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Book Review: The World Turned Upside Down (the second low carb revolution)

I recently read The World Turned Upside Down (the second low carb revolution) by Dr. Richard D. Feinman.  The book presents a biochemist’s view of the current state of research on metabolism, especially the impact of low-carb diets, and a very funny and biting commentary on the idiocy and dishonesty of the medical research establishment toward the science around low-carb diets.

Feinman does a great job exposing the lying, mendacity statistical cheating and dishonesty used to ignore the clear results of many studies, and the biases and double standards.

As a person with no chemistry background, I was able to follow a portion of the science (not all) in the book, which for me is pretty good.  I have read other books on this topic that are less clear to me.

Feinman explains something that I have always wondered about: why so many studies are reported in which high fat/low carb does about as well as low-fat/calorie-restricted diets.  He shows how through duplicitious counting of people who go off the diet, the LCHF causes the LCHF and the LFCR to converge while in reality the results are quite superior for LCHF.

Do you remember the Harvard “meat is the new smoking” study?  The raw data showed that you were less likely to die the more meat you ate.  The way they got meat causing you to die was to “correct” for ten other factors, including smoking.  Feinman points out the extreme unreliability of accurately removing a large signal (smoking) from data in order to accurately measure a small signal (meat).   Any error at all in the magnitude of the large signal will obliterate the small signal – e.g. if smokers were 31x more likely to die rather than 30x it would over-write a 3% signal due to something else.

Overall – highly recommended.

(lack of) disclosure: no affiliate relationship, quid pro quo, or any form of consideration of linkage between me and the author, bookseller, or anyone else.

 

Risk is a Statistical Concept: No Such Thing as Individual Risk

Something that has annoyed me for a long time — and here I find a

doctor blogging about it.   I have a particular marker on one of my lab tests which according to population statistics means that I have an X percent chance of a particular illness in the next 1 year.

 

That is ok, if understood to mean that X out of 100 people with my lab marker get the illness every year.  But statistics like that tell you nothing about any individual person.

 

Here’s an example which makes this point.  If we found that 25% of people who engage in unprotected sex become pregnant in one year, that does not mean that any one individual has a 25% chance of pregnancy.  If that individual is a male, their chance is 0%.  All of the 25% comes from the female population.

 

The concept of risk is abused by taking numbers derived from statistics and using it as if it mean “cause”.  This confusion is exacerbated by lumping together statistical associations with actual causes, such as smoking, and calling them both “risk factors”.

 

A cause is something that results in an effect, while associations can be present without cause, or without the direction of causality being known.  Going back to the example of my lab test, the fact of X/100 people getting an illness does not mean that if I reduced my lab test value to a lower value that I personally would have changed anything about my health.  That would only be true if the lab marker were a cause.

 

But if X is just a marker that happens to be correlated on a population basis, then making it lower by any means necessary has no meaning to any particular individual.  If X is a marker, it may be that causality runs in the other direction: X may be higher because the person already has the illness.  In that case, making X lower by taking a drug is nothing other than shooting the messenger.

 

Alert and Oriented blogs about the non applicability of population risk to individual risk.

 

Fluoride

  • The addition of fluoride to municipal water supplies has been justified based on its alleged prevention of cavities.  According to Newsweek (free here), a new meta study suggests that fluoridation does not even do that much. “Frankly, this is pretty shocking,” says Thomas Zoeller, a scientist at UMass-Amherst uninvolved in the work. “This study does not support the use of fluoride in drinking water.” Trevor Sheldon concurred. Sheldon is the dean of the Hull York Medical School in the United Kingdom who led the advisory board that conducted a systematic review of water fluoridation in 2000, that came to similar conclusions as the Cochrane review. The lack of good evidence of effectiveness has shocked him. “I had assumed because of everything I’d heard that water fluoridation reduces cavities but I was completely amazed by the lack of evidence,” he says. “My prior view was completely reversed.”

Diet/Obesity

  • Dr. Ronald Hoffman talks to physician and author Raphael Kellman about his new book The Microbiome Diet.  Kellman believes that weight issues are caused by a shift in the gut biome, which may act by causing the person to become more insulin-resistant.  Kellman advocates a diet of some very odd foods that encourage the right type of gut bacterial growth – artichokes, leeks, jicama, dandelion greens.  Part 2 here.

