most weight loss diets are fine. They involving eating less food, particularly unhealthy food, and more healthier food. Keto, Paleo, Mediterranean, DASH. It doesn't matter because the differences between these diets aren't anywhere close to the differences between surgery and diets.

If you can find just one 5 year study that shows diet works anywhere nearly as well as surgery I'll change my opinion. But they don't exist. I've looked.

I would add more ... when it comes to chronic diseases, modern medicine is about treatment after the fact, after the damage has occurred and not about prevention.

And while it’s incredibly efficient at treating acute conditions, it fails miserably at chronic ones because it’s treating symptoms instead of underlying causes.

And sometimes those symptoms might actually be part of the body’s defenses against inflammation, which doctors suppress with pills.

The perfect example is elevated LDL cholesterol. This is a marker for heart disease, however it can be high due to hypothyroidism or due to inflammation. LDL cells are actually part of the body’s immune system and by suppressing their synthesis or by accelerating their clearance, the body could be less effective at fighting infections or at repairing arterial walls that have been damaged. Plus pills are a blunt tool with many unintended side effects.

It is no wonder then that people taking statins don’t have a reduction in all cause mortality and personally I’d rather die of a heart attack than die of cancer or dementia.

Also the DASH diet, the one that is supposed to prevent CVD, is effectively poison as it’s encouraging people to eat ultra-processed food and oils high in omega-6, due to encouraging a big chunk of energy to come from “whole grains” (i.e. products which are often a lesson in chemistry and that might not even contain whole grains due to weak regulation), plus the phobia for saturated fat.

it fails miserably at chronic ones because it’s treating symptoms instead of underlying causes

I'm not sure if "fails miserably" is the proper characterization. It's just simple capitalism.

Just look at statins. They're something that they want to sell you for the rest of your life. Because statins treat symptoms, they're not a cure. But antibiotics? Just 10 days and you're done.

Hmmm. Which is more profitable? It it any wonder that the US government is looking into how to fund development of new antibiotics? Same with vaccines. The government has had to step in to fund them.

Yet one of the most profitable drug launches ever was a cure for hepatitis C.

Flash in the pan revenues. No company wants to have this press:

Gilead Sciences Inc. will continue to feel the financial sting this year of declining revenues from its hepatitis C business, forecasting combined 2018 sales of the drugs reaching only a fifth of what the biotech recorded at the height of its commercial success three years ago.

https://www.biopharmadive.com/news/gilead-hepatitis-c-revenu...

Contrast a statin for Pfizer: $125 billion in sales over 14 years. Lipitor alone "provided up to a quarter of Pfizer Inc.'s annual revenue for years."

https://en.wikipedia.org/wiki/Atorvastatin#History

Yeah, a company would certainly turn down a $10B a year drug because revenues declined after a few years!

Sure it’s not as successful as Lipitor (pretty much the most successful drug ever), but it’s total sales DWARF 95% of the drugs out there.

For good reason. Curing Hep C was a breakthrough medical innovation, which ultimately will save the healthcare system tens of billions of dollars (preventing end stage liver disease, liver transplants, etc)

> It is no wonder then that people taking statins don’t have a reduction in all cause mortality and personally I’d rather die of a heart attack than die of cancer or dementia.

Healthy people without any CVD taking statins experience no reduction in all cause mortality. People with a history of CVD definitely experience a reduction in all cause mortality.

> It is no wonder then that people taking statins don’t have a reduction in all cause mortality and personally I’d rather die of a heart attack than die of cancer or dementia.

So far statin's are associated with a reduced risk of dementia.(I have no idea about cancer, but can't imagine it increases the odds)

Also where are you getting that the DASH diet is effectively poison or ultra processed?

>> People with a history of CVD definitely experience a reduction in all cause mortality.

Actually it's people with a history of heart attacks and the reduction in all cause mortality is measured on average to be only a couple of months.

---

>> So far statin's are associated with a reduced risk of dementia*

The common side effects of statins are headaches, sleep problems, muscle aches or weakness, drowsiness, dizziness, nausea, abdominal pain, bloating, diarrhea, constipation, rash.

