All Medical Science is Wrong within a 95 % Confidence Interval
entropyproduction.blogspot.com
entropyproduction.blogspot.com
Also I'd like some specific opinion on rice. It's carb, but I haven't yet seen a fat Japanese.
Anyways, one thing is worth taking from all this: don't mix carbs with rich meals. A cake should be fine by itself, but fries with steak not so much.
Korea, Hong Kong and Taiwan are similar, both in terms of diet and in exception life expectancy as compared to economic development. All around the world, there's a pretty consistent relationship between groups of big protein eaters and big people. Americans get more calories of protein than anybody else and are fatter than anyone else. Mexicans and British are close behind in both categories.
Furthermore, research on high vs low protein diets has been pretty conclusive: http://news.ycombinator.com/item?id=613745
To have the Okinawan (or Japanese) diet work for you, you'll not only have to follow it closely you'll also need to live the traditional Japanese lifestyle.
It's overwhelming, sickening and yet fascinating all at the same time.
The low carb diets work... its just that they are very difficult to follow for most people. If you live in the US and have a fairly normal lifetyle, you will eat too much carbs unless you really go out of your way to avoid bread, rice, sodas (or just about any drink besides water), fruit, etc.
> "The problem is the carbohydrates in the diet, their effect on insulin secretion, and thus the hormonal regulation of homeostasis—the entire harmonic ensemble of the human body."
> "Insulin is the primary regulator of fat storage. When insulin levels are elevated—either chronically of after a meal—we accumulate fat in our fat tissue. When insulin levels fall, we release fat from our fat tissue and use it for fuel."
These are the central ideas to weight management.
Eat food, mostly plants.
You've never seen a sumo match, then? :)
Wheat (including whole wheat), sugar (which is half fructose), high fructose and Omega 6-PUFA rich processed oils are in the devil's stew.
Rice, oats, corn, potatoes -- starchy root vegetables -- seem to be fine. But that's only if you don't already have chronically elevated glucose.
People say exercise and everyone tends to think the gym. However this is total BS, you don't need to go to the gym to stay healthy, the only thing you need to do to stay healthy when eating lots of carbohydrates is to do an activity to burn them.
The other major misconception is people think thin=healthy when really all the 'healthy' (women especially) people on TV are definitely not healthy. In fact, unless you're very careful with a calorie restricted diet (lots of vitamins and enough protein to maintain your muscle tissue) you are doing significantly more damage to your body than if you were overweight.
It's been shown anorexia can shorten your life by 25 years. Being moderately obese (30-35 on the BMI) can take 2-4 years off your life and extremely obese (40-45) can take 8-10 years off your life expectancy. People who are in the overweight group don't see a reduction in life expectancy, unless they smoke.
Then it also depends on how healthy you are when you're obese. Many sportsmen and soldiers are obese to significantly obese, and I don't think you'll find a single one who's of normal weight. However, many of these men will live longer than the average normal weight person (assuming they don't use steroids), due simply to the fact that building muscle tissue usually helps build your heart tissue too, meaning you stand to live significantly longer.
That may be so when measured by BMI. That's a really crappy metric, since it holds muscle mass against you. That is, really developed count against you. And since muscle is much denser, it's as if they've got lots of fat.
IMHO, we'd be better tracking body fat %. Of course, even that's less-than-perfect. Subcutaneous fat may be unsightly, but it's not dangerous to health. It's the fat around your organs that's bad for you.
If you want to become diabetic, take some streptozotocin :)
http://www.plosmedicine.org/article/info:doi/10.1371/journal...
"Prior to my introduction to the world of low-carbohydrate diet, I hadn't paid too much attention to nutritional science. I worked on biophysics, where I formed the opinion that medical science was mostly garbage."
It's hard for me to take someone seriously who once believed that medical science is 'mostly garbage.'
He is giving his opinion on why the science is "garbage" and explicitly states that "This isn't largely the fault of the scientists involved"
He's committing the same offense he speaks out against in the same article.
Does medicine use 95% confidence intervals because it is actually sufficient to base a medical science off of, or do they use 95% confidence interval because it is all they can get? The problem is, the universe doesn't care if all you can get is a 95% result.
And he is right that at least some people in the softer sciences don't understand their confidence intervals in the slightest. That crack he made about standard deviations being computed for non-Gaussian distributions won't resonate with you unless you have a lot of statistical training, but it a damning criticism; doing that sort of thing is basically proof your entire analysis isn't worth the paper it's written on, in proportion to the deviation from Gaussianess. I've been witness to the training procedure on experimental stats for undergrad biologists, which consists mostly of endless hammering in of the p-value as mantra, with understanding neither asked for nor given (unsurprising, as given the math prereqs up to that point the true meaning of the p-value can't really be taught). At the time I wouldn't have realized how wrong it is to apply p-value analysis to a bi-valued distribution, but I bet they were asked to. I know there's a grad-level course on the topic for them, but I fear it may be the blind leading the blind there.
I'm less willing to write off medicine as a whole. It has had some undeniable success in some areas (but it should be observed that weight management with much less than stomach stapling hasn't really been one of them). I'm playing a bit of devil's advocate here, because I think you may not have given the article a fair reading after you flipped the idiot flag on the author.