Modern Medicine

  • Insightful piece about overdiagnosis by a doctor.  Over-diagnosis is the detection of markers that would never result in a health problem for the individual and leads to unnecessary over-treatment.   He shows some evidence that the increase if diagnostics resulting in more early detection does not impact lifespan.
  • A thoughtful physician/blogger writes:  Is medicine a scientific enterprise?: “Medicine itself cannot be viewed as scientific for the simple reason that the aim of science is to acquire knowledge, whereas the aim of medicine is to heal.  These are two distinct ends.  Furthermore, a scientific enterprise is best carried out with dispassion: observation and experimentation.  Healing, on the other hand, is best accomplished through personal involvement: caring.”

Politics/Economics of Health

  • The Rise of the Medical Bureaucrat and Centralized Health Care explains how central planning of health care depends on the false belief that it can be standardized, productized, and delivered in the same way to all people.
  • Scott Tips reports on the efforts of international food standards bodies meeting in Switzerland to push through an international standard asserting that rGBH is safe for cows.  “out that a herd of Holstein cows injected with the genetically engineered bovine growth hormone presented extremely shocking results upon autopsy, which the FDA and Monsanto did not make public. It was only upon publication in a dairy magazine that consumers learned that rBGH-injected cows lost an average of 100 pounds after six months, but that their hearts and spleens and other stressed organs had grown abnormally large.

Pharma

  • Red Ice Radio interviews Gwen Olsen, a former pharma sales rep.  Olsen’s book Confessions of an Rx Drug Pusher.  “She gives details about her awakening process that began with the realization that the information she was disseminating to doctors was extremely skewed, … She explains her role as a marketing tool for Pharma, where successful drug sales are calculated through doctor profiling and often encouraged with extravagant perks to prescribing physicians. We discuss the corruption and money making interests of the rapidly expanding 300 billion dollar global pharmaceutical market, and Gwen breaks down the greatly slanted process of FDA drug approval.
  • Behind the marketing of a new amphetamine-category drug to treat “binge eating disorder”, a  new fake illness invented to market the drug.

Vaccination

Agriculture/Real Food

  • Chris Martenson interviews sustainable farmer/advocate Joel Salatin about The Pursuit Of Food Freedom.  They discuss the reasons that high-integrity food will never be sold by large retailers, and the rise of web-based organic/pastured food distributors (e.g. Good Eggs, Grub Market) who remove take over and delivery of the products from farmers, who from what Salatin says, don’t really enjoy going to farmers’ markets or find it a good use of their time.
  • Attack on Small-Scale Dairy in Australia: “Elgaar Farm is one of Australia’s leading organic, ethical, multi-generational dairy farms with farming origins and practices dating back hundreds of years to their Bavarian roots. For almost 12 months they’ve been shut down by the local dairy authorities because they don’t fit the modern “standards” established by the commercial dairy industry in Australia. … The real issue, however, still remains: that regulations designed for large modern industrial operations are being applied to heritage farms, destroying centuries of traditional artisan foods.”
  • Custom meat processing bill introduced in congress – would allow small artisanal ranchers to process meta on a small scale for direct to consumer sales.  Sustainable rancher Joel Salatin explains why it is good for small ranchers who raise grass-fed/heritage breeds at small scale.
  • The upcoming movie Steak Revolution talks to cattle ranchers, butchers and chefs.  The trailer shows some discussion of grass-fed beef.

Industrial Agriculture

Fake Food

  • Really funny food p..n: Mundane Matters turns vegetables into junk food, and fancy fast food buys fast food takeout and refashions it into what looks like high end cuisine.

Brain

Sleep/Circadian Cycle

GMO

Cholesterol/Heart Disease

  • This frustrating article explains: Why Young, Slim, Vegetarian, Non-Smoking Indians Are Struggling With Coronary Artery Disease, Heart Attacks, and Diabetes.  The article is interesting in rejecting the common perception that vegetarianism is heart-healthy.  However it uses the term “risk factors” which conflates causes and indicators.  For example, smoking is a cause, while belly fat is an indicator of endocrine dysregulation, which may itself be an intermediate cause but not the final cause.  The article is unhelpful on the issue of causality.  Are the causes of these diseases in South Asian Indians mostly a greater genetic susceptibility to the same environmental factors, or a greater exposure to the actual lifestyle and external factors?  Near the end the article does mention inflammatory diet as an issue.  Are they saying that the vegetarian diet followed by the Indian population is more inflammatory?  Not clear.
  • The Widowmaker, a documentary film about coronary calcium scans, a type of imaging test that can show blockages in the arteries around the heart.  This test is more predictive of hear attacks than the popular cholesterol markers, but is not covered by most insurance.  Alert and Oriented reviews the film.

Coffee

Sugar

  • Swiss researchers discover connection between fructose and heart failure through a previously unknown metabolic function of the heart itself.

Paleo