There have also been reports of memory loss, forgetfulness and confusion. These are not emphasized, probably not so common, but the reports I've seen are freaking scary.

Also if there is no reduction in all cause mortality, but there is a reduction in heart attacks, this means there's an increased likelihood that some other chronic disease will kill you. It's simple math really, if you don't die of heart attacks, you're more likely to die of cancer or dementia, as these are the most common causes of death.

---

>> "Also where are you getting that the DASH diet is effectively poison or ultra processed?"

By advising people to eat less saturated fat, you're effectively advising people to eat seed oils (the "heart healthy" oils), which actually increase the likelihood of cardiovascular disease, due to the very high omega-6 content, which is inflammatory, along with toxins from the extraction process. Here are some studies on this subject:

https://gist.github.com/alexandru/5e21b75363904004f837c23f03...

Also go into any supermarket and carefully read the label on any food labeled with "whole grains", especially those made of wheat. Most of them meet the definition of "ultra-processed" food and many of them are not even made of actual whole grains, because fiber has poor shelf life, so what they do is to use white flour and then add some bran back, which doesn't have the same effect. In my city I couldn't find any local bakeries that made bread out of whole grains. Corn is the same story, unless you're eating your home made polenta. And brown rice is toxic, so you're you're actually better off eating the white variety.

The problem with DASH in this regard is not the advice to consume whole grains, but the advice to make whole grains a staple food in the diet.

>I have no idea about cancer, but can't imagine it increases the odds

Ironically, anything that makes you live longer increases your cancer risk.

Several of your claims are inaccurate, which I'll attempt to correct.

tl;dr - its way more complicated

LDL particles are not (at least directly) a part of the immune system. They are lipoproteins, generated primarily in the liver, that are implicated in the pathogenesis of atherosclerosis (buildup of plaques in the blood vessels).

The immune system, however, plays an important role in atherosclerosis, as it is thought that inflammation in the vasculature contributes to atherosclerosis.

Statins (contrary to your assertion) have in fact been conclusively shown to improve mortality from cardiovascular events. You can find many studies in the last 20 years that have demonstrated this with high statistical significance (do a pubmed search or look for articles in the New England Journal of Medicine).

Perhaps most interestingly, the latest research suggests that statins may improve cardiovascular outcomes not solely from LDL reduction (which has been the classically accepted hypothesis, as statins target the enzyme in the liver that regulates LDL reuptake), but also through anti-inflammatory mechanisms. This idea has been further strengthened by research suggesting that LDL reduction alone (as with a newer agent of drugs called anti PCSK9) may not provide as strong of a mortality benefit, weakening what is known as the "LDL hypothesis". In addition, another recent trial (called CANTOS) found that an anti-inflammatory agent targeting IL-1, an inflammatory cytokine, improved cardiovascular outcomes (such as heart attacks), further strengthening the notion that the immune system plays a key role in cardiovascular disease.

I do, however, agree with you that much of modern medicine is focused on treatment as opposed to prevention. Type 2 diabetes is probably the best example, which is largely preventable with a good diet and exercise. Unfortunately, it's much easier for patients to take a pill after they start feeling symptoms than it is to adhere to a healthy lifestyle when they are asymptomatic..

One anecdote (not diet related): Last winter I developed knee pain, which turned out to be an inflamation. The typical doctor's response: rest, inject cortisone and apply warming creams. After three months the pain was still there. I went to a kinesiologist. She acupunctured the leg (with added electricity) and cupped the knee. After one treatment (~30 min) the pain was gone for good.

I'm sure modern science can find ways, but those must be taught to doctors too. The doctors I've met in my life only treat symptoms (with chemistry) and rarely have a holistic look at what's going on in your body. The ones digging into a problem are rare breed.

Its not surprising that the doctor suggested those things, as its not really the domain they focus on. If you have bio-mechanical pain, its often better to see a physiotherapist, who can better diagnose the underlying reason and help you resolve it properly.

> Its not surprising that the doctor suggested those things

I saw an orthopedist who claimed to specialize in sport injuries. He immediately understood which part of the knee was affected. Also I'd expect a doctor who's out of his depth to suggest a specialist, not a "meh, try this".

