Assorted Links

Thanks to Bryan Castañeda and Dave Lull.

Assorted Links


Bariatric Surgery Linked to Acetaminophen Poisoning

Acetaminophen is a pain killer found in many over-the-counter drugs, such as Tylenol, NyQuil and Sudafed. It can cause liver failure. A new study at the California Pacific Medical Center in San Francisco reports that people who have had bariatric surgery seem to have a much higher risk of this:

Among 54 patients who had suffered acetaminophen-induced liver failure over a three-year period, 17 percent had had weight-loss surgery. . . . Less than 1 percent of the general population has had the surgery.

The study controlled for the possibility that people who have bariatric surgery are more likely to have liver failure unrelated to acetaminophen:

The researchers looked at 101 cases of acute liver failure seen at California Pacific Medical Center, more than half of which were caused by acetaminophen poisoning. Among the nine patients [of the 101] who had had weight-loss surgery, all of them had liver failure caused by acetaminophen overdose.

The article, by a reporter named Erin Allday, goes on to say:

At this time, there is no reason for bariatric surgery patients to be alarmed, and they should continue using acetaminophen if that’s their preferred pain medication or their doctor has prescribed it.

Allday attributes this bizarre advice to unnamed “researchers and weight-loss surgeons.” Of course bariatric surgery patients should be alarmed and cut down or stop using acetaminophen.

The next time someone says “correlation does not equal causation” or belittles epidemiology tell them about this case.

Thanks to David Archer.

Bayesian Shangri-La Diet

In July, a Cambridge UK programmer named John Aspden wanted to lose weight. He had already lost weight via a low-carb (no potatoes, rice, bread, pasta, fruit juice) diet. That was no longer an option. He came across the Shangri-La Diet. It seemed crazy but people he respected took it seriously so he tried it.  It worked. His waist shrank by four belt notches in four months. With no deprivation at all. Continue reading “Bayesian Shangri-La Diet”

Measuring Yourself to Improve Your Health? Want to Guest-Blog?

What surprised me most about my self-experimental discoveries was that they were outside my area of expertise (animal learning). I discovered how to sleep better but I’m not a sleep researcher. I discovered how to improve my mood but I’m not a mood researcher. I discovered that flaxseed oil improved brain function but I’m not a nutrition researcher. And so on. This is not supposed to happen. Chemistry professors are not supposed to advance physics.  Long ago, this rule was broken. Mendel was not a biologist, Wegener (continental drift) was not a geologist. It hasn’t been broken in the last 100 years. As knowledge increases, the “gains due to specialization” — the advantage of specialists over everyone else within their area of expertise — is supposed to increase. The advantage, and its growth, seem inevitable. It occurs, say economists, because specialized knowledge (e.g., what physicists know that the rest of us, including chemists, don’t know) increases. My theory of human evolution centers on the idea that humans have evolved to specialize and trade. In my life I use thousands of things made by specialists that I couldn’t begin to make myself.

Here we have two things. 1. A general rule (specialists have a big advantage, within their specialty, over the rest of us) that is overwhelmingly true. 2. An exception (my work). How can this be explained? What can we learn from it? I’ve tried to answer these questions but I can add to what I said in that paper. The power of specialization is clearly enormous. Adam Smith, who called specialization “division of labor”, was right. The existence of an exception to the general rule suggests  there are forces pushing in the opposite direction (toward specialists being worse than the rest of us in their area of expertise) that can be more powerful than the power of specialization. Given the power of specialization, the countervailing forces must be remarkably strong. Can we learn more about them? Can we harness them? Can we increase them? The power of specialization has been increasing for thousands of years. How strong the countervailing forces may become is unclear.

The more you’ve read this blog, the more you know what I think the countervailing forces are. Some of them weaken specialists: 1. Professors prefer to be useless rather than useful (Veblen).  2. A large fraction (99%?) of health care workers have no interest in remedies that do not allow them to make money. 3. Medical school professors are terrible scientists. 4. Restrictions on research. Some of them strengthen the rest of us: 1. Data storage and analysis have become very cheap. 2. It is easier for non-scientists to read the scientific literature. 3. No one cares more about your health than you. These are examples. The list could be much longer. What’s interesting is not the critique of health care, which is pretty obvious, but the apparent power of these forces, which isn’t obvious at all.

I want to learn more about this. I want learn how to use these opposing forces and, if possible, increase them. One way to do this is find more exceptions to the general rule, that is, find more people who have improved their health beyond expert advice. I have found some examples. To find more, to learn more about them, and to encourage this sort of thing (DIY Health), I offer the opportunity to guest-blog here.

