I don’t have much time to sit down and read an actual book. When I do read the old-fashioned way, it’s usually a book someone sent me to review on the blog. Hey, I like reading and reviewing those books, but I don’t want to be limited to them. There are more fascinating books that have already been published than I could read in a thousand years … and while I plan on living to a ripe old age, a thousand years seems overly optimistic.
Since driving to and from work takes a big chunk of each week, I make the commute useful by listening to books I don’t have time to sit and read. My Audible.com library online shows that I’ve downloaded 25 books so far this year. Yup, that sounds about right, a book every other week or so. I like a variety of genres: history, economics, psychology, and of course fiction. I’m a big fan of mysteries by Jonathan Kellerman and Michael Connelly.
I rarely listen to books on diet and health, but I often find myself connecting ideas from audiobooks to the topics I cover on the blog. (I also find myself slapping the steering wheel and grumbling aloud when a fiction writer refers to foods like bacon and eggs as “artery-clogging.” Kellerman does that on a fairly regular basis.)
Last week, I posted Nassim Nicholas Taleb’s essay about what he calls the Intellectual Yet Idiot – a description very much like Thomas Sowell’s description of The Anointed, the term I adopted for the blog. These are the people who think they know better than the rest of us and thus feel qualified to impose their Grand Plans on us. Think U.S. Dietary Guidelines.
Based on recommendations from readers in comments, I listened to three of Taleb’s books in the past year: The Black Swan, Fooled by Randomness and Antifragile. I don’t remember exactly which idea came which book, but I do remember that much of what he wrote applies to health and the health sciences.
One reason Taleb is so critical of the Intellectual Yet Idiot types is that (as he explained in all three books) human beings don’t know what they don’t know and are thus lousy at predicting future consequences. They don’t consider the rare or black-swan event that can cause everything to blow up or go sideways. So they make Grand Plans and 10-year forecasts that are nearly always wrong – way wrong.
As he explained in one of the books (I believe it was Antifragile), that’s why he considers centralization (especially a big, centralized government) dangerous. Centralization amplifies mistakes. Instead of small groups experimenting with their own ideas and producing results others can learn from, we get one plan and one set of results for everyone – often bad results.
Once again, think about those Dietary Guidelines. Back in the day, people decided which foods were good for them based on something like the Wisdom of Crowds. They learned from their grandmothers, their coaches, their friends, and perhaps their doctors – most of whom were speaking from experience.
Then for some reason, The Anointed decided we needed a national nutrition policy. Medical protocols, school lunch programs, nutrition labels on foods, you name it, they were all based on federal guidelines that told us saturated fat is bad, cholesterol causes heart disease, and grains are good for us. Those guidelines were a mistake – and centralization amplified the mistake. The national policy produced a national disaster for health.
Taleb also has rather a lot to say about education and experts. Many of us believe (because we were taught to believe) that most scientific knowledge comes from academics toiling in universities. They produce the pure science, then tinkerers and entrepreneurs put that pure science to practical use.
Wrong, wrong, wrong, according to Taleb. More often, it’s the tinkerers who produce new knowledge. They tinker and tinker and find something new that works. Then the academics come along and figure out why it works. Then they run off and write their papers. As Taleb explains, it’s not necessary to understand exactly why something works to know that it does, in fact, work. For example, the guys who invented the jet engine couldn’t explain the physics. They just knew they’d tinkered their way into something that worked. Academics figured out the physics of the thing later.
I of course related that back to diet and health while listening. Think of all the dietary wisdom our ancestors carried with them. They knew they should feed their growing kids saturated fats and cholesterol. They knew they should eat fermented foods. They knew they should eat organ meats. If you asked your great-grandmother which foods make people fat, she probably would have blamed sugar and flour, not butter and lard.
Could these people cite scientific papers to support their beliefs about diet? Not likely. But they knew what works. I believe that’s an important lesson for all of us: it’s more important to find and adopt what works than to read all the science.