As with engineers, the three least commonly uttered words among doctors are “I don’t know.”

Apparently, I'm not an engineer.

Because holistic looks have systematically been proven as being non medically effective ...

I was incredibly skeptical about acupuncture until my mother had it for sciatica. It was a last-ditch attempt after various drug-based treatments and it worked. More recently I had acupuncture to treat (weightlifting-related) shoulder pain. The results are pretty miraculous when it's applied properly and I recommend that everyone with any kind of muscular pain at least investigates it as a possible treatment.

The traditional medicine has worked in the past probably won't work in the future. The reason is that human has been travel a lot, and our fixed diet has changed. Traditional medicine relies heavily on the local environment, local produce and work on local people. These assumption is not true any more. Not only I see the kind of produce grow locally has changed, also the people are different. To my understanding of Chinese medicine, the treatment is personalized. It is not the medicine treating people, it is the doctor. He has a brain full of local knowledge, what water you drink, what season is now, what's going on in your village. These thing does not exist in current culture. Personalized medicine will take its place however. We can then treat people with minimal side-effect.

If you get stomach cancer, a holistic diet is not gonna help. And, I don't think there's a doctor that doesn't suggest we exercise, eat the right things etc etc. So the science is there, but people...are people, until it hits them.

All doctors recommend eating well. But none of them actually knows what eating well means. Or, rather, they might think they know, and still you get ten conflicting answers.

Diet and health is incredibly complex. Not only is it about which nutrients we get for our body, but also which bacteria live in our gut and which nutrients they need and in what concentration, so that the balance stays the same. A healthy diet is basically about trying to feed an ecosystem.

Definitely. However, this has been used to market a myriad of so-called health products that are far from ideal.

I follow a carnivore diet and have always been a bit scared of messing up my microbiome, while finding it quite strange that I defecate non-negligible amounts of waste, once a day on average.

Only recently has my knowledge gap been filled when I found out that our microbiome can survive solely on amino acids. In fact, all this "gut-brain axis" stuff regarding the production and/or catabolism of neurotransmitters by gut bacteria only makes sense if bacteria can ferment amino acids. Thinking that some bacteria strain can produce neurotransmitters from fibre is an insult to intelligence: where does the nitrogen come from?

in most cases it's nitpicking. While an apple might be 6.48% better than a pear for a certain person at a certain time, eating an apple is still way better than an order of french fries.

We're talking about basics, getting all the vitamins and nutrients needed for a healthy body. Exercise, eat about 5 servings of fruit and veggies a day etc ....

It might be nitpicking, but there are many, many subtleties that depend on individual aspects that exhibit a high level of variability.

Take, for example, minerals (electrolytes). Calcium absorption is greatly affected by the rest of your diet (fibre intake, phytates, oxalates and other antinutrients). A person eating a high amount of nuts containing calcium might absorb less than someone eating only meat (fish), which contains much less calcium by weight, but none of the factors that negatively affect absorption.

In other words, RDAs are not fixed. Someone on a purely carnivore diet needs less than 80 mg of magnesium per day, while someone on a vegetarian diet might need over 500 mg to maintain magnesium status.

Pardon the math analogy, but regarding the direct comparison of different food items, it is clear that some order relation can be defined between them (e.g. an apple is better than a serving of fries), but that relation is far from being complete. Is an apple always healthier than an rib-eye? Are they even comparable? Is a bowl of steamed rice healthier than a slab of butter?

> And yet here we are almost 200 years later and many common illnesses are still closely related to diet, and many still feel as though treatment through diet is flakey or inferior to modern drugs or surgery.

It certainly doesn't help that the science on diets nowadays contain so many contradicting studies. Moreso that some of them are pushed by powerful corporations for their own vested interests.

No one wonder people don't trust them.

Nutrition is just a really difficult field for robust studies. There is an enormous amount of variables you have to control for and the effects you're looking for are likely small or only appear after decades. Strict adherence to the experimental protocol usually can't be supervised, leaving you with observational studies or self-reported data. Blinding is pretty much impossible. Funding is very limited, especially if you don't want to take money from "powerful corporations".

