Health

[Warning: this post contains lots of guesses based on weak evidence. I’d be surprised if I got more than 80% of it right.]

I’ve long acted as if a good diet is fairly important, and I’ve gathered lots of relevant evidence. But until recently I classified that evidence into many small topics related to specific nutrients and health problems, and never organized those ideas into an overall assessment of how important a good diet is.

Comments by Jim Babcock prompted me to investigate a broader overview.

This post will mainly focus on evaluating the importance of nutrition for adults in wealthy nations, then will summarize my guesses about how to achieve a good diet.

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Book review: The Plant Paradox, by Steven R. Gundry.

This book describes a good diet, which Gundry seems to have put together by combining ideas from other competent nutritionists, testing many variations on himself and his patients, and keeping the components that showed the best results.

Unfortunately, his rhetoric is designed to convince us that he’s got brilliant, revolutionary theories. That rhetoric bears little resemblance to careful reasoning. It seems more likely that he tried a bunch of arguments on his patients, and kept the ones that more effectively scared them into following his diet.

His puns are mightier than his scalpel (“No More Mr. Knife Guy”).

I first noticed Gundry via the ApoE4 website, at about the time I gave up hoping that I could eat coconut fat without raising my cholesterol. I saw that Gundry recommended no coconut fat for my genotype, but liked coconut fat for others. That led me to think: here’s a paleo-friendly nutritionist who knows more than average.

Then I switched for 5 or 6 weeks to a diet more in line with his Apoe4 advice [1], and was surprised at how much more my cholesterol levels dropped than I expected. I only have modest evidence suggesting that that dietary change was the main reason for the cholesterol drop, but it’s still a bit of evidence that Gundry knows something valuable that I would have otherwise have overlooked.
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No, this isn’t about cutlery.

I’m proposing to fork science in the sense that Bitcoin was forked, into an adversarial science and a crowdsourced science.

As with Bitcoin, I have no expectation that the two branches will be equal.

These ideas could apply to most fields of science, but some fields need change more than others. P-values and p-hacking controversy are signs that a field needs change. Fields that don’t care much about p-values don’t need as much change, e.g. physics and computer science. I’ll focus mainly on medicine and psychology, and leave aside the harder-to-improve social sciences.

What do we mean by the word Science?

The term “science” has a range of meanings.

One extreme focuses on “perform experiments in order to test hypotheses”, as in The Scientist In The Crib. I’ll call this the personal knowledge version of science.

A different extreme includes formal institutions such as peer review, RCTs, etc. I’ll call this the authoritative knowledge version of science.

Both of these meanings of the word science are floating around, with little effort to distinguish them [1]. I suspect that promotes confusion about what standards to apply to scientific claims. And I’m concerned that people will use the high status of authoritative science to encourage us to ignore knowledge that doesn’t fit within its paradigm.

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Book review: The Elephant in the Brain, by Kevin Simler and Robin Hanson.

This book is a well-written analysis of human self-deception.

Only small parts of this book will seem new to long-time readers of Overcoming Bias. It’s written more to bring those ideas to a wider audience.

Large parts of the book will seem obvious to cynics, but few cynics have attempted to explain the breadth of patterns that this book does. Most cynics focus on complaints about some group of people having worse motives than the rest of us. This book sends a message that’s much closer to “We have met the enemy, and he is us.”

The authors claim to be neutrally describing how the world works (“We aren’t trying to put our species down or rub people’s noses in their own shortcomings.”; “… we need this book to be a judgment-free zone”). It’s less judgmental than the average book that I read, but it’s hardly neutral. The authors are criticizing, in the sense that they’re rubbing our noses in evidence that humans are less virtuous than many people claim humans are. Darwin unavoidably put our species down in the sense of discrediting beliefs that we were made in God’s image. This book continues in a similar vein.

This suggests the authors haven’t quite resolved the conflict between their dreams of upholding the highest ideals of science (pursuit of pure knowledge for its own sake) and their desire to solve real-world problems.

The book needs to be (and mostly is) non-judgmental about our actual motives, in order to maximize our comfort with acknowledging those motives. The book is appropriately judgmental about people who pretend to have more noble motives than they actually have.

The authors do a moderately good job of admitting to their own elephants, but I get the sense that they’re still pretty hesitant about doing so.

Impact

Most people will underestimate the effects which the book describes.
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I got interested in trying ashwagandha due to The End of Alzheimer’s. That book also caused me to wonder whether I should optimize my thyroid hormone levels. And one of the many features of ashwagandha is that it improves thyroid levels, at least in hypothyroid people – I found conflicting reports about what it does to hyperthyroid people.