The “settled” science, is of course, often wrong. Taleb points out several examples in his books. I was reminded of further examples in two books by David McCullough, The Wright Brothers and The Great Bridge: The Epic Story of the Building of the Brooklyn Bridge.
Orville and Wilbur Wright were master tinkerers. They were also geniuses. When they began designing their first airplane, they consulted the established books on physics and aeronautics. They were dismayed to discover that much of the “settled” science was clearly wrong. It didn’t hold up to their own tests and measurements. So they had to toss the books and tinker their way into finding what worked.
The Brooklyn Bridge was designed by another genius named John Roebling. The bridge was a mammoth undertaking, and when Roebling submitted his plans, some society of learned engineers in New York City published a long article explaining why his design would never work. The bridge would fall down, you see. The experts cited plenty of science to explain why.
The bridge not only didn’t fall down, it now easily withstands the weight of countless cars and trucks – despite being designed for pedestrians and horse-drawn carriages. The society of learned experts was wrong, despite their scientific citations.
Does that remind you at all of current dietary science?
Another book that reminded me of diet and health topics despite not being about diet and health was Yes! 50 Scientifically Proven Ways to Be Persuasive by Noah J. Goldstein, Steve J. Martin and Robert B. Cialdini. (I know, the title makes it sound like a book on marketing and sales. Trust me, it’s more about psychology.)
One major point the authors make is that warning people about a problem without also providing a solution that works is pointless – unless your goal is to make people depressed. In fact, if you regularly offer warnings without workable solutions, people will just avoid you.
That made me think of all the morons who believe we can fat-shame people into losing weight. Doctors need to more aggressive in telling people they’re overweight, ya see (according to some health official the U.K., if memory serves.) We need to make it socially unacceptable, blah-blah-blah.
Warning people that being overweight will kill them doesn’t provide a solution. Telling them to just cut calories or go on low-fat diets also isn’t a solution for most of them. So if health officials convince doctors to be more aggressive in telling people to lose weight (i.e., engage in white-coat fat-shaming), what do think will happen? Well, studies have already shown what will happen: people who can’t lose weight will stop going to the doctor to avoid the lectures. Someone please inform Meme Roth.
The book also explains that many people are persuaded by what the authors call social proof. If everyone else seems to believe something, they’ll believe it … even if logic and experience should tell them otherwise.
I think it’s safe to say that social proof had a lot to do with the low-fat diet craze. The government experts told us we should be on low-fat diets, major media began promoting the idea, and eventually everyone seemed to believe it. Watch reruns of TV shows from the ‘80s and ‘90s, and I guarantee you’ll hear references to arterycloggingsaturatedfat! I’ve noticed at least a dozen of those references while watching Seinfeld reruns.
I like to think of myself as someone not persuaded by social proof, but apparently I am – or at least I was then. I kept trying low-fat diets, despite feeling lousy and not losing any weight. Everyone says this is a healthy diet, so it must be a healthy diet! I hope I’ve become less easily persuaded as I’ve gotten older. I’ve certainly become more skeptical of experts and authorities.
But I also believe social proof can work both ways. Not everyone has the time or inclination to experiment with different diets or look into the research, so many just follow the herd. If the herd is moving towards paleo, or low-carb, or gluten-free, that’s not a bad result.
Now if you’ll excuse me, it’s time to leave the office and drive home while listing to a Jonathan Kellerman novel. I hope he doesn’t make any cracks about bacon and eggs clogging our arteries.
I’ll be taking Thanksgiving week off from both work and blogging. Jimmy and Christine Moore will be visiting, and when I’m not socializing or playing disc golf with Jimmy, Chareva and I will put in extra time on the book. I’ve asked The Older Brother to take over the Fat Head chair if the mood strikes him.
Geez, time flies. Blink twice, and it’s another birthday.