As a side-project me and a friend have been trying to formalize a set of different rules and models from which to establish a diet. But, as the consumption of certain micronutrients drive the need for others up it's pretty hard to beat just eating a varied diet of mostly clean food.

Some people on here mention organ meats, but that does not mean that it's safe to eat liver everyday either.

"Clean food" is such a vague term as to be nearly meaningless.

To make matters worse, varying gut biomes and environments tend to yield different nutritional requirements. Amongst other things. I'm not sure we'll ever nail that down.

Again though, traditional medicines were aware of this and it was typically recognized that diet was specific to an individual and their environment. There were (and still are) complex systems outlining how foods may affect different people and what it could mean.

Still, I'm not claiming anything here other than that it's interesting and worth considering. I take advil when my head hurts and I go to the hospital when I'm sick, and I'm not going to start treating cancer with fungus from my back yard. I just suspect there's a lot of useful knowledge in this tradition.

It's easy to laugh the old incidents. But it's pointless without considering the situation at that time. Otherwise, it's like laughing at old movies, saying: "Why don't they use cellphone to communicate each other?". The cellphone haven't invented at that time.

Japanese navy suffered beriberi for eating milled white rice and nothing else. Because milled rice only diet lacks essential vitamins. But the first vitamin hasn't been found until 1913(Vitamin A). Nobody in the world had a correct knowledge about healthy diet. In this case, eating un-milled brown rice.

At that time, majority of them believed that beriberi was caused by some kind of bacteria. So Japanese navy did everything they could do to prevent infection. It was not like they were trying. They didn't know the correct solution.

So your next question would be, why didn't they test it scientifically? Well, in 1880, Statistics hadn't been developed like today. So not many people, even the scientists didn't have a proper statistic knowledge like modern scientists today must has or else they are doomed to be called unscientific idiot.

You must also consider that at that time, the brown rice was for poor. It's taste aren't that good compared to white rice. Rich people was enjoy eating white rice everyday. Now imagine you were drafted for military, serving for the country, and you can't get a delicious and enough meal. That' a shame. So Japanese navy serve the best meal the traditional Japanese soldiers want, a lot of white rice.

...because no other navy had encountered issues from feeding their crew a monotonous diet before. Maybe not this specific set of issues, but issues nonetheless.

Until very recently, traditional Japanese meal was consists of a bowl of rice, miso soup with some vegetables, and some vegetables.

Because of religious and cultural reason(it was not that strong ban but most people follow it), Japanese at that time rarely eat meat.

And what relevance does that have? That's not the diet the sailors in question had or the replacement diet that was proposed.

The issue wasn't restricted to the navy, and was especially present in the urban upper class (including the imperial clan), so much so that it was nicknamed "edo disease" as polished white rice was much more easily obtained in Edo (given enough means) than in more provincials cities.

Interestingly, early industrialisation made things worse: mechanical mills made the desirable polished white rice way more accessible to all.

You haven't read the article. It already speaks to all of your points, and highlights the navy's (and later the army's) resistance to change, even in the face of irrefutable evidence. Only the direct word of the emperor was enough to bring them to heel.

There's another story - the Japanese Curry was invented by the British to prevent scurvy [1]

The earliest recipe for "raisu kari" is from the "Beeton's Book of Household Management" [4] which in turn uses "INDIAN CURRY-POWDER, founded on Dr. Kitchener’s Recipe"

The Brits got curry from India (duh!)

One of the leaders of India's freedom struggle against the British - Rash Behari Bose - escaped to Japan and created the "Indo-karii" Nakamuraya curry [2] . You can still eat it [3].

the Japan Maritime Self Defense Force still serves curry every Friday as a tradition. And each ship has its own recipe [5]

[1] https://en.wikipedia.org/wiki/Japanese_curry

[2] https://www.thebetterindia.com/109063/rash-behari-bose-ina-n...

[3] http://www.nakamuraya.co.jp/

[4] https://www.japantimes.co.jp/life/2011/08/26/food/curry-its-...

[5] https://www.mod.go.jp/msdf/formal/family/recipe/archive/curr...