I think the fundamental reason you can improve on what health experts tell you is that you can gather data. Health experts have weakened their position by ignoring vast amounts of data. Three kinds of data are helpful:  (a) other people’s experiences, (b) scientific papers and (c) self-measurement (combined with self-experimentation). No doubt (c) is the hardest to collect and the most powerful. I would like to offer one or more people the opportunity to guest-blog here about what happens when they try to do (c). In plain English, I am looking for people who are measuring a health problem  and trying to improve on expert advice. For example, trying to lower blood pressure without taking blood pressure medicine. Or counting pimples to figure out what’s causing your acne. Or measuring your mood to test alternatives to anti-depressants. I don’t care what’s measured, so long as it is health-related. (Exception: no weight-loss stories) and you approach these measurements with an open mind (e.g., not trying to promote some product or theory). I am not trying to collect success stories. I am trying to find out what happens when people take this approach.

Guest-blogging may increase your motivation, push you to think more (“I blog, therefore I think“) and give you access to the collective wisdom of readers of this blog (in the comments). If guest-blogging about your experiences and progress (or lack of it) might interest you, contact me with details of what you are doing or plan to do.

“The Scale of the Scandal”: Tony Scott’s Suicide Quite Possibly Due to Antidepressant

As pointed out by dearime, the columnist Peter Hitchens recently made the following comment in The Mail on Sunday:

When I read in August that the talented Hollywood film director Tony Scott had killed himself without any apparent good reason, I was fairly sure that pretty soon we would find that the poor man had been taking ‘antidepressants’. Well, a preliminary autopsy has found ‘therapeutic’ levels of an ‘antidepressant’ in his system. I take no pleasure in being right, but as the scale of this scandal has become clear to me, I have learned to look out for the words ‘antidepressant’ or ‘being treated for depression’ in almost any case of suicide and violent, bizarre behavior. And I generally find it. The science behind these pills is extremely dubious. Their risks are only just beginning to emerge. It is time for an inquiry.

Tony Scott Suicide Remains a Mystery After Autopsy,” wrote a Vanity Fair editor. The autopsy found that he had been taking the antidepressant Remeron, whose known side effects include suicide. SSRI’s, of which Remeron is an example, cause suicidal thinking in people who are not depressed.

The psychiatrist David Healy was the first to emphasize this point. In 2000, after he began this research, he was offered a job at the University of Toronto. In a very unusual move, the job offer was rescinded. Apparently psychiatry professors at the University of Toronto realized that Healy’s research made the psychiatric drug industry look bad.

I don’t think it’s wrong to sell drugs that improve this or that condition (e.g., depression), even if the improvement is slight. I do think it’s wrong to make false claims to induce people to buy the drugs. In the case of depression, the false claim is that depression is due to a “chemical imbalance.” No chemical difference has ever been shown between people who later become depressed and people who don’t later become depressed. This claim, repeated endlessly, makes it harder to do research into what causes depression. If you figured out what caused depression, you could treat it and prevent it much better. This false claim does enormous damage. It delays by many years discovery of effective treatment and prevention of depression, a disease from which hundreds of millions of people now suffer.

This happens in dozens of areas of medicine. Dermatologists say “acne is caused by bacteria“. Most doctors appear to believe “ulcers are caused by bacteria”. Ear nose and throat surgeons claim that part of the immune system (the tonsils) causes illness. The “scale of the scandal” — medical school professors either (a) don’t understand causality or (b) deceive the rest of us — is great.

Quantified Self Utopia: What Would It Look Like?

On the QS forums, Christian Kleineidam asked:

While doing Quantified Self public relations I lately meet the challenge of explaining how our lives are going to change if everything in QS goes the way we want. A lot of what I do in quantified self is about boring details. . . .  Let’s imagine a day 20 years in the future and QS is successful. How will that day be different than [now]?

Self-measurement has helped me two ways. Continue reading “Quantified Self Utopia: What Would It Look Like?”

The Reddit Protein Powder Tests

A few months ago, a Redditer with access to a protein measurement device offered to measure the protein content of protein powders that readers sent him. He got about twenty samples, presumably from all over the United States. Most of them turned out to have reasonable amounts of protein but four had much less than expected.

The tester interpreted the results here. One of the tested brands, American Pure Whey, clearly has problems. Call it a positive control. By confirming those problems, the rest of the measurements gain credence. One company whose protein powder scored low is Gaspari. Unfortunately I cannot read their reply, which appears on my browser without text.

