The Primal Blueprint: An Epistemocratic Map for Health Decision Making

Maps matter.

Especially in cognitive psychology (thanks to Dave Lull).

In practice, cognitive maps for decision making don't tell you where to go or how to navigate in every specific case or at every point in time; instead, they provide sign posts, indicators of contours and textures, notes about landscapes, and other framework-related notions such as social-scaffolding nodes, platforms, outlines, and forewarnings. Maps provide information for people to make choices in their particular situations: maps serve as choice architecture.

But that does not mean that all maps are created equal. It also does not mean that all maps are useful. Personally, when given the choice, I prefer to move about the world without a map rather than to rely on the wrong map: I don't want a false-sense-of-security or a false-confidence in the wrong map to lead me off the edge of a cliff like a lemming. Rather, I want a map that assists me in negative Black Swan avoidance while positioning me with exposure to the envelope of serendipity so that I can capture positive Black Swan hits along the way.

When I reflect about health(care), fitness, nutrition, medicine, and beyond, especially when I compose essays, I tend to focus on big-picture concepts and try to avoid too many details. Why? Simple: For a long time, unfortunately, I studied the details of Conventional Wisdom maps extensively, in much depth, and then I made decisions in accordance with these 'facts'. The net result: chronic inflammation and nagging illness. Why? Because I had the wrong maps. Using Conventional Wisdom maps diligently as decision-making tools did not help me navigate grocery stores, restaurants, gyms, medical offices, hospitals, etc. in healthy ways. Frankly, I got lost--really lost--using these deceptive, misleading maps to inform my choices. That platonic Food Pyramid triangle served as the (broken) compass on many of these maps, and chronic cardio filled in the borders: a catabolic recipe for disaster.

What did I learn? I realized, through successive hard knocks, that I had falsified these Conventional Wisdom maps. I learned that no matter how many details I know about a particular map, those details will simply lead me astray if they aren't embedded in the right map in the first place.

Better maps do exist.

A few years ago, I--luckily, thankfully, and serendipitously--stumbled upon some better maps (the stars aligned, so to speak): The Black Swan by Nassim Taleb, Evolutionary Fitness by Art DeVany, and The Primal Blueprint by Mark Sisson (Nassim tipped me to Art; Art tipped me to Mark; the rest is history). What did I do with these epistemocratic maps that countered Conventional Wisdom in everything from physiology to finance? I learned that, as Nassim likes to say, "The best way to cut a diamond is with a diamond." We need new narratives to displace falsified narratives; we need new stories to live by that help us survive and then thrive in modern times. I learned that we need new maps. In response, I constructed my own m=1 my-thologies (captured under the Ancestral Fitness epistemocracy mythology umbrella) that compelled me to conduct n=1 self-experiments: I operationalized my thinkering model for biotechnology by running Patient of One clinical trials on myself in my local ecology. While conducting these tests, I searched rigorously, openly, and honestly for 'chinks in the armor'--I tried to falsify the hypotheses and conjectures that my personal interpretations of these new maps generated. So far, I have falsified, in the case of my personal physiology, some of these hypotheses/conjectures: I don't eat fruit anymore, for instance, suspecting that I struggle, like many folks of European descent, with fructose malabsorption; I also don't consume much wine, only rarely for an ongoing experiment with hormesis, for the same reason, given that, as Dr. Lustig at UCSF concludes, alcohol and fructose are metabolized in parallel fashions. Yet, despite setting out to falsify--disprove--the ideas suggested by Evolutionary Fitness and The Primal Blueprint, I have yet to experience many data points that would suggest I should not continue to inform my lifestyle decisions with the support of these practical, flexible, and insightful maps. As a result, for the foreseeable future, these maps will remain critical parts of my 'tried-and-true' health and fitness portfolio, providing the Barbell base upon which I will continue to tinker, thinker, and self-experiment in lifestyle design.

Thus, in the Thanksgiving spirit, I want to say, as I did at BIL:PIL when I spoke about Nutritional Bricolage, that I am thankful to Mark Sisson for turning his personal m=1/n=1 voyage into a map that empowers others to self-experiment safely and effectively. We must remember that all maps are mythologies--the Hume/Popper/Black Swan et al. problem of induction suggests this much--and there is no distinction between fact and fiction in reality: everything is fiction--we've just falsified some 'fictional' statements while others remain yet-to-be-falsified. In this context, the vibrant Grok archetype (contrasted with the unhealthy Korg anti-archetype) that Mark develops in The Primal Blueprint is tremendously valuable because this fictional character and the associated question of "What would Grok do?" help us engage in bricolage in our own lives and then falsify/disconfirm components of our regular health habits that do not support the optimal epigenetic expression of our physiologies and biochemical individualities. It's ancestral mimicry, where useful and fruitful, and it's how humans have learned and developed for many, many years. Like I have said before, "We'd be wise to learn from our ancestors," and this concept permeates Mark's wonderful work in so many ways. That should, at least, be our default, and the burden of proof should be on more recent developments to prove their value in our lives.

Defaults matter.

I default to learning by grace (as much as possible).

Since I find much value in the following proverbial statement that I learned from my mom, "We can learn by grace or by hard knocks," it is no surprise that the following quote is one of my favorite snippets in Mark's book: "The wise man sees in the misfortune of others what he should avoid"--Marcus Aurelius, Roman Emperor (121-180). In line with this thread, The Primal Blueprint supplies ample negative advice, what we shouldn't do, such as "Avoid Poisonous Things" and "Avoid Stupid Mistakes" (which sounds like negative Black Swan avoidance to me!).

My hard knocks with health (migraines and sinus infections) and fitness (achy joints and catabolism) resembled Mark's in so many ways that I needed little justification to experiment on myself based upon his lessons-learned over the years: we both beat ourselves up with chronic, excessive endurance training, fueled on grains, only to realize that there had to be a better, healthier, more enjoyable way. Today, I am so very thankful that I took the Primal Challenge spirit and put it to practice a few years back--my life has transformed in so many positive ways as a result.

I'll stop here, hoping that I have enticed you enough to read The Primal Blueprint as a research-rich resource full of 'grace nudges'--a bottom-up map (blueprint), born out of real-world experience, that will help you make health decisions amidst the minefields that are our contemporary ecologies.

I also hope The Primal Blueprint map displaces Conventional Wisdom maps expediently.

Because maps matter.

Time to build your own m=1/n=1 map from the ground up.

Time to bricolage.

Grok on!

To good health,

Brent

Ancestral Fitness MeetUp: Mark Sisson

Ancestral / Primal Fitness MeetUp @ Intelligentsia Coffee Bar in Venice Beach today (11/23/09).

Pictured: Aaron Blaisdell, Mark Sisson, Chris Owens, and me.

Good coffee. Good conversation. Good laughs. Good times.

To good health,

Brent

A Lifestyle-Based Co-Op: A Promising Model for Healthcare Financing

Thanks to Dr. Doug McGuff, author of Body by Science, an excellent conversation emerged in the comments section to my recent essay, "Black Swan Health Policy: What's in a Domain?"

Head over there, either by scrolling down or by clicking here, read the original essay and the associated comments conversation melody, then watch my extra thoughts here:

My positive Black Swan treasure hunt will not cease.

The Ancestral Fitness Epistemocracy (AFE) Anti-Health Insurance Co-Op will remain a Blogosphere reality, a working component of the evolving evolutionary mythology for the Patient of One community.

Alternative universe dynamics do come true.

But, the more we standardize something, as we like to do in education and in healthcare, the more we drown out curiosity and creativity. The lifestyle-based co-op model for financing healthcare could be a disruptive innovation that helps supplant United, Aetna, et al. mainstream health insurers from their monopsonistic power positions. We just need enough wiggle room, amidst the miles of red tape and towering barriers to entry that are now so steeply entrenched and in place, to operationalize this concept in some way.