In two years, I’ll be 60. I remember when 60 sounded old. Maybe it is, but I predict I won’t feel old. I’m 58 today, and I feel better than I did at 35. No arthritis in the shoulder, no psoriasis on the back of my head, no bouts of mild asthma, no gastric reflux, no belly aches, no restless legs or mysterious backaches at night.
I should probably send Morgan Spurlock a thank-you card. Super Size Me annoyed me, which inspired the idea for Fat Head, which led to me learning a lot more about diet and health than I’d ever planned to know. None of this — the film, the blog, the little farm in rural Tennessee, the upcoming book — was what I envisioned 20 years ago, which just proves the universe had better plans for my life than I did.
We had the family celebration on Saturday night. Tonight I’m just going to kick back and watch Monday Night Football and enjoy feeling alive and healthy and optimistic about the next 50 years.
In case you hadn’t noticed, I haven’t had much time for posts lately. The programming job, Sara’s birthday (for which she chose a family zip-lining expedition over a party), sessions with Chareva to go over her graphics for the book, trying to wrap up a script for the film version of the book … not much bandwidth left at the end each week.
This won’t be a full post either, even though it’s long. Twitter brought me an essay I believe is worth sharing. The author is Nassim Nicholas Taleb, and the essay is apparently from a work in progress titled Skin in the Game.
I first became aware of Taleb in March, when I quoted one of his Facebook posts because it seemed like a perfect comment on The Anointed. Several of you chimed in to say I should read his books, so I did, and I heartily recommend all of them.
Turns out that Facebook post was from the essay below (although I think the essay has since been updated.) Taleb asked that people who reproduce the essay do so in its entirety, so I will. The Intellectual Yet Idiot is, once again, a perfect commentary on the people who are so impressed with their own intelligence, they feel qualified to tell the rest of us how to live. Enjoy.
The Intellectual Yet Idiot
by Nassim Nicholas Taleb
What we have been seeing worldwide, from India to the UK to the US, is the rebellion against the inner circle of no-skin-in-the-game policymaking “clerks” and journalists-insiders, that class of paternalistic semi-intellectual experts with some Ivy league, Oxford-Cambridge, or similar label-driven education who are telling the rest of us 1) what to do, 2) what to eat, 3) how to speak, 4) how to think… and 5) who to vote for.
But the problem is the one-eyed following the blind: these self-described members of the “intelligentsia” can’t find a coconut in Coconut Island, meaning they aren’t intelligent enough to define intelligence hence fall into circularities — but their main skill is capacity to pass exams written by people like them. With psychology papers replicating less than 40%, dietary advice reversing after 30 years of fatphobia, macroeconomic analysis working worse than astrology, the appointment of Bernanke who was less than clueless of the risks, and pharmaceutical trials replicating at best only 1/3 of the time, people are perfectly entitled to rely on their own ancestral instinct and listen to their grandmothers (or Montaigne and such filtered classical knowledge) with a better track record than these policymaking goons.
Indeed one can see that these academico-bureaucrats who feel entitled to run our lives aren’t even rigorous, whether in medical statistics or policymaking. They can’t tell science from scientism — in fact in their eyes scientism looks more scientific than real science. (For instance it is trivial to show the following: much of what the Cass-Sunstein-Richard Thaler types — those who want to “nudge” us into some behavior — much of what they would classify as “rational” or “irrational” (or some such categories indicating deviation from a desired or prescribed protocol) comes from their misunderstanding of probability theory and cosmetic use of first-order models.) They are also prone to mistake the ensemble for the linear aggregation of its components as we saw in the chapter extending the minority rule.
The Intellectual Yet Idiot is a production of modernity hence has been accelerating since the mid twentieth century, to reach its local supremum today, along with the broad category of people without skin-in-the-game who have been invading many walks of life. Why? Simply, in most countries, the government’s role is between five and ten times what it was a century ago (expressed in percentage of GDP). The IYI seems ubiquitous in our lives but is still a small minority and is rarely seen outside specialized outlets, think tanks, the media, and universities — most people have proper jobs and there are not many openings for the IYI.