I look forward to more truth-in-advertising tests. It is really helpful that the data is public — in this case, via Google Docs. Jimmy Moore (of Livin’ La Vida Low Carb) has measured the effect of several supposedly low-carb-friendly products on his blood sugar. His results are here.

Thanks to Eric Meltzer.

New Product: Cascal Fermented Soda

This low-calorie soda (60 to 80 calories in a 12-ounce can) falls somewhere between kombucha and less-sweet sodas such as the aptly named GUS (Grown Up Soda). Its hook is the use of fermented juices as its base, resulting in a more complex flavor than sodas and sparkling waters based on plain juice.

$1.25 at Whole Foods. I’m in.

My interest in fermented foods partly derives from learning about a similar product. At a Fancy Food Show a few years ago, I learned about someone who wanted to develop a high-end non-alcoholic alternative to wine. He found he couldn’t get enough complexity without fermentation. That emphasized to me how our food preferences — in this case, a desire for complexity — push us to eat fermented foods.

The 2012 Nobel Prize in Physiology or Medicine

As usual, there is plenty of disease and disability in the world: depression, diabetes, heart disease, cancer, stroke, obesity, autoimmune disease, and so on. As usual, the Nobel Prize in Physiology or Medicine — supposed to be given for the most useful research — is given for research with no proven benefit to anyone (except career-wise). Once again implying that the world’s best biomedical researchers — judging by who wins Nobel Prizes — either don’t want to or don’t know how to do useful research.

Once again the press release tries to hide this. “From surprising discovery to medical use” reads one heading. If you read the text, however, you learn there is no actual “medical use”. Here’s what it says:

These discoveries have also provided new tools for scientists around the world and led to remarkable progress in many areas of medicine. iPS cells can also be prepared from human cells. For instance, skin cells can be obtained from patients with various diseases, reprogrammed, and examined in the laboratory to determine how they differ from cells of healthy individuals. Such cells constitute invaluable tools for understanding disease mechanisms and so provide new opportunities to develop medical therapies.

Apparently you can make “remarkable progress” in medicine without helping a single person, which says a lot about what passes for medical progress. Although iPS cells are supposedly “invaluable tools” for understanding disease mechanisms, we are not told a single disease that has thereby been understood or a single therapy that has been developed.

The Guardian printed a roundup of responses to the award. I read it eagerly. Maybe one of the comments will explain how the prize-winning work actually helped someone (besides career-wise). After all, Yamanaka, one of the winners, had previously won the Finland Prize, given to research that “significantly improves the quality of human life today and for future generations”. Paul Nurse says the prize-winning work did such-and-such, “paving the way for important developments in the diagnosis and treatment of disease” unfortunately not saying what those “important developments” are. Martin Evans says:

The practical outcome is that now we not only know that it might be theoretically possible to convert one cell type into another but it is also practically possible. These are very important foundation studies for future cellular therapies in medicine.

Emphasis added. Another comment: “These breakthroughs will ultimately lead to new and better treatments for conditions like Parkinson’s and improve the lives of millions of people around the world.” A bold prediction, given that they have not yet improved the life of even one person. Julian Savescu, an ethicist at Oxford, says “This is as significant as the discovery of antibiotics. Given the millions, or more lives, which could be saved, this is a truly momentous award.”

Year after year, the Nobel Prize in Physiology or Medicine is given for research that, we are told by biologists with huge conflicts of interest, will — no doubt! — be incredibly valuable in the future. Indicating there was no research that might be honored that had already been useful. It is as if you have a baseball award for best hitter but all hitters all over the world strike out all the time so you end up giving the award to people who strike out best. They are the best hitters, you tell credulous sportswriters. They receive the prestigious award for best hitter at an elaborate ceremony, with toasts all around. Nobody says they cannot hit.


Vitamin D3 Eliminated Colds and Improved Sleep When Taken in the Morning (Stories 24 and 25)

A year and a half ago, the father of a friend of mine started taking Vitamin D3, 5000 IU/day at around 7 am — soon after getting up. That his regimen is exactly what I’d recommend (good dose, good time of day) is a coincidence — he doesn’t read this blog. He used to get 3 or 4 terrible colds every year, year after year. Since he started the Vitamin D3, he hasn’t gotten any. “A huge lifestyle improvement,” said my friend. His dad studied engineering at Caltech and is a considerable skeptic about new this and that.

Much more recently his mother changed the time of day she took her usual dose of Vitamin D3. For years she had been taking half in the morning (with a calcium supplement) and half at night. Two weeks ago she started taking the whole dose in the morning. Immediately — the first night — her sleep improved. She used to wake up every 2 hours. Since taking the Vitamin D3 in the morning, she has been waking up only every 3-6 hours. A few days ago, my friend reports she had “her best sleep in years”.