So, we will continue to write because, somehow, we have faith (hat tip to Dave Lull) that we could, one day, set things right.

MLK had dreams; I have dreams; we all have dreams.

Dreaming is part of our ancestry.

And, it's part of the Ancestral Fitness Epistemocracy (AFE).

To good health,

Brent

(*Note: This post is part of Prevention Not Prescriptions Tuesday)

Making the Unseen Seen: We all can be scientists in the art of self-experimenting

Scientists seek the unknown: they venture into the unlit, unexplored caverns of our world by conducting experiments to learn more about how the universe, including all of its inhabitants, works or doesn't work. They map out the complex, uncertain landscapes of our ecosystems based on the results from those trials. Uncovering system dynamics in this manner requires bottom-up, quasi-blind, trial-and-error because scientists don't know what they are actually looking for a priori. Before the "invention" of the wheel, the wheel was an unknown entity--no one knew it existed--but after someone stumbled upon it, the unseen became seen, and scientific breakthroughs proliferated from there, from the bottom up. Human beings have engaged in this humble tinkering process for millions of years; it's how we survived the course of evolution using creativity. Luckily, our ancestors took seemingly unconnected data points and linked them together in novel ways to drive the development of technological innovations (Nassim Taleb's positive Black Swans): taking the notion of a wheel and applying it in the construction of the wheel-barrel, as one basic example.

In this context of discovering the unknown, there are no experts because you cannot be an expert in something that we don't know exists. If we define science as the field that attempts to uncover the unknown, then there are no real experts in science. Hence, we can all be scientists trying to make the unseen seen--we all can bricolage--that is, we all can tinker with whatever happens to be available in our local ecologies and run our own small-scale experiments, just as someone did with a round-shaped object that existed in nature prior to the "invention" of the wheel. As Seth Roberts, a self-experimenter, says, "Everything starts somewhere; somewhere small." In health affairs, thus, where challenges with various diseases and illnesses abound, we can all start somewhere small and run our own self-experiments, shedding insightful light on medical darkness by learning from our own bodies, by listening to feedback from our own physiologies. The cures to our modern health problems will not come from the top down; instead, they will emerge from the bottom up--they will bubble up serendipitously, most likely unexpectedly. By diversifying science efforts broadly across many small-scale experiments and research studies, we increase our chances of striking "Eureka!" and "Ah Hah!" moments that provide preventions and treatments to debilitating conditions like neurodegenerative maladies. If each of us views our own body as a chemistry flask and our local ecosystem as an open anthropology lab, then the number of people engaged in bottom-up science would multiply rapidly, and our likelihood of progress would increase exponentially. Many n=1 self-experimentation Patient of One clinical trials would prove more fruitful than a few large-scale, n=many, studies because we solution-search in more directions when we each tinker in our own unique ways.

But self-experimentation seems risky--and it can be if not done properly--so we must approach it strategically. One practical way around this hurdle is to self-experiment with nutrition since we already do this anyways, whether we recognize this reality or not, every time we shop at the grocery store and then cook our meals--these are mini-experiments in basic metabolism biochemistry. So, we could each engage in nutritional bricolage as our self-experimental efforts to elucidate the dietary effects that foods and beverages have on our own conditions and health states. Remove a certain food from your diet; see what happens. Add another food or drink to your diet; see what happens. Catalogue your observations, as scientists do, and then analyze the results to draw conclusions. Eventually, you may try generating hypotheses too. Personally, I stumbled upon a cure for my migraine headaches and sinus infections this way. Drugs and mainstream medical therapies did not save the day; at least not for me. I removed foods from my diet that caused inflammation--namely, I reduced my exposure to sugar toxicity and countered by engaging in healthy hyperlipidity (my diet now consists of roughly 70% lipids from saturated animal fats and from a hearty-friendly ratio of omega-3 to omega-6 fatty acids)--and my symptoms disappeared quite rapidly, thankfully. This experience solidified for me the power of n=1 tinkering: we can all play active roles in shaping the future of our well-beings when we nurture and approach the thinkering process in the right way ecologically.

From this reference frame, I recognize the clinical wisdom of any institution, ranging from individuals to research centers to foundations (such as the Myelin Repair Foundation), that support bottom-up science and experimentation philosophies. By focusing on non-top-down approaches, these entities diversify their solution-searching efforts for prevention and treatment modalities, which is critical for the survival chances and health robustness of any ecosystem, whether in medical research, financial investments, personal wellness, or other areas of life. Discoveries in science are not controlled centrally by "experts" through top-down engineering and design from on high; rather, they are driven by humble scientists (people) who recognize the limits of being human, do fail--often many times--along the way, but fail fast, recover, learn from their negative results (deductivism), and then forge forward with renewed vigor and insatiable curiosity so that they can one day savor that moment--that sweet success--when they make the unseen seen and discover life-changing things--in the spirit of the wheel discovery--that prevent or treat our painful, previously-incurable health maladies.

We are all experts in at least one thing, our own bodies, so we can all participate in science through self-experimentation: we'd be wise to embrace this empowering reality and start thinkering!

To good health,

Brent

(Warm thanks to Dave Lull for editing assistance; thanks to Justine Lam for prompts and feedback)

Black Swan Health Policy: What's in a Domain?

What's in a domain (name)?

Hopefully, a bit of Black Swan health policy.

Of course, I know it's a dream; a dream to make the unseen seen.

But I do own a domain (thanks to Navanit Arakeri) -- AncestralFitness.com -- that I'd like to build out iteratively, without any deadlines or rigidity, in order to operationalize Physiological Economics in some capacity.

So I am thinkering of ways to use it most effectively.

In some shape or form, I want it to involve elements of Black Swan health policy--such as an anti-health insurance co-op, as one potential possibility--because that seems like the logical next step to me. The Ancestral Fitness Epistemocracy (AFE) is coalescing on the periphery quite nicely, and I have been listening intently to this online collaborative communication melody, and I suspect that it would be a semi-travesty if we did not, at some point, attempt to organize this genuine positive energy in a creative manner to somehow influence health policy constructively. However this spirit of influence manifests is fine with me--after all, it's a bottom-up, spontaneous-order epistemocracy, and I am open to everyone's valuable and distinct my-thologies.

And there are many perceptive leaders--like Art DeVany--who entered this vibrant health and fitness space well before me, so I want to respect everyone's territory, autonomy, and unique approaches to mythologizing and tinkering. But for those who are interested in joining me, send me your thoughts and ideas on how best to cultivate this emerging epistemocracy so that we can bubble up as many positive Black Swan hits as possible from the envelope of serendipity.

To start this process rolling, here are a few of the basic 'choice architecture' social scaffolding nodes that I envision currently:

• A sign-up form/petition section where folks can sign their names and leave comments as a way of expressing interest in joining the AFE Anti-Health Insurance Co-Op should this dream ever become a reality.
• An information page that explains this Co-Op concept, like MediShare does.
• A page that captures all the active Bloggers in the AFE in one place.
• A Wiki-type platform that is an open Web-book: that is, anyone can write this book. It would be the ultimate user/community-authored book. People could share their self-experimentation experiences--that could be one chapter--share foods and drinks and fitness links--another chapter--etc.

In the interest of avoiding information toxicity, this project must be deployed and implemented strategically--the last thing we need is an echoing chamber that lacks novelty. We must aim for novelty. Thankfully, Jeff Erno and a few other comrades have already agreed to assist me.