Beware the semi-erudite who thinks he is an erudite. He fails to naturally detect sophistry.
The IYI pathologizes others for doing things he doesn’t understand without ever realizing it is his understanding that may be limited. He thinks people should act according to their best interests and he knows their interests, particularly if they are “red necks” or English non-crisp-vowel class who voted for Brexit. When plebeians do something that makes sense to them, but not to him, the IYI uses the term “uneducated”. What we generally call participation in the political process, he calls by two distinct designations: “democracy” when it fits the IYI, and “populism” when the plebeians dare voting in a way that contradicts his preferences. While rich people believe in one tax dollar one vote, more humanistic ones in one man one vote, Monsanto in one lobbyist one vote, the IYI believes in one Ivy League degree one-vote, with some equivalence for foreign elite schools and PhDs as these are needed in the club.
More socially, the IYI subscribes to The New Yorker. He never curses on twitter. He speaks of “equality of races” and “economic equality” but never went out drinking with a minority cab driver (again, no real skin in the game as the concept is foreign to the IYI). Those in the U.K. have been taken for a ride by Tony Blair. The modern IYI has attended more than one TEDx talks in person or watched more than two TED talks on Youtube. Not only will he vote for Hillary Monsanto-Malmaison because she seems electable and some such circular reasoning, but holds that anyone who doesn’t do so is mentally ill.
The IYI has a copy of the first hardback edition of The Black Swan on his shelves, but mistakes absence of evidence for evidence of absence. He believes that GMOs are “science”, that the “technology” is not different from conventional breeding as a result of his readiness to confuse science with scientism.
Typically, the IYI get the first order logic right, but not second-order (or higher) effects making him totally incompetent in complex domains. In the comfort of his suburban home with 2-car garage, he advocated the “removal” of Gadhafi because he was “a dictator”, not realizing that removals have consequences (recall that he has no skin in the game and doesn’t pay for results).
The IYI has been wrong, historically, on Stalinism, Maoism, GMOs, Iraq, Libya, Syria, lobotomies, urban planning, low carbohydrate diets, gym machines, behaviorism, transfats, freudianism, portfolio theory, linear regression, Gaussianism, Salafism, dynamic stochastic equilibrium modeling, housing projects, selfish gene, Bernie Madoff (pre-blowup) and p-values. But he is convinced that his current position is right.
The IYI is member of a club to get traveling privileges; if social scientist he uses statistics without knowing how they are derived (like Steven Pinker and psycholophasters in general); when in the UK, he goes to literary festivals; he drinks red wine with steak (never white); he used to believe that fat was harmful and has now completely reversed; he takes statins because his doctor told him to do so; he fails to understand ergodicity and when explained to him, he forgets about it soon later; he doesn’t use Yiddish words even when talking business; he studies grammar before speaking a language; he has a cousin who worked with someone who knows the Queen; he has never read Frederic Dard, Libanius Antiochus, Michael Oakeshot, John Gray, Amianus Marcellinus, Ibn Battuta, Saadiah Gaon, or Joseph De Maistre; he has never gotten drunk with Russians; he never drank to the point when one starts breaking glasses (or, preferably, chairs); he doesn’t even know the difference between Hecate and Hecuba (which in Brooklynese is “can’t tell sh**t from shinola”); he doesn’t know that there is no difference between “pseudointellectual” and “intellectual” in the absence of skin in the game; has mentioned quantum mechanics at least twice in the past five years in conversations that had nothing to do with physics.
He knows at any point in time what his words or actions are doing to his reputation.
But a much easier marker: he doesn’t even deadlift.
My daughter Sara is a big fan of the comedy troupe Studio C. I’m a fan too, mostly because they do all clean comedy and I don’t have to worry about my kids picking up any interesting new words or ideas while watching. Sara occasionally puts a dozen or so of their YouTube videos into a playlist, then we all enjoy a family Studio C night.
