Comedy, Conjectures: Frank Caliendo

Comedy, Conjectures: "Anything with wings is a pretty tasty treat."

Post 200: Cancer & Natural Disaster Dynamics

Note: This marks my 200th post, according to my Blogger archives, of attempting interdisciplinary inquiries into the human condition via essays.

Above: A picture from Squaw Valley near Lake Tahoe in California; quite a scene for late May! Note the eye-pleasing aesthetics of this fractal landscape.

Cancers, like avalanches, can be devastating.

Both are events that we'd like to prevent from causing catastrophe.

Cancer is a single cell gone haywire. An avalanche is a single snowball gone awry.

And nothing acts independently; interdependent communities (see The Daily G) tie these single entities to the fates of those in their proximities.

Cancer is a single cell that has manipulated its nearest neighbors into dividing uncontrollably. In time, this cancerous cell and its deceived 'followers' reach a critical mass, forming a tumor. For awhile, cancerous tumors remain isolated (Stages I-III), and extraction of this dangerous region of body tissue is still possible (say with robotic surgery): Physicians can still, "remove the tumor," as Nassim Taleb likes to say (hat tip to Dave Lull). However, cancer tumor mathematics behave like avalanches do: that is, explosive pressure builds up rather silently for awhile and then, all of the sudden, cascading effects spread nonlinearly and unpredictably with the force and fervor of a hurricane. This type of systemic rupture--a blow up--is known as metastasis in the context of cancer dynamics. As cells from the original tumor migrate throughout the body--like the snowballing that marks avalanche unfolding--other organ systems feel the effects: these shock waves, which initially only influenced a localized region, now begin degrading global physiological functioning (the entire mountainside starts crumbling). In a fractal manner, the 'one-cell-deceiving-neighboring-cells-to-produce-a-tumor' process repeats itself, throwing kindling on the burning fire. As this miscommunication problem expands like a forest fire, patients experience the signs and symptoms that we call Stage IV Cancer. At this point, the medical treatment approaches resemble those of fire fighters attempting to contain large-scale epidemics in the hills: chemotherapy is like direct attack, for instance.

And, the best way to counter a forest fire is to recognize and extinguish it during its early stages. The same applies to cancer (and to avalanches). Once the flood gates open, the limits of being human curb our intervention abilities. That doesn't mean we don't try our best to contain and treat the problem--we do--but when it's all said and done, we realize that the mathematics of these natural disaster phenomena suggest we'd be wise to expend resources up-front (prevention and detection) to nip these problems in the bud before they ever gain any sizeable momentum to start snowballing, cascading, spreading, and metastasizing (often, uncontrollably, unfortunately).

It's fascinating to then extend these links to economies, especially in light of the notion that economies are just fractal manifestations of physiologies, produced by simplicity embedded within simplicity, creating extensive complexity along the way. If economic bankruptcy for society is like a cancerous human body, and if cancer mathematics resemble those of avalanches and forest fires (and earthquakes, etc.), and if we suspect that the misbehavior of markets follows rough Mandelbrotian randomness and fractal flickering (Pareto / Zipf / Le'vy / Taleb et al. power-laws; though, Mother Nature tends to obey gravity, while digitally-driven extremistan markets face virtually no real physical ceiling), then hybridizing oncology with other disciplines seems like a decent idea to me. For starters, we could look at how detection and prevention of catastrophes are understood, studied, and practiced in these different fields.

Notably, in the field, avalanche prevention relies on two premises:

1. "Forests and trees are a good line of defense because they hold back snow like a giant fence."

2. "Another good way to prevent avalanches is to break up heavy masses of snow."

The net result:

"As long as these methods are followed, many avalanches can be prevented each year. Of course, it is always important to know that none of nature’s disasters can be wholly prevented. Therefore, it is best to be prepared for what may someday come."