In addition to blogging sporadically, I already co-own and co-operate--with a few close friends--a company called Academic Impact (Ai) and a non-profit program called Game Plan Academy (GPA), so working via Nassim Taleb's dentist-writing-novels-on-the-weekend model seems apt, reasonable, and sustainable to me: there's a novel out there that needs to be written, so you starting writing, with no completion date or timeline in sight, because you enjoy writing--you feel compelled to write. For example, years ago, as early as middle school, I expressed passion and interest in child development as part of my future 'career' (life) goals, never imagining, at that point, that I would end up mentoring youth in the wonderful, fulfilling roles that I currently do. Life tends to work out that way, interestingly.

So, here are some thoughts--some of it is 'old hat', of course--to accompany this dream (warm thanks to Aaron Blaisdell and to Dave Lull for offering feedback on this working-draft essay piece):

Black Swan Health Policy: Healthcare Financing & Nonlinearities

Healthcare dynamics in the United States reflect some troublesome nonlinearities that health policy efforts must address creatively. To frame this problem, consider an alternative universe, a world devoid of chronic illness. The metabolic syndrome is foreign there. People rarely get sick, luckily, but when they do, they suffer from acute bouts of illness that modern medicine responds to quite rapidly. Occasionally, poor health conditions linger longitudinally, but for the most part, chronic conditions do not exist because people fuel and expend energy ancestrally by self-experimenting with ancestral mimicry.

Now consider our contemporary world, where linearity in disease courses continues to increase in prevalence exponentially: preventable chronic illness consumes an ever-increasing majority of our healthcare expenditures--that's a troublesome nonlinearity. In this context, it's imperative that we implement healthcare policy foundations and frameworks that support, facilitate, and drive the re-evolution of medical diseases back to acute, rare, catastrophic health events. Chronic disease medical care plagues--overwhelms--our current healthcare delivery and finance system immensely, and (largely) preventable conditions like diabetes, various heart maladies, hypertension, obesity, stroke, and others, which act on patients each and every day in repetitive, constant, linear ways, consume most (>80%) of our healthcare resources and are stressing our medical services bandwidth extensively: currently, our bodies, collectively, are 'too-far-broken' for our medical practitioners to 'fix' effectively. The real fix is to reduce the prevalence of chronic, linear and repetitive illness in society and return disease events back to their rightful status as rare negative Black Swan strikes.

In his splendid book, The Black Swan: The Impact of the Highly Improbable, Nassim Taleb examines the nonlinear, power-law nature of high-impact events. If we model illness--such as trauma or other highly-improbable, unexpected medical events--as negative Black Swan hits, an approach to health policy and administration emerges with far-reaching implications: health insurance must be re-designed as real insurance (a product/financial instrument that we are incentivized and compelled to avoid using); that is, it must protect us financially against catastrophe and bankruptcy from unexpected, unfortunate health risks, but it must not pay for regular, chronic, and linear day-to-day medical care. Right now, our healthcare system does the inverse: we pay first-dollar coverage for linear, non-insurable health events, where paying out of pocket and acting as a 'consumer' are appropriate, but we fail to prevent bankruptcy and cover catastrophic, nonlinear health strikes fully, when and where 'shopping' and worrying excessively about the prices of health services are not appropriate or socially desirable (we surrender some agency to our entrusted medical professionals in these cases).

We must invert this approach to financing medical care; we need the opposite nonlinearities. High-deductible health insurance plans, scaled according to wealth/income/ability-to-pay could help accomplish this task. By requiring patients to pay out-of-pocket or through savings from health savings accounts for their linear, routine medical care, patients would respond to this appropriate personal responsibility feedback landscape by searching actively for ways to prevent and heal their chronic illnesses like obesity and diabetes (perhaps, they would examine their lifestyles more closely and would reflect on how they fuel their physiologies and expend energy regularly). Then, as linear, chronic illness declines in prevalence as a result of healthier (ancestral) lifestyle choices, diseases would look more and more like nonlinear, unexpected, and unfortunate (and some unavoidable) negative Black Swan hits--events that we could roughly anticipate, on a larger scale, like car accidents, and turn into Grey Swans that we could insure against sustainably. In this evolution process, we would 'kill two birds with one stone': the robustness of our collective health states would increase exponentially--we would traverse the medical system much more cautiously, attempting to prevent illness in the first place--and our ability to pay properly for medical care would be restored, allowing us to avert a healthcare system collapse like our financial system recently experienced.

When it comes to financing medical care, insurance can't pay for everything: medical services should be distributed nonlinearly, but in an inverted power-law manner than they are currently, with most (about 80-90%) of medical events representing small, routine preventive types of services (including things like ancestral nutrition) that patients could and should pay for as market-price conscious shoppers/consumers, while providing bankruptcy-protection against the few (~10-20%) medical events that are catastrophic, high-impact, acute, and high-cost--this is where modern Western medicine thrives and helps us survive. No more donut holes or gaps in coverage; we need clean breaks. Scaled high-deductible, catastrophic insurance approaches support this healthier, more financially and operationally stable distribution of national healthcare expenditures. It's an application of nonlinear dynamics to health policy, and it's the power-law prescription for a flourishing healthcare system in the 21st century.

Sometimes alternative universe dynamics do come true.

So, then, what's in a domain?

Well, I hope there's more than just a name.

But if not, that's alright.

The name Ancestral Fitness Epistemocracy is now part of my m=1 my-thology.

It's existence makes no difference, ultimately, for me, because I will continue with my n=1 self-experimenting bricolage for the rest of eternity.

I will continue with ancestral mimicry.

That's simply how I enjoy living.

By mythologizing and searching for epistemocracy ...

By thinkering on the periphery.

To good health,

Brent

Thinkering: A New Model for Biotechnology

There's a Biomedical Mutual Organization (BMO) taking shape.

I suspect William Baines and Seth Roberts would agree.

It may still be in the start-up stages, but it's building momentum as we speak.

I envision, perceive, and actively participate in (thankfully and luckily) an intriguing and innovative Ancestral Fitness Epistemocracy (AFE) that is coalescing on the periphery in the Blogosphere.

I suspect Nassim Taleb would agree.

From m=1 my-thologizing thought-experiments to n=1 tinkering self-experiments, Patient of One clinical trials provide a new model and modus operandi for biotechnology in the Information Age: t h i n k e r i n g.

Thinking + Tinkering = Thinkering

It's an artistic, practical, and real-world bricolage of searching and acting--a meritage for taking Theory to Practice--and it's unveiling and uncovering wisdom in the clinical practice of leading lives where we thrive.

Carlos Rizo--mi amigo de Innovation Cell--and I started tinkering with thinkering awhile back, behind the scenes, and since then, some of our concepts, ideas, and hypotheses have come to fruition interestingly, bubbling up in various forms, such as my presentation on Nutritional Bricolage at BIL:PIL a few weeks ago.

So the initial inertia is not insurmountable and the ongoing momentum is building: we just need to ensure that we capture it and channel this positive energy effectively so that we blaze these new frontiers and pathbreaking trails in a manner that allows everyone to benefit from our trial-and-error collectivities.

Remember: We can learn by grace or by hard knocks--let's choose grace.

The Ancestral Fitness Epistemocracy (AFE), as a highly-diversified, graceful community of self-experimenting deductivists connected through the power of the Web, acts as a self-funded biotechnology 'company': various bloggers are cataloguing--as Sextus Empiricus and members of the Empiric School of Medicine did--their self-experimentation hypotheses, observations, results, and conclusions and then sharing them openly and honestly with the world.