Anyway, I think some of you will relate to this skit.
But we already knew that, right? You can hardly open a newspaper without being told this-or-that is “linked” to a higher or lower rate of cancer. Some researchers with a sense of humor decided to randomly select ingredients from a cookbook and see how many of them have been associated with cancer in observational studies. Here are the opening paragraphs from the study:
Background: Nutritional epidemiology is a highly prolific field. Debates on associations of nutrients with disease risk are common in the literature and attract attention in public media.
Objective: We aimed to examine the conclusions, statistical significance, and reproducibility in the literature on associations between specific foods and cancer risk.
Design: We selected 50 common ingredients from random recipes in a cookbook. PubMed queries identified recent studies that evaluated the relation of each ingredient to cancer risk.
A “highly prolific field” … yeah, that’s one way to phrase it. Anyway, here’s what the researchers found:
At least one study was identified for 80% (n = 40) of the ingredients selected from random recipes that investigated the relation to cancer risk: veal, salt, pepper spice, flour, egg, bread, pork, butter, tomato, lemon, duck, onion, celery, carrot, parsley, mace, sherry, olive, mushroom, tripe, milk, cheese, coffee, bacon, sugar, lobster, potato, beef, lamb, mustard, nuts, wine, peas, corn, cinnamon, cayenne, orange, tea, rum, and raisin.
We found that 80% of ingredients from randomly selected recipes had been studied in relation to malignancy and the large majority of these studies were interpreted by their authors as offering evidence for increased or decreased risk of cancer.
So darned near everything causes or prevents cancer.
However, the vast majority of these claims were based on weak statistical evidence.
No kidding. But I’ll bet most of them also led to big headlines.
At least okra doesn’t give me the munchies.
This is an old CNN story, but only came to my attention recently when a reader warned me that Chareva’s okra might lead to a raid by cops.
The grower was alarmed when the police helicopter swooped low over his property.
Soon, Bartow County, Georgia, deputies — “strapped to the gills” and with a drug dog in tow — converged on his doorstep. They had the grower dead to rights.
Except the plant that the chopper cops had spotted from the air was … okra.
The helicopter was combing the area in search of cannabis plants when it came across the five-leaflet okra plant, the station reported. Marijuana plants can have anywhere between one and 13 leaflets per leaf, depending on maturity and health, but they generally have seven or nine.
“It did have quite a number of characteristics that were similar to a cannabis plant,” Georgia State Patrol Capt. Kermit Stokes told WSB.
If you haven’t already heard Kermit the Frog in your head, explaining how okra looks a lot like marijuana, something went very, very wrong in your childhood.
“Here I am, at home and retired and you know I do the right thing,” Perry told the station. “Then they come to my house strapped with weapons for no reason. It ain’t right.”
Upon realizing that it had dispatched officers to confiscate a popular gumbo ingredient, the Georgia State Patrol, which operates the task force, issued an apology, both to Perry and publicly.
I’ll bet Mr. Perry was so annoyed with the cops, he gave them each a bag of okra.
Spread the news: Butter may not be the unhealthy food many Americans believe it to be, new research suggests.
“Overall, our results suggest that butter should neither be demonized nor considered ‘back’ as a route to good health,” study senior author Dr. Dariush Mozaffarian, dean of the Tufts University School of Nutrition Science and Policy in Boston, said in a university news release.
The new study was funded by the U.S. National Heart, Lung, and Blood Institute. Mozaffarian’s team reviewed data from nine studies that included more than 636,000 people living in 15 countries.
The findings showed that eating butter was only weakly associated with increased risk of premature death and not associated at all with heart disease. There was a slight association with protection against diabetes, the study found.
I’m sure those findings won’t surprise you. Unfortunately, this probably won’t surprise you either.
One nutritionist said her views on butter remain unchanged, however.