From these notes on avalanche mitigation, we could deduce a few conclusions about economic reasoning. Namely, economics and its associated mathematical modeling tend to push people to discard of redundancy. At the margin, profit maximization in the short-term, for instance, nudges firms to remove or change the use of any resources that don't drive the bottom-line toward the green right away. This stands in stark contrast to Nassim Taleb's Black Swan recommendations for how to be robust: (1) reduce leverage, (2) be over-insured, (3) avoid clustering, and (4) be resistant to shocks. Based on some forms of economic reasoning, trees that currently prevent avalanches would suddenly appear to be nuisances to resort owners: "Cut them away; their blocking our ski runs," they may say--that is, until that day, when the system-sans-reinforcing-and-redundant-scaffolding-nodes crashes to the ground, knocking out the recently built ski lifts, costing the company an unanticipated fortune that its insurance policy fails to cover properly. Similarly, in economies, when firms get 'too big to fail', the risk of blow-ups surfaces rapidly. Breaking up large chunks of snow is like enforcing anti-trust policy, as one possibility. Of course, deciding when to intervene is not easy: just exactly when did that clump of snow get too big for its local environment to handle anyways? But the connections are there, regardless. When gigantic firms go bankrupt, the resulting shockwaves effect the entire economy, as we've seen recently with the banking industry collapsing. Likewise, when large tumors start metastasizing (physiological bankruptcy), the entire body starts malfunctioning. In medicine, I see room for translating lessons learned from handling disasters in nature to caring for patients in emergency rooms, clinics, hospitals, and elsewhere (with a kindred spirit to the integrative work that Didier Sornette at UCLA likes to do).

Finally, this reflection reveals the importance of a related issue: accurate detection and preventive intervention. Much of what self-experimentation supplies is linked to tools for increasing self-awareness. In a way, self-experimentation (blending the Qualitative and Quantitative Self) is an execution framework for becoming more aware of ourselves and our multidirectional interactions with our immediate surroundings. For example, in his recently published paper, "The unreasonable effectiveness of my self-experimentation," Seth Roberts discusses how artisanal and hobbyist (stochastic) tinkering reflects human nature, and self-experimentation captures and applies these dynamics effectively. Whether working to prevent headaches, avalanches, or cancers, people must have ways to detect information signaling correctly; that's the foundation of Meta-Rule formation as a method for mapmaking.

And, when I work on cartography, I attempt to be hyper-optimistic in concert with being some type of skeptic; I do my best to see potential and seek promising opportunities while simultaneously working to hedge against instability, against avalanche-like catastrophe.

I want to prevent cancer disasters fervently, but I also want to detect serendipity perceptively. Yet, the Paradox of Living (searching versus acting) makes another appearance when we realize that preventing and curing cancer are really the same thing fundamentally.

What does that mean? Easy: self-similarity.

To good health,

Brent

Mapmaking: Cartography as a Hedge to Robustify Society Against Black Swans

(Above: Grilling chicken, onions, and eggplant in butter, attempting to occupy my time this holiday weekend in Quadrant III: Modern Environment + Ancestral Energy Intake & Expenditure)

It has to originate from within to be a sustainable strategy.

I suspect that mapmaking is one such strategy: act like a cartographer and make your own personalized m=1/n=1 maps; or, as I often like to do, adapt other people's epistemocratic maps in your own unique ways to start playing with the concept of being robust to Black Swan shocks. Store these maps away in your imaginary backpack or briefcase/purse, and carry them around with you each and every day.

For instance, mapping health into Four Quadrants (applying Nassim Taleb's Fourth Quadrant notion) helped me integrate the links between physiology and finance/statistics concretely because this layout provided my bustling brain with a simple tool to catalogue and track my experiences mindfully: To start, I can ask myself, "Which Quadrant does this activity appear to occupy?" From there, I can hedge my bets as I allocate my time to these zones, hopefully maneuvering through Quadrant IV: The Limits of Physiology without staying too long. Awhile ago, the ever-insightful Melissa McEwen (Hunt. Gather. Love) engaged in a similar exercise that resulted in this excellent diagram (click image to enlarge):

Now that's what I call exemplary cartography!

Mapping health risks in relation to lifestyle choices in the context of our ancestral heritages and modern cultural practices seems like an exercise, even when done intuitively, that just might help us robustify ourselves against (what should be considered) negative Black (or Grey) Swan medical events (trauma, stroke, heart attack, cancer, et al.). But, being robust isn't easy; in fact, at the margin, it's impossible, really. In reality, for starters, we cannot tell whether a Black Swan is positive or negative a priori; doing so would mean assigning causation without knowing the future consequences completely. Take, for instance, the advent of agriculture. On one hand, agriculture permitted humans to sit around and tinker with things to create tremendously powerful technological innovations that support our lifestyles today: a positive Black Swan, some would say. On the other hand, agriculture could be viewed, as Jared Diamond of UCLA does, as "the worst mistake in the history of the human race"--that is, as a negative Black Swan catastrophe. Either way, though, everyone can probably agree, on some level, that the rise of civilization following agrarian domestication represents a high-impact, low-probability event within the scope of universal history--it's a fracture, as Benoit Mandelbrot would say. So, here we are today, typing and reading away as historical fractures seem to be compressing (consider that the distances between agriculture to the industrial revolution and then to the information age have compressed with each successive leap) and extremistan seems to be growing exponentially, with the resulting neolithic consequences continuing to impact us daily, for better and for worse, trying to figure out how best to respond with some original mapmaking, with some crafty hybridized adapting. For example, Daniel Kahneman recognizes that human cognition is imperfect, messy, intuitive, and error-prone to the nth degree; however, he still works diligently and creatively to try to untangle the web of complexity that guides our thinking, all the while enjoying things like superstitions that show how vulnerable human beings are in the face of uncontrollable uncertainty (I'm imagining Boston baseball players, off the top of my head). Similarly, by working on concepts like Meta-Rule formation, we can do our best to break down some of the barriers that seem to be blocking our current health(care) system from operating more effectively. That is, as Melissa has done so nicely, we can try our hands at mapmaking and empirical map testing.