With falsification and the history of science, the history of medicine in mind, we must not forget the Black Swan reality that PubMed is an Anthology of Mythologies. Research studies, of all shapes and sizes, suffer from various biases, statistical limits, errors, and misinterpretations, but they do serve as good narratives--abstracts are like short-stories--for fueling thought-experiments that could potentially motivate self-experiments. The statistics of individuals--n=1--trumps the scant observation of many because all that really matters is what works, what doesn't work, and what else is possible in our own specific cases. Different ancestral lineages and genetic backgrounds, biochemical individuality (*see Roger Williams, hat tip to Dave Lull), aesthetic preferences, cultural nuances, religious traditions, sensory perceptions, etc. all point to the far-reaching implications of individuality that we must respect, at some point, and then operationalize by systemically exposing ourselves to the envelope of serendipity. In this context, it takes m=1 my-thologizing to surmount inertia--to serve as venture capital--and then it takes Barbell-framed n=1 self-experimenting to gather, maintain, and build momentum throughout a Patient of One clinical trial. It's the physics of thinkering, Richard Feynman style, of course.

So what does this thinkering process look like in practice?

Well, I conduct--as Einstein did--thought-experiments as I interact with the various textures of this world in my local ecology, and these active reflections--like a stream of consciousness--often go something like this: A cell membrane--what I call the epigenetic Cell MemBRAIN--is composed of a phosphoLIPID bilayer, and cholesterol is embedded in this bilayer as an integral structural component that contributes mightily to membrane fluidity and many other things. In fact, without phospholipids, life would not be possible as we experience it today because phospholipids permit the formation of a micelle, an entity which separates the contents of the inside of a cell from the outside of the cell, allowing a cell to control its internal environment through mechanisms like selective permeability, despite fluctuations and changes in the external ecology. Cholesterol and (good) lipids don't seem harmful to me in that context; on the contrary, they seem quite critical and functional. What else do I know about cell composition in relation to lipids? Well, nerve cells, like the ones in my brain that intake, process, and signal vital information throughout my body, are composed primarily of lipids. That's interesting: our brains are mainly made of lipids. And what do neurons do? They conduct electrical signals. How do those electrical signals move? They jump between Nodes of Ranvier along the neuron's axon, speeding the conduction of electricity immensely, thanks to electrically-insulating myelin sheaths. Myelin sheaths are almost entirely (~80%) made of lipids, and many neurodegenerative diseases like Multiple Sclerosis are linked to degradation of the myelin sheath--that means the erosion of lipid structures in nerve cells. Myelin repair (*see the Myelin Repair Foundation, thanks to the awesome Justine Lam who wore Vibrams to BIL:PIL and worked on the Ron Paul campaign) is a ripe area of research right now, but what causes the breakdown of myelin sheaths in the first place? Could it be diets deficient in saturated animal and omega-3 lipids? That seems plausible given that we have ostracized lipids in modern day (to our own peril, that is) in favor of inflammation-causing 'complex' carbohydrates. What else do I know about lipids? Well, I know that they lubricate surfaces; they facilitate fluid flow through a vessel. Coronary arteries are vessels with fluid (blood) flowing through them. If I were an engineer or physicist studying fluid dynamics in these vessels, I suspect I might conclude that the right soluble lipids would support blood flow through arteries and veins, thus preventing strokes and heart disease. That could be important to cardiology--another specialty of medical mythology. And, finally, I remember studying the formation, absorption, and transportation of vitamins and hormones, only to learn that lipids (and cholesterol) play central roles in orchestrating the use of these molecules in our physiologies. Where are the lipids in Gatorade? All those vitamins sans lipids does not make sense to me. Lean protein never made sense to me. That seems hard on the kidneys, which led to the "Atkins folly". Maybe we should design multivitamins and other supplements based upon the liver contents of healthy, active, wild animals that we evolved to consume? Animal livers could have served as our ancestral 'multivitamins' for many years. Well, that's enough for now, I must pull my head out of the clouds.

It's time to test hyperlipidity directly, on myself, just to see what happens. That makes sense to me. Let's see if I can falsify the conjectures generated by my thought-experiments.

So, I conduct these types of thought-experiments 'randomly'. In fact, this is how I built my novel model for the intricate interaction between antibiotics and intestinal-tract microflora: Clostridium difficile is a weed inside your digestive tract. Research studies, physiological concepts, and other scientific principles served as data points and reference frames for my thinking about 'good' and 'bad' bacteria, which compelled me to tinker through nutritional bricolage with good bacteria in my diet via fermented foods as a proactive, preventive approach to embracing a probiotic culture in modern medicine in hopes of averting the antibiotic-resistance slide that current healthcare practices drive. Later, I re-edited this model when I learned that many bad bacteria survive on sugars (fructose, in particular), and I responded by entering Fructose Detox to explore further how best to optimize my gastrointestinal health. I also added high-lipid FAGE, raw cheese, kombucha, apple cider vinegar, and other good bacteria items into my energy intake patterns, and I submitted my hypothesis to a running, practical and grounded real-world empirical test. The best parts: this test is cheap--I didn't have to write a grant or convince an organization for funding--is embedded naturally within my life experiences--I eat food and consume beverages already, regardless--and is enjoyable to conduct--I get to try new foods as a bricoleur / connoisseur. It also captures and benefits from the placebo effect--I serve as an active agent in determining my own health state: agency is a beautiful thing.

So I have thinkered my way through each day for awhile now, continuing to read, research, reflect, write, and re-edit/re-design my tentative, working 'story system' on the fly, only to recently realize, after traversing this fractal 'm=1/n=1' philosophy path iteratively, spontaneously, and organically for quite some time, that the Ancestral Fitness Epistemocracy (AFE) is a real, active, and rapidly evolving and growing Biomedical Mutual Organization (BMO), uniting Nassim Taleb's vision of an epistemocracy forming in the Blogosphere with William Bains' vision of n=1 clinical trials in biotechnology via Seth Roberts-inspired self-experimentation.

Just take a look (click) around the Web; we have all the leadership pieces in place (Note: This is only a partial list of the exemplary self-experimenters in this expanding health space):

We have our MDs, our PhDs, and our CDs (Doctorate of Curiosity): William Davis, Michael Eades, Kurt Harris, Doug McGuff, Dr. T, Dr. B G, Art Ayers, Loren Cordain, Stephan Guyenet, Aaron Blaisdell, Art DeVany, Seth Roberts, Mark Sisson, Richard Nikoley, Keith Norris, Matt Metzgar, KetoWarrior, Don Matesz, Jimmy Moore, Tom Naughton, Jeff Erno, Robb Wolf, Bryce, Skyler Tanner, Peter, Brian Geremia, Marc, Zach, etc.

And then there's me; just sitting here, trying to make sense of this online conversation melody.

It's all in the spirit of ancestral mimicry.

I see an AFE.

I see a new approach to biotechnology.

But maybe that's just me.

To good health,

Brent

I interviewed Dr. Siegal of the Cookie Diet ...

I recently took an opportunity to interview Dr. Siegal of The Cookie Diet.

Here is the transcript:

BP = Brent Pottenger

DS = Dr. Siegal

BP: Seth Roberts wrote a book about weight-loss, based on the set-point theory, by conducting research on himself. What is the theory behind your diet, and do you believe the set-point theory is true?

DS: I wrote a book some years ago in which I did discuss set-point. As far as it having any real practical value in a medical practice like my own: it doesn't. Because if you have to accept that there is a set-point for every individual, and some of these set-points are set very high, then you have to accept that the prospect of them losing weight is essentially impossible, and I simply don't accept that because the simple fact is that everyone can lose weight: if you don't eat, if you eat a reduced number of calories, you lose weight, that's all.

BP: Seth thinks that certain foods change the set-point.

DS: I don't have any evidence of that. I truly don't believe that.

BP: What is the theory behind your diet; is it based on a purely thermodynamic model?