When I lived in Japan as a kid my two favorite foods were miso soup and that curry. It came in a box with gold writing and I think it was called S&B Golden Curry. It was amazing.

S&B Golden Curry can be found in America as well, luckily.

I make a big pot at least once a month and have leftovers for the whole week. It's possibly one of my favorite meals that I can prep in bulk.

The only next step I'm really interested in taking would be trying to make a curry roux from scratch, but I can't deny how amazing the prepackaged stuff is.

Not sure where you are, but it's easy enough to find in western Europe at least.

It's odd that the article doesn't mention curry. The whole purpose of the introduction of curry to the IJN was to prevent beriberi, and it's become one of Japan's best-known dishes.

> Takaki fought hard to institute fixed diets—but the navy resisted, saying it would double the cost of feeding crews.

The navy made this argument while facing 1/3 to 1/2 rates of total crew loss due to the disease.

Vitamin B1 deficiency causes beriberi, and white rice lacks B1. The article says that Japanese ships actually made a variety of food available but only white rice was free. It was the economic incentive that killed them.

Similarly, corn lacks vitamin B3, and a corn-only diet causes a disease called "pellagra", which was once common in the US among the poor.

If you read the ingredients on say a packet of corn flakes, you'll see thiamine and niacin (B1 and B3) are now added to prevent both kinds of disease.

Casimir Funk, who basically discovered vitamins, helped find the role of thiamin in the etiology of beriberi, and also investigated pellagra. Funk said that pellagra was caused by B3 deficiency in 1912, but nobody listened and pellagra continued to devastate parts of the US into the 1940s.

This is why they have VERY interesting vitamin B1 analogues

https://en.wikipedia.org/wiki/Vitamin_B1_analogue

Very related HN posting from 7 months ago on the supplementation of white rice (with curry): How Curry Became a Japanese Naval Tradition.

HN post: https://news.ycombinator.com/item?id=18305211

Linked article: https://www.atlasobscura.com/articles/japanese-curry-history

Spoiler alert, they were not getting enough Vitamin B1.

I have a tool that breaks down nutritional densities on a per calorie basis. You can, for instance set the slider to B1 and see what foods contain the highest concentrations of B1: https://kale.world/c

You'll notice that unenriched rice noodles only contain 3% of your Vitamin B1 needs in a 200 calorie serving.

Note: that these days the issue is less likely to come up because white rice and white flours are often enriched with those Vitamins (similar to the way that cereals often are enriched with the vitamins they're missing)

But, they also seem to suggest it might be lack of protein which I find harder to believe. Rice is 9% protein which is significantly more than the WHO's minimum recommendation of protein. I know some countries like the US state 10%, but that's double what the World health organization recommends.

That's a very useful site! Thanks.

Beriberi was mostly caused by the replacement of whole rice by white rice. White rice is not a whole grain and has most of its fiber and many nutrients removed. If they had eaten whole rice instead, the disease is then easily prevented.

But eating whole rice was apparently not socially well seen, as it was a food associated with the very poor.

Later some of the nutrients have been sprayed back into the white rice, with the recommendation to not wash the rice before cooking, not to wash away the nutrients.

I recently have accidentally learned that my entire family is seriously deficient in vitamin D (even despite it's summer). A big surprise, and one that could have stayed undetected for many more years.

My almost 90 years old grandmother was having episodes of demency. She would see stuff that didn't exist, talk to people that weren't there, and not recognize her own relatives. After weeks of doctor visits, and we all being 100% sure she was having something serious like Alzheimers, turns out it was vitamin D deficiency.

Just sharing this here because I had no idea vitamin D deficiency could cause this.

Vitamin D deficiency actually really common, especially with dark skinned people living at higher latitudes. Most office people could do with a bit more UV.

Somehow this is not a problem in Indian rice.

Page crashed twice while I was trying to read this and only made it a few paragraphs in. My phone also got very hot. Too bad sites like these have to rely on shady adware to produce interesting content like this.

They have to pay the bill somehow.

they didn't even make the content. The original article is https://medium.com/war-is-boring/eating-too-much-rice-almost...

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