But how do we construct and test maps without knowing the sign (+/-) of Black Swans beforehand? And just how do we account for unknown events with incalculable odds given that their impacts will likely trump white noise data points completely, like a Mavericks-grade wave engulfing a surfer wholly? Good questions. Let's roll up our sleeves; we've certainly got some philosophical work to do. And don't be fooled, I certainly don't have any infallible answers, but as Nassim and others seem to eventually do, we can focus on principles, on examining the structural makeup of the systems that we operate within and the platforms that we depend on as foundations for acting. We can ask whether 'the bridge' is robust against 'earthquakes shock waves' that register higher in magnitude on 'the Richter scale' than we have ever experienced before. We can stretch our imaginations a bit. And, hopefully, in the process, we can eliminate weaknesses while simultaneously enhancing structural strengths. Namely, we could start by reducing leverage: subtraction before addition. De-leveraging manifests in multiple ways. In financial matters, reducing leverage could mean eliminating debt and/or other financial obligations ASAP. In health affairs, reducing leverage could mean eliminating dietary toxins for our food supply as effectively as possible. In both domains, de-leveraging could mean being as aware of the Fourth Quadrant as possible. Because, at some point, awareness of where we place our faith is the best we can do with mapmaking. And, if we place our faith in searching for truth, then we can recognize even another way to de-leverage in practice: telling the truth while simultaneously exposing and making amends for lies. Lies weave convoluted webs that act as obligations that shackle genuine human potential. Lies, like debt and toxins, serve as false-sense-of-security-blankets that prop up unsustainable systems in the short-term while increasing exposure to blow ups in the long-term. Unfortunately, in the short-term, deception is often a winning, corner-solution strategy. That's how Donald Trump made his brand into what it is today: along the way, he went bankrupt and let his debts die with his lenders and investors--not in his own stead, as Popper suggests we do--starting over with an essentially clean slate, without feeling the consequences of his non-robust mode of investing and developing. He got lucky ... eventually. Repeat that process a few times and other people (like taxpayers) and institutions (governments, banks, venture capitalists, et al.) end up paying for your greedy mishaps while you skate on (not so gracefully) to build another monstrosity in Dubai that looks like a palm tree from the sky. With that, I digress.

Back to mapmaking; back to cartography at Ancestry.

One of the main goals of Ancestry is to increase awareness about the rise of mono-culture--a dangerous clustering event that reduces the robustness of society immensely--by nudging folks gracefully to reconnect with and respect our diverse ancestral heritages as human beings. Of course, some may think that I am writing/talking way-too-intuitively when I state that we are coalescing an Ancestral Health epistemocracy on the periphery (though, I do wear my shortcomings proudly, like ornaments, as Nassim suggests we do); but, collectively, I do think we're collaborating openly to meet/serve a role that Dr. Jerome Groopman highlights as valuable to understanding and advancing the human condition in the 21st century (thanks to Dave Lull):

"There are certain unique individuals who are able to put their finger on the pulse of the culture because they come at it with a fresh perspective."

What's so encouraging about the potential for health revolutions connected through the Internet is that fresh perspectives bubble up and then spread rapidly, increasing the rate of trial-and-error progress. That, and the vast reduction of barriers to entry--an egalitarian spirit defines the Blogosphere--make thinkering through activities like blogging so rewarding and interesting.

In essence, blogging is nothing more than mapmaking: iterative cartography spread out over the course of a series of posts.

It's a craft to hone on the fly, but it might just help us robustify.

To good health,

Brent

The Evolutionary Biology of Human Body Fatness: Thrift & Control by Jonathan Wells - Preface

It looks promising; this book, I mean.