DS: Well, I suppose that is true, but I don't like to make it sound so complicated. My theory is based on the fact that each one of us with normal activity requires a certain number of calories to maintain weight--you can call that a metabolic level if you want--and if you eat less than that amount, then of course, you lose weight, and if you eat more than that amount, you gain weight. So, yes, that is thermodynamics, but that sounds awfully academic.

BP: So, then, the source of the calories doesn't matter?

DS: You are asking if certain calories are more apt to take weight off than other calories? For example, are calories from protein more apt to take off weight than are those from carbohydrates? There is some evidence for that. In fact, that was a theory that was very prevalent up to about 30 or 40 years ago; it was called the Specific Dynamic Action of Protein. And this theory was very much in vogue and believed by many scientists. It said that if you eat carbohydrates, you end up with a plus amount of calories--you burn a certain number of calories in burning the carbohydrate, but you still end up with more calories than you started with. In the case of protein, it was believed, in digesting protein, that you burn up more calories than the protein provides, so that, in essence, if you ate nothing but protein, you would lose weight, no matter what quantity of protein. What happened to this theory is that it disappeared; no one ever disproved it; but, for whatever reason, it fell out of favor with scientists, and the truth of the matter is that I have never found any study that disproved that it was true. That's interesting, isn't it.

BP: Yes; it is. That's the tale of the history of modern nutrition because, for example, I happen to reject the notion that saturated animal fat causes heart disease. So, then, when you use the Cookie Diet in practice, I am assuming you use it as a short-term intervention that would lead to a more sustainable diet at some point. Or, is this a long-term course that you imagine for patients?

DS: It's neither short-term nor long-term, but rather, it's both depending upon how much weight each patient has to lose. If they have to use a little weight, it's short-term. If they have to lose a lot of weight, then it's long-term. But, it's a method of weight losss.

BP: Say someone did lose weight effectively, what would be an ideal diet for someone to transition into?

DS: Well, you are assuming that I want patients to transition into a different diet, and actually, you are correct. My particular interest is in the diet we use on our patients and advocate on the internet and on our Web site. What it is, is the use of this cookie that I have been manufacturing for 30 years as a source of hunger suppression; a means of controlling your hunger, as opposed to eating other foods that may stimulate your hungry. So, our patients and customers eat 6 cookies per day at times when they are hungry, and then they eat a sensible meal for dinner. The total calorie count for the cookies and the dinner is about 1,200 calories--which is what I advocate--and at that level, everyone loses weight: there are no failures when you eat 1,000 - 1,200 calories a day. Some people lose a little faster; some lose a little slower, but everyone loses weight. That is the method for losing weight and that should go on for as long as it takes to get to a normal weight. A person with a normal metabolism, normal activity, would probably maintain his/her weight on about 2,000 calories per day. So, on a diet like this, they would lose approximately 10 lbs. per month, so the time it would take to get to normal weight would vary, but at the rate of 10 lbs. per month, they would eventually lose it. Now, once they lose the weight, then comes the hardest part, and that's the hardest part--whether using my method or someone else's method, the problem is still the same: you are now faced with how to maintain the weight, and if you go back to old habits, with excessive calories, then, of course, you gain the weight back. Well, my preference for maintaining weight is to burn up more calories than you take in, and so that means exercise, and I am a big advocate for exercise, particularly the kind that burns calories like cardiovascular exercise and that is what I recommend to my patients and to people who follow my diet by going to our Web site or buying our products at Walgreen's or GNC.

BP: So, have you found there are particular ways of eating that people have trouble maintaining their weight on, or is it a problem across the board?

DS: Here is why specific foods matter: in terms of calories, no, they are all the same. But there are differences in different foods, and the real difference is in controlling hunger, or, for that matter, causing hunger. Without a doubt, carbohydrates are stimulating hunger--that's my opinion and the opinion of quite a few other medical doctors. Proteins, by contrast, are more satisfying for hunger than are carbohydrates. Now, strangely enough, the most satisfying for hunger are fats. But, the problem with fats is that is doesn't matter if they satisfy hunger if they give you more calories than you need. So, it's nice that fats satisfy hunger, but they also don't help that much with helping you lose weight. So, as you can guess, I am a big advocate of losing weight via a high protein diet, and in my most recent book, Dr. Siegal's Cookie Diet, I go into great detail on the history of high protein diets over the ages, and I mean, from way back when. You know, the public has always embraced the idea of high protein diets as the way to lose weight--when I say always, I mean up until the last 30 years or so, and then we have this absolute reversal where we fall in love with carbohydrates, and what happens: obesity blossoms; its explodes. When I was first in practice, which was a long time ago in the 1950's, and way back then, about 50% of our population was overweight. Today, 65% of our population is overweight. I attribute it to following all their advice they are given by the so-called Ivory Tower of experts who advocate such things as complex carbohydrates and things of that sort. Obesity is totally out of control as a result of that kind of advice, and I guess I am watching to see when it reaches 100%, and somebody says, "Wait a minute; this is no way to control your weight."

BP: I am curious to hear how this all makes sense in terms of evolutionary history and how humans have consumed foods across millions of years?

DS: Oh yes! You'll have to read my book! That's what it is about. That's one of my favorite subjects. I believe that we are essentially meat-eaters, even thought the vegetarians will argue that we don't appear to be meat-eaters because we have teeth and nails like chimpanzees and so forth, but I explain this fully in the book, and I am not unique--I didn't come up with this idea--but a lot of anthropologists would agree with me in saying that we are adapted to be protein-eaters, to be meat-eaters. In fact, you and I are here today because our ancestors were meat-eaters: if they weren't, we wouldn't have survived, or the human race wouldn't have survived, and I believe we should remain meat-eaters, and I am not talking about steaks from Ruth's Chris--although they are pretty good--but I am talking about eating high protein foods like chicken, turkey, fish, seafood, that type of thing, because I believe we are far better adapted to eating that than we are to eating grains, fruits, and vegetables.

BP: How does fat factor into that? When thinking along those lines, in terms of evolution, anthropology research shows that people would have consumed lots more saturated animal fat?

DS: Well of course that's what they ate: if they ate meat, then they ate saturated fat--they ate animal fat. Keep in mind that the human race has been eating protein for millions of years. It's only in the last 10,000 years--which is like yesterday in the evolutionary process--that we started eating fruits and vegetables to any extent, and the reason for that is because the human race has always been nomadic; they were on the move; they didn't settle down to cities or villages. Why were they on the move? Because they had to follow the herd; they had to go where the animals were--that was their source of food. But about 10,000 years ago, that's when agriculture came in, and of course, if you are going to grow crops, you can't be on the move; you have to settle down. So, you form societies; you build cities; and, you develop a whole new type of lifestyle and you start eating these vegetables, which you are poorly adapted to, because for millions of years, you have been eating high protein foods. But, nonetheless, human beings are adaptable, and so for 10,000 years, we have been eating fruits and vegetables and grains and so forth, and it obviously wasn't much of a weight problem in the early days of agrarian societies because the lifestyles were much different; the lifestyles were hard; you had to burn up a lot of calories just to exist, to carry on your normal daily functions. But, of course, in the last 100 years, we have all these conveniences; we have elevators and automobiles, and we don't live on farms anymore; we live in the city; and so we don't burn the calories that we did back then, and so this high-carbohydrate diet that we are eating, I believe, is a major contributor to obesity.

BP: Are you aware of Dr. Weston Price?

DS: No, I haven't heard of him.

BP: He studied the diets of populations that were still eating according to their ancestral diets, and these people displayed excellent physical health despite not having access to modern Western medicine.

