
All Medical Science is Wrong within a 95 % Confidence Interval - jackchristopher
http://entropyproduction.blogspot.com/2009/02/all-medical-science-is-wrong-within-95.html
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radu_floricica
Interesting article. The only question I have: Atkins diet exists for some
time. If so, then why hasn't it been a wild success? I know it works very well
short time, but I also know no diet, including Atkins, managed to do well long
term (2+ years). Except fringe cases of people who dedicate half of their life
to weight maintenance, specific diets tend to hurt more then help.

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.

~~~
xiaoma
I agree. This guy's claims are flatly contradicted by world evidence. As I've
posted here before, the Japanese diet derives _half_ its calories from rice,
and well over 70% from carbohydrates in general. Two generations ago, it was
nearly 70% just from rice. As many know, the Japanese live longer and have
fewer "life-style diseases" than anyone else.

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>

~~~
defen
Yes but have you seen the serving sizes in Japan? A meal there would barely
count as an appetizer for your average (overweight) American.

~~~
xiaoma
Just think how people like me feel when visiting America and seeing _"no
vegetables"_ as an selling point for double or even triple stack whoppers.

It's overwhelming, sickening and yet fascinating all at the same time.

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derefr
The article cites a hypothesis that boils down to "all of these things are bad
because they make you produce more insulin." The proposed solution is to do
less of all of those things. Why not, instead, _modulate insulin_? Then, if
the cited hypothesis is right, we could eat however we wanted and be perfectly
healthy and thin. I'm curious as to the correlations between diabetes or
hypoglycemia and the diseases mentioned in the article.

~~~
lena
This is why you should exercise, and why people in other countries, who eat
lots of carbohydrates, even refined ones, do not have high rates of diabetes
and obesity.

~~~
electromagnetic
Let's please be accurate here. People in other countries generally have lower
rates of obesity not because they exercise, but because they actually have to
do physical work and don't sit on their asses in an office all day.

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.

~~~
CWuestefeld
> Many sportsmen and soldiers are obese to significantly obese

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.

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tokenadult
Link to the primary research finding, "Why Most Published Research Findings
Are False," from PLoS Medicine:

[http://www.plosmedicine.org/article/info:doi/10.1371/journal...](http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020124)

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bbgm
How does one get from a very narrow discussion of medicine to all medical
science? Without questioning the merits of the post (happen to agree with a
good chunk of it), that's a sliver of what one might call medical science,
albeit a rather lucrative sliver.

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larryfreeman
I am especially bothered by one sentence:

"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.'

~~~
jnorthrop
Your quote is a bit out of context. He goes on to explain, "As a physicist, if
I get an correlation coefficient, R2 < 0.9997 in an experiment, I would
consider that a poor result. A nutritional researcher working with human
patients cannot even dream of achieving the degree of control or
characterization I can, and their data are overloaded with spurious noise."

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"

~~~
3pt14159
This part bothered me a lot. R __2 of 0.9997! Thats ridiculously accurate.
Unless he is measuring meters with an electron microscope I don't think he
could ever get that close to accuracy.

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magoghm
It's easy to see that most nutriton specialists aren't very scientific: they
refer to meat as "proteins" and measure everything in "calories" (which are
really kilocalories) instead of joules.

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duncanj
It seems to me that he is leaving out a discussion of slow-twitch and fast-
twitch muscles. Slow-twitch muscles are used in maintaining posture and light
activity and burn primarily fat. Fast-twitch muscles are used for strength and
burn primarily glucose. Hard exercise like he suggests would use mostly
glucose. Walking slowly while working 8 hrs a day (treadmill desk) would
presumably use more fat. It would be interesting to see if that is actually
the case (within a 95% confidence interval, of course ;) )

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ZeroGravitas
Can someone explain the entropy and thermodynamics bit?

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.

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lincolnq
See also (some conflicting views), the Hacker's Diet :
<http://www.fourmilab.ch/hackdiet/www/hackdiet.html>

~~~
radu_floricica
Not necessarily at odds. Hacker's Diet is about how one individual can get a
substantial weight loss in a short time, and keep it with maintenance. This
article is about long time effects of a certain diet. They don't contradict.

~~~
Oxryly
They contradict where the Hacker's Diet makes no attempt to differentiate
between types of calories.

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.

~~~
ZeroGravitas
That's a very harsh review of the hacker's diet.

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.

~~~
Oxryly
It sounds like the Hacker Diet is pushing for the magic here. Do extra
calories you eat magically become fat? If not, then how do they become fat? If
you exercise to burn fat, what's to stop you from becoming cripplingly
exhausted rather than burn even a gram a fat?

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.

~~~
ZeroGravitas
"Stimulating your metabolism" means burning more calories. You've not blown
away the existing framework, you're actually just working within it and yet
have somehow convinced yourself that you're not.

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iamelgringo
Nutrition != Medicine.

~~~
Oxryly
If you're talking about the title, I'll agree it's a tad sensationalistic.

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.

~~~
iamelgringo
Diabetes: I'd much rather have a surgery or procedure that could replace my
Islet of Langerhans rather than take insulin 2 times a day and live with a
strict diet the rest of my life. Many diabetics I know would agree. We don't
have that treatment yet.

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.

~~~
Oxryly
Diabetes: do you have type 1 or type 2?

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.

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joe_the_user
The article is quite interesting.

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.