I had plenty of evidence that my thyroid levels were lower than optimal, e.g. TSH levels measured at 2.58 in 2012, 4.69 in 2013, and 4.09 this fall [1]. And since starting alternate day calorie restriction, I saw increasing hypothyroid symptoms: on calorie restriction days my feet felt much colder around bedtime, my pulse probably slowed a bit, my body burned fewer calories, and I got vague impressions of having less energy. Presumably my body was lowering my thyroid levels to keep my weight from dropping.

I researched the standard treatments for hypothyroidism, but was discouraged by the extent of disagreement among doctors about the wisdom of treating hypothyroidism when it’s as mild as mine was. It seems like mainstream medical opinion says the risks slightly outweigh the rewards, and a sizable minority of doctors, relying on more subjective evidence, say the rewards are large, and don’t say much about the risks. Plus, the evidence for optimal thyroid levels protecting against Alzheimer’s seems to come mainly from correlations that are seen only in women.

Also, the standard treatments for hypothyroidism require a prescription (probably for somewhat good reasons), which may have deterred me by more than a rational amount.

So I decided to procrastinate any attempt to optimize my thyroid hormones, and since I planned to try ashwagandha and DHEA for other reasons, I hoped to get some evidence from the small increases to thyroid hormones that I expected from those two supplements.

I decided to try ashwagandha first, due mainly to the large number of problems it may improve – anxiety, inflammation, stress, telomeres, cholesterol, etc.
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Book review: The End of Alzheimer’s, by Dale E. Bredesen.

Alzheimer’s can be at least postponed for years in most people, and maybe fully cured.

The main catches: It only works if started early enough (and Bredesen only has crude guesses about what’s early enough), the evidence is less rigorous than I’d like, and it’s not a medical treatment, it’s a quantified self approach on steroids ketones.

My guess is that the book is roughly 70% correct. If so, that’s an enormous advance.
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Book review: Seasteading, by Joe Quirk, with Patri Friedman.

Seasteading is an interesting idea. Alas, Quirk’s approach is not quirky enough to do justice to the unusual advantages of seasteading.

The book’s style is too much like a newspaper. Rather than focus on the main advantages of seasteading, it focuses on the concerns of the average person, and on how seasteading might affect them. It quotes interesting people extensively, while being vague about whether the authors are just reporting that those people have ideas, or whether the authors have checked that the ideas are correct. Many of the ideas seem rather fishy.

I suspect that seasteading’s biggest need now is businessmen and/or VCs who can start cruise-ship-sized projects. Yet the book seems aimed more at creating broad, shallow support among ordinary readers than it is at inspiring competent entrepreneurs.
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Book review: Aging is a Group-Selected Adaptation: Theory, Evidence, and Medical Implications, by Joshua Mitteldorf.

This provocative book argues that our genes program us to age because aging provided important benefits.

I’ll refer here to antagonistic pleiotropy (AP) and programmed aging (PA) as the two serious contending hypotheses of aging. (Mutation accumulation used to be a leading hypothesis, but it seems discredited now, due to the number of age-related deaths seen in a typical species, and due to evidence that aging is promoted by some ancient genes).

Here’s a dumbed down version of the debate:
<theorist>: Hamilton proved that all conceivable organisms age due to AP and/or mutation accumulation.
<critic>: But the PA theories better predict how many die from aging, the effects of telomeres, calorie restriction, etc. Also, here’s some organisms with zero or negative aging …
<theorist>: A few anomalies aren’t enough to overturn a well-established theory. The well-known PA theories are obviously wrong because selfish genes would outbreed the PA genes.
<critic>: Here are some new versions which might explain how aging could enhance a species’ fitness …
<theorist>: I’ve read enough bad group-selection theories that I’m not going to waste my time with more of them.

That kind of reaction from theorists might make sense if AP was well established. But AP seems to have been well established only in the Darwinian sense of being firmly entrenched in scientists’ minds. It got entrenched mainly by being the least wrong of a flawed set of theories, combined with some poor communication between theorists and naturalists. Wikipedia has a surprisingly good[1] page on the evolution of aging that says:

Antagonistic pleiotropy is a prevailing theory today, but this is largely by default, and not because the theory has been well verified.

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I’ve substantially reduced my anxiety over the past 5-10 years.

Many of the important steps along that path look easy in hindsight, yet the overall goal looked sufficiently hard prospectively that I usually assumed it wasn’t possible. I only ended up making progress by focusing on related goals.

In this post, I’ll mainly focus on problems related to general social anxiety among introverted nerds. It will probably be much less useful to others.

In particular, I expect it doesn’t apply very well to ADHD-related problems, and I have little idea how well it applies to the results of specific PTSD-type trauma.

It should be slightly useful for anxiety over politicians who are making America grate again. But you’re probably fooling yourself if you blame many of your problems on distant strangers.

Trump: Make America Grate Again!

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