DS: I am not aware of his research, but I am aware of the concept. There have been many people who have studied that. One that I talk about extensively in my book is a researcher who lived among the Eskimos of western Canada and observed how healthy they were when they ate this high protein, very high fat diet--you know, whale blubber and so forth--and they were in excellent health and didn't have heart disease and dental cavities and so forth. So, yes, I am aware of the concept.

BP: Yes, it's the same concept, and I actually consume about 70% of my calories from fat.

DS: Really?

BP: Yes, and about 20ish% from protein and less than 10% from carbohydrates.

DS: Well, I am not too sure I can argue much with that. I don't know I see the advantage of all that fat. But, if you appear to be healthy, and your cholesterol is okay and your triglycerides are okay, it obviously isn't doing any harm. Now, all this is far away from what I really do. I don't go into the theoretical with my patients. I simply put them on a diet, after examining them and studying them, which involves a high protein cookie, but a particular mixture of proteins that is particularly hunger-suppressing, and this enables them to go all day with no real food: all they do is eat cookies during the day, and the number is 6--they are limited to 6--and then they eat a dinner. And, of course, these are people who need to lose weight, and it is very successful, if--and that's the big if--if they do exactly what they are supposed to do, and if they don't, then they are not as successful. In a diet like this, which is limited to 1,000 - 1,200 calories--and, in practice, I sometimes go much lower--on that regime, people lose weight very, very rapidly. I am a big advocate of fast weight loss. The reason is that there is no negative to it; there is no danger to fast weight loss. The advantage: it enhances the motivation of the individual to continue to lose weight. When my patient gets on the scale and sees real weight loss every month, she is encouraged to go on and finish the job. When you get on the scale, and you only see a pound per week come off, you say, "This is too much drudgery; this is too difficult; I can't do it; I am going to quite." So, there you have the essence of my theory: In order to lose weight effectively, to have an effective method, it has to be fast, and you have to control hunger because hunger wrecks diets, and everything I do is geared toward controlling hunger. I do it with a cookie, and it is a very effective way.

BP: Is the fiber and the protein combination of the cookie what controls hunger?

DS: No. Interesting question. If you do a little research, you will find a book I wrote way back called Dr. Siegal's Natural Fiber Permanent Weight Loss Diet, in which I am a big, big advocate of eating a high fiber diet, not only as a way to lose weight, but to improve and support health, and I go into all the ramifications of that. However, admittedly, it is a much slower method than what I currently advocate, and the problem with a slower method is that people lose interest in a process that is slow. If they were to follow it, slow or not, everyone would get to their normal weight, but they drop off because of the slowness. See, you have to understand: you are dealing with real human beings, and what theoretically works is not what actually works in practice, and that's the problem. All the Ivory Tower experts suggest slow weight loss over a period of time--eat right, eat all the right things, and so forth--but guess what: nobody does it. They pay homage to it, but they don't do it, and that's my big criticism of most of the diets that are out there: yes, they would work if people would follow them; but, nobody follows them, so what good are they?

BP: Do you see benefits in caloric restriction?

DS: No. I don't participate in that, and the reason for that is those are super low-calorie diets; those are diets that are lower than what the government calls 'Very Low Calorie Diets'--800 calories or less. All those studies weren't so much directed toward losing weight but were aimed at longevity. It may be that these super low-calorie diets do increase your lifespan, but one of the problems with them, of course, is hunger, so it takes an awful lot of discipline to follow those kinds of diets. But, I am really not negative on them; I think it is admirable if someone is willing to do that, and probably not harmful. But, it's simply not the kind of diet that the masses are willing to follow, and that's what I have to deal with: masses of people.

BP: What about intermittent fasting?

DS: I see no advantage of fasting whatsoever. During that short period of time, obviously, you are deprived of all the basic things that you need to live. In the process of doing it, your metabolism drops because your body goes into this protective mode which is a very nice mechanism that keeps you alive a little longer when you are starving. I don't like it; I don't think fasting has any real value.

BP: Thank you. Is there anything you want to add?

DS: I would love for people to come to my Web site because there are a lot of tools that I have developed for people to lose weight. Particularly, there are a lot of calculators that I have developed that help people get a real handle on what they are facing: How long is it going to take to lose weight? My Web site is: CookieDiet.com. I have treated 500,000 patients over the past 30-40 years, and so this is born of experience, with real people, not laboratory animals.

BP: Do people ever need to make sense of the diet to choose to go on it; do they need to see how it fits into a bigger picture of health?

DS: Absolutely. Well, we have many, many advocates, but, at the same time, there are some people who have no interest. What they are looking for is magic; the magic pill that you take and the weight will just drop off. The world is still full of people who are not willing to 'bite-the-bullet', so to speak.

BP: Thank you very much for your time.

(Note: The views expressed above are Dr. Siegal's, and they don't necessarily represent the views of this author, save the ideas implied by the questions. Also, this post is part of Prevention not Prescriptions Tuesday--hat tip to Keith Norris--hosted by the Kathleen Show.)

To good health,

Brent

Part 3: Interview Series with Aaron Blaisdell of UCLA

The much anticipated Part III ... and the plot thickens.

Part I & Part II

KP = Kai Pottenger
AB = Aaron Blaisdell

KP: In what ways does your research shape your perception of human foraging behavior in a modern ecology?

AB: The research I do in my lab doesn’t effect [it] too much. My research focuses on one omnivorous species, rats, and one granivorous species, pigeons (although they don’t just eat grains--they eat other stuff like meat, but they are primarily granivores). They are very different species than humans.

What's interesting is to read the medical literature that uses rats or rabbits to establish the diet research, like the lipid hypothesis for heart disease. I recognize that even an omnivorous animal like a rat still is very different. It's like a Venn diagram--there is some overlap because we are both omnivores to some extent, but rats are a very different type of omnivore. Rats don’t eat nearly as much animal product as humans have during their recent evolutionary history. They aren’t necessarily going to be the correct animal model--if there is any animal model for humans. I am more cognizant of that now. Two years ago, I would have looked at a rat study that said, for example, “Rats that consume more sunflower oil have more heart disease, giving evidence for the lipid hypothesis," but now, I have grown much more critical of conventional wisdom. I am much more aware that there is so much out there that we assume blindly. It's humbling.


KP: How do you weave the concepts of the paleo/primal community blogs into your public health message to students or to family?

AB: Well, with my family--I have a four-year-old and a one-year-old--I have tried to change their diets. I have only been embarking on this adventure for two years. At that time, my four-year-old was two. We had already gone through the progression of introducing foods like rice cereals, then other cereals, then some vegetables and fruits--meat came a little later--and then whole grain crackers, whole grain cereal. And now she is addicted to all that stuff.

Now, I have given all this stuff up, and I feel ten times better, but try arguing with a four-year-old that she should have an egg instead of her gold fish crackers. It's very difficult because there is an addictive quality to the carbohydrates.

My wife gets on my case about preaching too much, so there is a balancing act between being happily married and how far we are going to go. Raw milk was a battle for awhile. I was able to get her to allow me to drink it myself and give it to my four-year-old. So there are some strides. I hide fish oil--fermented cod liver oil that smells and tastes terrible--in the kids' yogurt with some chocolate powder. At first, my wife was skeptical, but she has finally come around on it.

I have also been starting to bring this stuff up in my classes. I have been talking about it in my laboratory for a long time. Last fall, a year ago, I thought I really needed to get this message across. My students, to a large degree, are pre-med. I figured that I have an opportunity, if not an obligation, to at least open their minds against the conventional wisdom and clamped dogmatic mindset. I will keep doing that.

I have actually toyed with the idea of teaching a seminar on the paleo lifestyle approach. We would go through the blogs and pick key examples, maybe even use the Primal Blueprint as the text, and dig into the primary literature here and there. It would be an initial starting point to help students navigate and make their own decisions.