Sleep and immune function are linked in many ways beyond the fact that we sleep more when we’re sick. A molecule that promotes sleep turned out to be very close to a molecule that produces fever, for example. I found that when I did two things to improve my sleep (more standing, more morning light) I stopped getting colds. So it makes sense that a treatment that improves one (sleep or immune function) would also improve the other (immune function or sleep).

A few days ago I posted a link about a recent Vitamin D study that  found no effect of Vitamin D on colds. The study completely neglected importance of time of day by giving one large injection of Vitamin D (100,000 IU) per month at unspecified time. I commented: “One more Vitamin D experiment that failed to have subjects take the Vitamin D early in the morning — the time it appears most likely to have a good effect.” These two stories, which I learned about after that post, support my comment. What’s interesting is that the researchers who do Vitamin D studies keep failing to take time of day into account and keep failing to find an effect and keep failing to figure out why. I have gathered 23 anecdotes that suggest that their studies are failing because they are failing to make sure their subjects take their Vitamin D early in the morning. Yet these researchers, if they resemble most medical researchers, disparage anecdotes. (Disparagement of anecdotes reaches its apotheosis in “evidence-based medicine”.) The same anecdotes that, I believe, contain the information they need to do a successful Vitamin D clinical trial. Could there be a serious problem with how Vitamin D researchers are trained to do research? A better approach would be to study anecdotes to get ideas about causation and then test those ideas. This isn’t complicated or hard to understand, but I haven’t heard of it being taught. If you understand this method, you treasure anecdotes rather than dismiss them (“anecdotal evidence”).


Five Most Important Rules of Nature Photography

A friend sent me some photos taken on a mountain hike. They seemed to derive from the following rules:

1. Carry a small camera in a big bag.

2. Always take a picture of a flower.

3. Change clothes from one picture to the next. (For example, wear pants in one picture and shorts in another picture, or a blue shirt in one picture and a white shirt in another picture.)

4. Make a funny face (for example, press finger into cheek).

5. Wear a funny shirt.

Assorted Links


Thanks to Chuck Currie, Grace Liu, Alex Chernavsky and Dave Lull.

Two Dimensions of Economic Growth: GDP and Useful Knowledge

Ecologists understand the exploit/explore distinction. When an animal looks for food, it can either exploit (use previous knowledge of where food is) or explore (try to learn more about where food is). With ants, the difference is visible. Trail of ants to a food source: exploit. Solitary wandering ant: explore. With other animals, the difference is more subtle. You might think that when a rat presses a bar for food, that is pure exploitation. However, my colleagues and I found that when expectation of food was lower, there was more variation — more exploration — in how the rat pressed the bar. In a wide range of domains (genetics, business), less expectation of reward leads to more exploration.  In business, this is a common observation. For example, yesterday I read an article about the Washington Post that said its leaders failed to explore enough because they had a false sense of security provide by their Kaplan branch. “Thanks to Kaplan, the Post Company felt less pressure to make hard strategic choices—and less pressure to venture in new directions,” wrote Sarah Ellison.

Striking the right balance between exploitation and exploration is crucial. If an animal exploits too much, it will starve when its supply of food runs out. If it explores too much, it will starve right away. Every instance of collapse in Jared Diamond’s Collapse: How Socieities Choose to Fail or Succeed was plausibly due to too much exploitation, too little exploration (which Diamond, even though he is a biologist, fails to say). I’ve posted several times about my discovery that treadmill walking made studying Chinese more pleasant. I believe walking creates a thirst for dry knowledge. My evolutionary explanation is that this pushed prehistoric humans to explore more.

I have never heard an economist make this point: the need for proper balance between exploit and explore. Continue reading “Two Dimensions of Economic Growth: GDP and Useful Knowledge”

The Growth of Personal Science: Implications For Statistics

I have just submitted a paper to Statistical Science called “The Growth of Personal Science: Implications For Statistics”. The core of the paper is examples, mostly my work (on flaxseed oil, butter, standing, and so on). There is also a section on the broad lessons of the examples — what can be learned from them in addition to the subject-matter conclusions (e.g., butter makes me faster at arithmetic). The paper grew out of a talk I gave at the Joint Statistical Meetings a few years ago, as part of a session organized by Hadley Wickham, a professor of statistics at Rice University. Continue reading “The Growth of Personal Science: Implications For Statistics”

