Slicing The Bologna

If there are not hundreds there are at least dozens of newsletters and websites devoted to health advice. People are told to get their cellular telomere length assessed, to only shower with filtered water as municipal water causes cancer, the letters warn about estrogen overload due to contaminated water, why soy prevents breast cancer, why it causes breast cancer, why less water is better than more water, how Indian Yogas live without exercise and why the Tarahumara of Mexico live so long because they run and exercise all of the time, why vegan is best, why being a carnivore is our true genetic history and healthiest destiny, vitamin C prevents colds, lycopene prevents prostate cancer or causes it, calcium is good for bones but causes heart attacks: I could go on for page after page with all of the advice and its variants. You pays yer money and you takes yer chances.
Can they all be right, can they all be wrong, can they all be irrelevant? I vote for the latter. Here is why.
There is a spectacular, even mystical, correlation between the structure of mathematics and the physical world. It is only by virtue of the apparent mapping of mathematical systems onto physical reality that we have confidence that the world not only makes sense but  that we have the capacity to understand it. Have some crazy theory of everything, conjure a formula that expresses it, test it against the world, and sure enough reality seems to conform to the formula. Thus begins the presumption of the ‘scientific mind.’
Our empirical endeavors, our research, lays bare the quivering innards of life; follow that data and we can know what is true. Or so we think. But first notice there is a vast difference between discovering the standing stones of Easter Island and understanding Newtonian mechanics or even how insulin works. Following the thread of difference is rarely done, especially by the advocates of medical science and pseudoscience when the findings of medical science are urged on the public. Or even the findings of herbalists and chiropractors. Everyone has an opinion and some have validity. But usually not.
So for now start here: the way tensor calculus describes gravity is not, I repeat, is not like the relationship between fish oil and heart attacks. Cholesterol is up, or down, in no way establishes a causal link between that fact and the incidence of heart disease in a population. Were it that simple the populations that have higher cholesterol levels than Americans, there are several, would have higher heart disease risks, or not, and they don’t. And, it isn’t this simple either; which is my point. We do not have an adequate experimental model for humans, Guinea pigs either, to enable us to draw conclusions or make predictions about links between almost all biological variables and disease and death. The exceptions are so large scale and obvious that they barely need thought much less ‘science’ to account for them; examples are crude to silly: cancer kills, morbid obesity is unhealthy, paraplegia makes walking difficult. Even here there are exceptions. Any honest doc knows he has some very healthy fat people in his practice and cancer doesn’t always kill.
Sometimes the difference between physics and biology is assigned to the distinction between the categories of deductive reasoning and inductive reasoning: top down thinking versus bottom up thinking. Unfortunately there is no such clear distinction even within physics and biology broadly understood. You still need the apple to have hit Newton on the head, inductive experience, for him to have begun or understood the quest for the deductive thinking evidenced by Newtonian mechanics. Part of the problem is that biological systems are messier, or at least from our angle of view are messier, than the order of nucleogenesis and stellar evolution. Connections are obscure and patterns can be misleading. Let me give you a simple concrete example: for decades we have been urged to take aspirin to lower the risk of heart attack and stroke. OK. This was seen as particularly important in diabetics who have a higher incidence of those problems. Well, recent ‘research’ has shown that for most diabetics the risk of hemorrhagic stroke versus ischemic stroke out weighs the benefit and aspirin is no longer  advised from many in this category. Of course some ‘researchers’ demure and others advocate an even broader ban. Aspirin’s role for the general population has undergone new scrutiny, with some- remember this has been long standing conventional wisdom- advocating no longer using aspirin even in the setting of otherwise healthy populations. Then again, recent ‘research’ has shown that it is a great idea for primary prevention: those with no known pre-existing conditions. Back to the ‘lowers the risk of cancer, stroke and heart attack.’ Unless, of course, you are one of those who bled to death from the aspirin or have kidney damage from aspirin or underlying chronic gastric reflux exacerbated by aspirin. If you woke up dead from taking aspirin, no one denies this happens to some, and were offered the reassurance that it also prevented someone else’s heart attack only your ennobled soul would keep you from feeling like someone tricked you into taking something you didn’t need. This examples illustrates the category of unintended consequences; the uselessness of counterfactual speculation. Don’t be a victim of this.
Well once again I’ve dug into a topic far too big for this blog but I have tried to sketch out a way for you to understand my skepticism about almost all claims of supplements, health scares, magic cures, and the industry of health newsletters and advice. Well, OK, I guess you could call my blog a ‘health newsletter’ but I certainly hope it is somewhat different in this essential respect; I am selling a kind of ‘common sense’ rather than supplements and health scares.
Even in the case of cancer, being exposed to carcinogens is not new; the earth has always had them and in one way or another they have always been part of the environment; witness to this is how well adapted our liver and immune systems are to this threat.
So, for now, back to the health newsletters: they are completely irrelevant to downright harmful. So far as they take your eye off the ball that matters, the simple things, they both worry you about what should not and distract you from doing that which you should. By the time you are eating right, exercising right, relaxing and smiling more you have done the things which are orders of magnitude more important, more powerful, than all of the nit picking dos and don’ts of any health newsletter I have ever seen. And my patients make sure that I’ve seen most of them.
If you spend one moment buying selenium tablets that robs you of an additional second of preparing healthy food you have lost what might have been gained. All of the time you spent searching the Internet for the latest ‘magic bullet’ of health could have been spent listening to Mozart’s Requiem.
There are some prime actors, some prime movers, powerful fulcrums of health. Attend to these and almost everything else will follow. Even if there is anything in all of the detailed advice and warnings it is of the order of painting black rather than red the fulcrum under a lever rather than lengthening the lever or increasing the height of the fulcrum. I’ve too often had the experience of a diabetic in poor control telling me about their tumeric supplements even as they noted how small was their serving of Tiramisu. This is silly, this is irrational. As long as there are those buying, if by no other means than newsletters, such advice there will not be enough silence to hear simple truths. In silence understand this: eat whole, real food, exercise in a way to increase heart rate variability, improve joint integrity and increase mitochondrial power, sleep well and long, breathe, and know peace. All else will almost surely follow.
Smile, Have Fun, God Speed,
Dr. Mike

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