“Despite the findings of this study, I am not about to make a huge shift in the recommendations I make about consumption,” said Dana White. She is a dietitian and professor of sports medicine at Quinnipiac University in Hamden, Conn.
“Butter remains a very high-calorie and high-fat food with little nutrient density to offer, and therefore still needs to be consumed in strict moderation,” White said.
In other words: I’ve been telling people to strictly limit their butter intake for years, and I’m going to keep on doing it, no matter what the evidence says.
Head. Bang. On. Desk.
The FDA plans to poops all over poop transplants.
If you’re a regular reader, you know I think our government’s regulations are often full of poop. So it seems rather appropriate that a branch of the government wants to regulate poop, as reported by BuzzFeed.
Gastroenterologist Colleen Kelly performed her first poop transplant eight years ago, on a young woman with a life-threatening gut infection who had run out of options. The bacterium Clostridium difficile had invaded the woman’s gut, bringing her constant diarrhea and pain, and antibiotics weren’t working.
Kelly’s patient persuaded her to try a fecal transplant, in which poop from a healthy person is put into a sick person’s colon in the hope of resetting the mix of microbes there. The patient’s boyfriend provided fresh stool, and Kelly introduced half a cup of it into her patient via a colonoscopy. To Kelly’s surprise, it worked — by the next day, the woman’s symptoms began to wane.
Kelly, an assistant professor of medicine at Brown University, has since performed some 300 fecal transplants for C. diff infections. These days, she usually buys healthy stool samples from OpenBiome, a nonprofit “stool bank” in Somerville, Massachusetts that launched in 2013. “It’s really unlike any therapy to date,” she told BuzzFeed News.
So this spring, when the FDA announced that it intended to tighten its rules on the procedure, known as fecal microbiota transplantation (FMT), making it harder for doctors to buy stool from banks, Kelly was among the commenters who wrote back, opposing the proposal.
It’s the typical pattern. People working in a profession find something that works. Businesses spring up to provide that something at a reasonable price. Then the feds, seeing something successful happening that they don’t control, step in to regulate.
“If the FDA makes it prohibitively difficult for clinicians to work with stool banks, I believe this will actually make the procedure less safe, and of course, less accessible,” wrote Sarah McGill, a gastroenterologist at the University of North Carolina Medical School who has performed about 30 fecal transplants on C. diff patients in the last two years.
Yes, of course that’s how it will play out. If I’ve said it once, I’ve said at least twice: most of the “protect the public” regulations that come along are backed by businesses who want to leverage the coercive power of government to stifle their competition. Public safety is merely the excuse. The BuzzFeed writer, unlike most media writers, actually understands that.
But one company, at least, welcomes more government regulation of stool. Rebiotix, a startup based in Minnesota that is developing an enema treatment of bacteria extracted from poop, told the FDA to shut down the stool banks and adopt the strictest regulation possible in dictating how samples are procured. The company contends that this is for the patients’ own good, as stool banks may not be fully screening their samples for diseases.
And now for the real reason …
Rebiotix is also worried about its bottom line. If the company’s poop-like drug for C. diff makes it through the rigorous clinical trial process before anybody else, it would win the rights to be an exclusive seller of the product for seven years, gaining a huge lead in a market expected to be worth $1.5 billion by 2024.
Anyone who tells you the FDA is imposing this limit on patient choice to protect the public is full of unregulated poop.
It’s been a bit busy around here, what with the full-time job, trying to make progress on the book and film, four extra people living in the house, etc., etc.
I thought I’d finally have time tonight to write a post I’ve had in mind, but a client discovered a little bug in a software package I sell to law firms. Fortunately, the client is also my best friend of 40-some years, so he told me about the bug over dinner and a couple of beers, as opposed to, say, in an angry email.
Now that I know I’ve got a bug, I feel obligated to track it down and kill it as soon as possible … before a less-chummy client runs across the same issue. So there goes my evening.