Drug Companies Hide Unfavorable Evidence

Ben Goldacre, a British epidemiologist and newspaper columnist (“Bad Science”), who used to attack homeopathy (trivial), has now written about something important: drug companies hide vast amounts of unfavorable evidence.  I already knew this but many details were new to me. Continue reading “Drug Companies Hide Unfavorable Evidence”

Last Weekend’s Quantified Self Conference

Last Saturday and Sunday there was an international Quantified Self Conference at Stanford. I attended. In Gary Wolf’s introductory talk, he said there are 70 Quantified Self chapters (New York, London, etc.) and 10,000 members. I was especially impressed because I recently counted about 50 chapters. One new chapter is Quantified Self Beijing. It has its first meeting — in the form of a day-long conference — in nine hours and I haven’t quite finished my talk (“Brain Tracking: Why and How”). Please indulge me while I procrastinate by writing about the Stanford conference. Continue reading “Last Weekend’s Quantified Self Conference”

Benefits of Fermented Foods

A simple story:

When Steven Kent did an internship at The Farm, a hippie commune in rural Tennessee, he had an epiphany. Eating a steady diet of sauerkraut, pickled vegetables, sourdough bread and other fermented foods, he found the digestive problems that had plagued him since college largely vanished.

There is more here about tempeh (fermented tofu) and a small Northern California company that Kent started called Alive and Healing that makes only tempeh.

Want to Track Your Brain Function?

I am looking for people who want to try a mental test I have developed to track brain function. You do it on your laptop, once or more per day. One test session takes three minutes. For five years, I’ve been using various tests to track my brain function — first, balance, then, for a long time, arithmetic speed. The new test is better than these earlier tests, at least for me, because I find it enjoyable, which makes it easy to do several times/day. Via brain tracking, I have found that flaxseed oil and butter make my brain work considerably better. I was also able to find the best dosages. I believe that learning what foods (and dosages) make your brain work best is a good way to figure out what foods (and dosages) are best for the rest of your body. For example, after I figured out what amount of flaxseed oil was best for my brain, my gums became much healthier (less inflammation). The new test, which I do more often than the older tests, has made clear that there are all sorts of reliable yet mysterious ups and down in my brain function. I was unaware of this. Continue reading “Want to Track Your Brain Function?”

Lessons of SOPA: How a Slam Dunk Bill was Stopped

Passage of SOPA (Stop Online Piracy Act) seemed inevitable. It was introduced with 40 Senate co-sponsors, including plenty of both Republicans and Democrats. (At the time it was called PIPA — Protect IP Act.) Senate passage requires 51 votes; to override a filibuster you need more. The entertainment industry (Hollywood) had spent hundreds of millions of dollars per year to pass such a bill; the people behind the lobbying felt the survival of their industry was at stake. Senator Patrick Leahy, whose office wrote the bill, is in the new Batman movie.

Yet SOPA was defeated.

The story, as I was told it, begins on a Sunday. The bill was scheduled for a vote on Wednesday, three days later. Peter Eckersley, who works at the Electronic Freedom Foundation in San Francisco, called Aaron Swartz, who lives in New York, to ask, “How are we going to defeat this?” At that point, Aaron hadn’t heard of it. Aaron’s talk about this.

It is a stunning example of David defeating Goliath. I asked Aaron what he learned from it. He told me three lessons:

1. Popular support matters. It can overcome large amounts of money. The anti-SOPA forces spent little money but got many people to tell their Congressman or Senator that they opposed the bill. The domain registrar GoDaddy reversed its position on the bill. Aaron worked with lobbyists for Google. The lobbyists believed, at least at first, that the bill could not be stopped, only weakened.

2. A little-known issue can be made a well-known issue. When SOPA was introduced, shortly before the scheduled vote, no one had heard of it. At MSNBC, and presumably other news organizations, employees were told not to cover it. When people at Google were approached to support the opposition, at first they said the bill couldn’t possibly be that bad or they would have heard of it. Without coverage by MSNBC etc., eventually everyone heard of it.

3. People will act if they can be convinced they are responsible. People at Wikipedia and Google, not to mention the originator of the GoDaddy boycott, were convinced to act, says Aaron, because they were convinced that they bore responsibility for the outcome, whatever it was. (I would put it differently. I would say they were convinced they could help determine the outcome.)

What interests me most about this story is how wrong the lobbyists were. They’re the experts in how to change/defeat legislation. They were utterly wrong. They understood the forces within their system but had no understanding of what was possible outside their system. I think healthcare experts will turn out to be equally wrong.