In biomechanics I often saw complete scattershot X-Y correlations, which after enough statistical dancing, were revealed to be "statistically significant" enough to be publishable, though they obviously had very little predictive power. I personally know how hard it is to isolate all factors and get a decent correlation, and that's just the way it is in medical science, but that's what gives me skepticism.
In the "hard, controlled" sciences, generally if you can't see an obvious correlation by eye you already throw it out. Statistics are used to quantify just how powerful the correlation is, not to prove there is a correlation at all.
Would a mathematician be ok for dismissing physics since a physics experiment is not as rigorous as a mathematical proof?
Calling "medicine" garbage because it is not as precise as physics is so silly that I don't really know how to respond. I am imagining a physicist who just had a massive hard attack saying to his doctor: "I'm sorry, please let me die, I don't believe your technique is based on sufficiently precise data."
He appears to be arguing against the concept of calories in minus calories burned equals calories stored, but he lost me.
He's got "entropy" in his blog name so you'd think this is his area, however, it sounds fishy to me.
For the Hacker Diet, all calories count against your total the same way. There's no concept of calories that throw off your blood sugar and consequently your insulin, and those that help maintain it. Therefore there's no attempt to manage the core fat building or fat burning mechanism of the body. It just pretends that food = bad and exercise = good.
More accurate would be food = energy, exercise = energy expenditure, obesity = prolonged energy surplus stored as fat, and weight loss = prolonged calorie deficit leading to fat reduction.
While I agree that there are wrinkles due to when, how and what you eat, I can't see a problem with that basic maths. You could say a 'bad' calories is one that triggers you to eat more calories, whether that's through habit, or addiction, or stomach stretching, or sugar rushes and crashes leading to hunger. But that still reduces down to more calories.
This book seems to be suggesting that the energy you store as fat comes from somewhere other than the food you eat. That's entering creationism or perpetual motion machine territory for me, and as you would then expect is accompanied by claims that the whole field is crooked.
The rebuttal linked from the article (by one of the "villains" of the book) suggests that the weird data comes down to people lying about what they eat to researchers. Not only do they not record everything they eat, they lie even more about their consumption of fatty foods which (correctly or not) the average person thinks are bad.
This makes it seem like people are gaining weight mysteriously, and that carbs are over-represented. Given the choice between overweight people misrepresenting what they eat and a whole branch of science being corrupt I'll take the former. Particularly if the book writer is happy to cherry pick out the results that he likes and ignore the rest of the field.
If we can establish the body's mechanism for building fat or burning it, that is the thread that will unravel most fad diets, exercise regimens, and theories. If you take the time to understand the hormone feedback and homeostasis system involved in fat building/burning, then simplistic "eat less burn more" approach begins to break down. You can see that eating certain foods certain ways actually stimulates your metabolism and triggers fat burning. Also, certain approaches to exercise actually trigger fat building.
> More accurate would be food = energy, exercise = energy expenditure, obesity = prolonged energy surplus stored as fat, and weight loss = prolonged calorie deficit leading to fat reduction.
This view turns the human body into a very simple black box. That's an awfully medieval approach.
If it's your view that the statement has wider meaning, I'd say turn it on its head: consider nutrition to be the first and best application of medicine.
If you had a chronic health condition (e.g. thyroid problem, diabetes, cardiovascular disease, migraines, etc etc) and you had three options: diet change, drugs, or surgery. Which would you choose every time? Which do you think would be healthier for you overall? Lead to more longevity, better quality of life, etc?
Nutrition certainly is medicine, and medicine at its cheapest and most effective.
Migraines: Poorly understood and generally poorly treated with pain medicines. Anyone that says that they can be cured with diet is trying to sell you something. Again, if a simple procedure could be devised to end people's needless suffering from migraines, I'm sure vast numbers of people would elect the surgery.
Cardiovascular disease: One of the top killers in the US. Most people end up treating this with a procedure (Cardiac Stenting or Bypass Surgery). It's certainly not ideal, but that's what the majority of people in this country choose. Dietary treatment is somewhat helpful for this, but genetics play a huge roll in this, and pure dietary treatment isn't going to solve the problem.
Thyroid: The treatment for this is generally taking a dose of thyroid medicine every day. For some people with an overactive thyroid which can be life threatening, a thyroidectomy is done. Otherwise, daily doses of medicine are about as unpleasant as being constantly vigilant about your diet.
Dietary (coupled with lifestyle) changes can produce lower inflammation and better blood sugar control. These two things attained early and often enough are enough to help avoid obesity, type 2 diabetes, hypertension, cardiovascular disease, arthritis, various auto-immune diseases.
These changes will leave you healthier overall, something that cannot be said of surgery or drugs.
But it has two different parts to it. One part is how dubious and unreliable much of medical science is. The other part is a plausible argument for the causes of "life style diseases". Both arguments are interesting but they are somewhat at odds with each other.
If there is so much uncertainty in medical research and medical advice, then shouldn't we have something like a call to step and spend some time just evaluating our methods and figuring how to increase the objectivity of the process rather than jumping to yet another not yet full substantiated approach - not that the approach itself sound particular bad or dubious but the juxtaposition of the two arguments gives me pause.