I have lab meetings once a week--I still bring donuts. I still have one [donut] once a week. I figure it's like Mark Sisson's 80/20 rule. It might be sacrilegious in some circles, but that’s OK.

Again, thanks to Kai and Aaron for this wonderful series.

Stay tuned ...

Leave questions for Aaron in the comments section of this post; he will respond.

To good health,

Brent

n=1 Self-Experimentation Positioning: How to Not be Fooled by Randomness

Living in a world that we don't understand is a humbling, human endeavor.

The history of science and the history of medicine teach us that causation is murky, at best, and that things often work for reasons that we don't understand. People have been tackling this conundrum for many years, in various ways, and there are lessons to be learned from our ancestors' insights and experiences.

The best we can do, of course, is be human: We can tinker. That's what our ancestors did.

We can self-experiment via n=1 clinical trials and set our physiologies (and healthcare systems) free.

That all sounds good--great--but, how do we tinker, today, in the real-world, and not be fooled by randomness in the long-run?

Ironically, John Maynard Keynes said, "In the long-run, we are all dead." This notion, unfortunately, lead him to support theories that further blunted critical short-term feedback loops in banking practices and throughout our economic systems. The expansion of credit--debt leverage--that followed from these theories spread our economy too thin over many years while silent financial risks built up. It's like having problems with your feet and back, blaming these pains on your shoes, but then adding orthotics and arch supports to 'bolster' those shoes: the extra shoe material--like solving debt problems with ever more debt--further drowns out the biological feedback loops that shoes block in the first place. Evolution--Mother Nature--'designed' (the ultimate bottom-up, trial-and-error iteration process) your feet to interact with the ground intimately and dynamically. Shoes are like the Gaussian: they both are platonic constructs that provide false senses of security when navigating complex terrain. This is why rugby players experience fewer severe head injuries than football players do: rugby players, playing without helmets, learn how to tackle and hit with their head up or positioned strategically to avoid head trauma, while football players, wearing helmets that they think offer protection, use their bodies as torpedos and expose themselves to catastrophe. Instead, the real solution is to remove the shoes--the toxic agent, like debt--and barefoot or wear minimal shoes like Vibrams so that the natural short-term feedback cycles can operate properly: entrepreneurs recognize this concept as 'failing fast' but never blowing up. You falsify startup business conjectures--marketing approaches, for instance--that don't work and still keep enough resources on hand to pursue future options that emerge serendipitously--you avoid enslavement to obligations, like debt, as much as possible. In healthcare, a similar situation occurs when we provide first-dollar coverage for basic medical needs: people are shunted from experiencing the true costs of their daily lifestyle choices, and without these short-term feedback loops in place, patients leverage their physiologies out, pushing the limits, assuming that the medical system will take care of them when their bodies fail. This process breeds another example of silent erosion, where hidden negative Black Swan health risks build up over many years. So, the irony is that Keynesian economics, which purports a short-term emphasis in the name of stability, actually exposes us systemically to the problem of being 'dead', via blow up collapse, in the long-run: this approach builds fragile economic/physiological systems, lacking robustness to negative Black Swan strikes.

We should learn from our immune systems: Mother Nature shaped them over many, many years.

As human beings, we can try to construct some rules to live by that hopefully position us in ways that clip exposure to negative Black Swan events while maintaining exposure to positive ones.

The deductivist/falsification approach, embedded in a Barbell diversification schema (80-90% hyperconservative paired with 10-20% hyperaggressive, highly diversified), appears, to me, to be the best we can do in many ways.

In order to not get fooled by randomness in the short-term (and subsequently in the long-run), we must do our best to capture and respect short-term feedback loops--whether quantitative or qualitative--that lead to long-term results. For instance, if diseases like breast cancer and heart disease are linked to / caused by inflammation (in a general sense), then a reasonable short-term feedback loop is to measure/capture our bodies' inflammatory responses to different environmental stressors and stimuli. The cumulative effect of 'silent inflammation' leads to negative Black Swan health strikes in a manner similar to how avalanches work (it's the power-law, fractal math of Mother Nature): Snow builds up for long periods of time, without any sign of impending collapse, and then one tiny event--a triggering event--causes the non-linear consequences of an avalanche cascade. It's like those stories you hear about people eating their morning toast and then boom: they suffer heart attacks. Their bodies' inflammatory responses that day were just like the final snow buildup event that triggered the avalanche. Our immune systems work in a similar fashion. We fend off toxins and pathogens successfully for some time until the toxicity reaches a threshold, breaks a barrier, and unleashes chaos: our bodies start attacking our own cells; our cells start communicating with each other improperly; and, unfortunate events like cancer and autoimmune disorders (Lupus, to name one) ensue. So, to avoid this type of physiological collapse, we need to identify and test (enter self-experimentation once again) short-term feedback loops for energy expenditure and for energy fueling.

Energy Expenditure: As an example, consider the condition we label as arthritis. Arthritis is a problem that builds up over time, so soreness, pain, and aches seem like potentially useful short-term feedback measures: After a work out, we should track how sore and 'debilitated' we feel. This is why Dr. Doug McGuff wrote Body by Science: to consider ways that we can limit damage while maximizing anabolism. Mark Sisson listened to his body's feedback and elected to hike in the hills more often--as Grok would have done--and do body-weight exercises (such as hand-stand pushups) more frequently so that he doesn't feel sore, inflamed, or achy after working out--that works for him. Personally, in my current 'n=1' self-experiment, I like to hybridize Doug and Mark when I expend energy, blending in more swimming and dynamic yoga work from my own trial-and-error learning and discussions with Gio. Furthermore, in this domain of arthritis avoidance, I know that jogging produces lots of soreness in the wrong areas (in major joints, like my knees), while sprinting very briefly (high-intensity, low-duration) does not (for me). When I am sore, I want it in the core (stabilizing) muscles of my body--not in my joints. I work diligently each day to strengthen my tendons and ligaments via balancing and stretching exercises for this reason: suppleness and superior posture are two primary goals in this domain. I falsified the jogging-at-a-constant-rate-for-extended-periods-of-time conjecture long ago. It doesn't work for me.

Energy Fueling: When we self-experiment with our diets, as we do when we try to mimic our evolutionary ancestral eating ways by using archetypes and mythologies, we can frame our experiences from this same deductivist/falsification perspective. For instance, residual aftertaste is an ultra short-term feedback loop that we can pay attention to. After I eat foods, I monitor aftertaste: If eating a food or drinking a beverage produces a terrible aftertaste in my mouth, then I edit it out of my food my-thology story (it's poison avoidance; and, I am the Editor-in-Chief, after all). [Note: most carbohydrates produce this bad aftertaste for me. The exceptions are the minimal residual lactose in FAGE greek yogurt and the carbohydrates in some nuts and some vegetables--I have not disconfirmed these items yet.] Undoubtedly, the list of metrics is an experiment in itself, but here is another possibility: If my mood or my energy levels decline precipitously in response to an item in my diet, regardless of whether this item is in the 'experimental' portion or the 'tried-and-true' section of my Barbell portfolio, then I excise this item from my energy intake schedule. In essence, we need to monitor our bodies in this grounded manner and hopefully--we can't avoid hoping; it's an inherent part of the human condition--our physiological responses, shaped by millions of years of evolution, will signal us correctly in the right directions and away from the wrong ones when nurtured in the right manners. Decades ago, when High-Fructose Corn Syrup (HFCS) intake started ramping up, if folks had listened intently to their bodies and responded to short-term feedback signals from a falsification perspective, then they would have changed course and edited HFCS-laden sodas/drinks and foods out of their diets before the long-term effects--alien tissues--could set in. We would have falsified the hypothesis that human metabolisms can handle HFCS long ago because this poisonous chemical triggers inflammation, acne, obesity, bowel problems, etc. in the very short-term.

Since I see life as an active, ongoing experiment and view myself as a walking lab rat / guinea pig, this approach, however messy, resonates well with my 'n=1/m=1' philosophy. Yet, stepping back, on a broader scale, I think we fail to engender this thinkering view and curious spirit in children because our educational approaches focus on the known, rather than on the unknown. We also tend to, culturally and psychologically, favor confirmation over disconfirmation. I try my best--it's a work in progress, of course--to search actively, openly, and honestly for data points that disconfirm my tentative story--I know what is bad for me with much more certainty than I know what is good for me (it's the asymmetry of uncertainty). This approach is why I edited fruit and wine (except for a new running wine experiment with hormesis) out of my existing ancestral diet--these items produced water retention, bloating, and other negative results for me. So, I made the logical negative empiricism conclusion, re-edited my Ancestral Fitness story by entering Fructose Detox, and continued (cautiously but boldly) forward, looking high and low for new data points that falsify other conjectures that I currently live by.

Then, as we iterate along this deductivist/falsification path, we must remind ourselves that we can learn from our ancestors in important way: Those who came before us lived out and experienced the longer time-scales that we are making conjectures about today based on short-term feedback loops, reflection, and thought experiments. Many of our longstanding ancestral traditions--like the fact that intermittent fasting is built into many cultures and religions or that certain cultures ban debt--reflect gems from long-term feedback--positive Black Swan treasure hunts--that people have embedded in mythologies to teach future generations in hopes that they will learn by grace and avert hard knocks. We can heed this proverbial knowledge and clinical wisdom in the art of living as best as possible.

We can also do as Nassim Taleb suggests: respect complexity. If economic systems are complex and wildly recursive, then we should not be fooled (by randomness) into thinking that something as platonic--propped up on hot-air theory--as the Gaussian--so crisp, clean, and human-derived--is useful and reliable. The math of Mother Nature reflects many long-term experiments, incorporating blowup eruptions and the resulting shockwaves that occurred along the way. The elephant is the largest animal on land, thanks to Mother Nature; perhaps, our governments and corporations should take a hint from this insight in regards to the too-big-to-fail problem (thanks to Dave Lull). Thus, by respecting the complexity of Mother Nature, we are, in effect, heeding the wisdom of long-term clinical trials so that we don't have to repeat the hard knocks that our ancestors endured: each successive generation builds on the previous generations, standing on their shoulders and progressing to new levels in the human experience, this way.

As I referenced in my BIL:PIL presentation, we are each limited by our own experiences, so I think we would be wise to create communities of self-experimenters who share their feedback notes and results with each other--particularly their falsification data points--so that we can help each other avoid being the Turkey on Thanksgiving Day.

That's why the Ancestral Fitness Epistemocracy (AFE), as a community of self-experimenters in the Blogosphere, is so important to me. I learned from Mark Sisson because Mark's experience resonated with me as a former athlete who trained and fueled how he used to. By learning from Mark's experience now, at a younger age than he did, I have improved my chances of mitigating the effects of the poisonous diet and catabolic exercise choices that I made for many years. (I also learned from Art DeVany, Dave Lull, and many others along the way--it's such a rich, dynamic, and ever-growing list of perceptive mentors.)

Sure, causation will always be murky/hazy/cloudy/opaque--it's the melting-ice-cube, reverse-history problem--but if we constantly and honestly scrutinize our stories from a deductivist perspective, then we will hopefully 'fail fast', re-edit our stories, and move on, like our immune systems do, more robust to the next negative event: We strengthen our 80-90% portion of our Barbell platforms this way. Being hyperconservative in this regard will vary from situation to situation, but avoiding leverage is a universal concept. Leverage for businesses gives a false sense of security and delays feedback--debt allows you to continue operating into the future without underlying sustainability. Starting a company without debt, as I have done with my businesses and business partners, exposes you to short-term feedback loops much more closely, and this helps for long-term sustainability because you build from the bottom-up, editing out things that don't work quickly--your business will disappear if you don't.

So, perhaps the best we can do is try to barefoot as much as possible and avoid 'false sense-of-security' mechanisms in complex systems, while learning from our ancestors, Mother Nature, and entities that have withstood large-scale shockwaves in the past: these are resilient mentors, models, and archetypes to mimic.

I bet this topic would be a prime question for a self-experimentation community--folks would share their proverbial knowledge--clinical wisdom--in how to structure living in ways that make us robust to blow ups while maintaining exposure to the envelope of serendipity.

Yes, I don't know the best answer to this fooled-by-randomness challenge, but admitting that is the first step to uncovering solutions. The first step is admitting humility.

Since we must be concerned about probability times impact--that's what matters--diversifying our experiments in our 10-20% Barbell portfolio portion likely helps mitigate the risk of high-impact, negative events, but we must always test the waters carefully.

No matter how tentative, this is a conversation that should, really, never cease.

We need to do our best to learn from our experiences, catalogue our observations, practice epoche, and apply these insights to very similar situations; from one similar situation to another, always searching for situations that seem similar but then reject our procedures and approaches. We also need to build (personal) general maps of environments in which we don't mind being fooled by randomness--the arts, for instance--and ecologies where we don't want to be fooled by randomness--finance and healthcare, for example.

It's a humble process, but I think we are making progress.

Time to bricolage.

To good health,

Brent

(Hat tip to Jeff Erno: this essay emerged organically from conversing with him)

(As always, thanks to Dave Lull: my deductivist/falsification mentor -- and -- thanks to Seth Roberts: my self-experimentation mentor)

Nutritional Bricolage - BIL:PIL 2009

(Above: My friend, Stephen Cheung, and me post-BIL:PIL)

Stephen and I recently completed our Master of Health Administration (MHA) degrees at the University of Southern California (USC). Our final project for our MHA capstone course was a case study about leadership in a rural hospital scenario, and it will be published as a chapter (with an accompanying teacher's manual) in the upcoming 5th Edition of Cases in Health Services Management (2010).

Stephen and his girlfriend accompanied me to San Diego for BIL:PIL--we had a blast--and I presented (fittingly) on Halloween Day--the day that we celebrate our Sugar Mythology. I brought packs of almonds for everyone in attendance as my small effort to displace our toxic Sugar Mythology with a much healthier Ancestral Fitness my-thology.

I also passed out these two sets of awesome 'treats':

1) 3 copies of Mark Sisson's book, Primal Blueprint

Mark mailed me three copies of his wonderful book, and I gave them out during my talk to folks who named something primal or anti-primal in contemporary society (*see video below).

2) 3 copies of Seth Roberts' book, Shangri-La Diet

Seth mailed me three copies of his insightful book, and I gave them out during my talk to folks who named something that started small and then got big (*see video below).

BIL:PIL recorded my presentation in high-quality video format and will post it live on the Web soon, but in the meantime, here is the 'pirated' version that Stephen recorded on the spot, in the spirit of the un-conference format, of course!

Enjoy ...

Here are my slides:

BilPil Slides

View more presentations from Brent Pottenger.

Self-experimentation sets physiologies free.

Nutritional bricolage sets healthcare free.

Be human: tinker.

n=1 clinical trials.

Cheers to the BIL crew for organizing (spontaneous order at work) BIL:PIL and creating a warm, inviting thinkering (thinking + tinkering = thinkering) reflection and collaboration space for interdisciplinary inquiry into the Patient of One condition in the Information Age.

To good health,

Brent

(*feedback/comments/etc. welcomed)