Often, when I read good works, I get that exciting feeling where my 'eyes light up'. Although I am still working my way through this book, here are some snippets to entice your imagination to start thinkering freely, as the recently-retired President of the University of Southern California (USC), Steven B. Sample, suggests that Contrarian Leaders must do ("Think gray" & "Think free" are reminder statements that he likes to reiterate).

In my opinion, the Preface to this book stands alone as its own mini-book; that is, as an awesome essay for reflection and consideration. In short, it's a mythology that speaks to me.

In The Evolutionary Biology of Human Body Fatness: Thrift and Control, Jonathon C.K. Wells, a Reader in Paediatric Nutrition at the University College London (UCL) Institute of Child Health, argues that "adiposity is integrally linked with ... our capacity to colonise and inhabit diverse ecosystems. It is because human metabolism is so sensitive to environmental cues that manipulative economic forces are now generating the current obesity epidemic."

That sounds like an examination of the human ecological niche and modern health to me.

[Note: Thanks to Dr. Robert Lustig of UCSF (see "Sugar: The Bitter Truth") for tipping me to this book.]

In his Preface, Jonathon tells a short story about a trip to Sarawack, Malaysia to study undernourished Iban babies that took an unexpected turn for the better. Instead of conducting the formal research protocol that he had set out to do, he soaked in the Iban culture and learned lessons about human nutrition that were much more powerful than he ever could have imagined beforehand (bold = emphasis mine):

"What I really learnt on this trip had very little to do with formal research and was much more about how the Iban live, work and enjoy themselves. Though formerly headhunters, still with skulls hanging down outside the long-house rooves, they offered unstinting warmth and hospitality throughout our visit.

Many of my strongest memories are about the range of foods we were offered. Steamed fish; tender fern shoots; pleasantly bitter vegetables; many varieties of wonderful red rice that I have never found since; curly-shelled snails; ... a duck, which I was obliged to select from the pond myself. ... And one day, some men came back from a hunting trip with a pair of bush pig.

Naturally, we were invited to the barbecue, and soon the smell of roasting meat filled the air. Two plates were passed around, one of meat and one of fat: large cubes of fat, with the coarse bristles of the skin slightly crisped. We never tried the meat, because the fat was reserved for us. It was clear at the time that we visitors were being offered the delicacy, yet at that time I had no idea why fat, rather than the meat, should have been considered more special. Meat has conventionally been portrayed by anthropologists as a luxury food item, as well as a key source of protein.

... Since that visit, I have become aware that lean meat has such a low ratio of energy to protein that a diet based on it can impose significant energy stress on the body - the 'rabbit malnutrition' known to polar populations. Fat is not just a delicacy but an important source of energy and fat-soluble vitamins. In western industrialized populations, experiencing an epidemic of obesity in both adults and younger age groups, fat is routinely portrayed as a 'bad' food. Things must have been very different until recent decades, and it is likely that the Iban like many other societies consider pork fat a tasty luxury food" (ix-xi).

Dr. Lustig is a modern medicine leader concerned about obesity too, and he writes and talks a lot about fatty liver disease (FLD). Interestingly, my ancestor, Dr. Francis M. Pottenger, Jr., MD, used to prescribe 'healthy hyperlipidity' to his patients via items like butter, liver, and eggs to combat liver maladies and other diseases (see his paper, "Reduction of hypercholesterolemia by high-fat diet") while practicing medicine in Los Angeles (he also warned about the emerging links between asthma and smog/pollution way back then as well; he was, in many ways, "ahead of the curve," as they say). In this spirit, it appears that Jonathon C.K. Wells perceives room to re-perceive lipids both scientifically and culturally:

"Most research on human body fat has been conducted by the biomedical community, showing how high levels of fat increase cardiovascular risk. An evolutionary perspective is urgently required to clarify why humans became so good at acquiring fat, given plentiful food and low activity demands" (x).

And, like any sharp philosopher of science should do, Jonathon makes sure to start his tale with some epistemic humility, warning his readers to keep the mythological nature of scientific inquiry in mind, creating ample room for ongoing falsifiability:

"This is a book involving substantial speculation, and it is inevitable that some of it will prove incorrect. Some unkind critic once defined prehistory as 'the study of the unverifiable to prove the unwarrantable about what never happened anyway' (Cockburn 1971), and the longer-term evolutionary reconstructions are ideal material for such inadequacies. Nevertheless, what I strongly believe is true is that without substantial refinement of hominin adipose tissue biology, modern humans would never have come to exist" (xi).

Which sounds a lot like what Billy E. said to Dr. T on Nephropal the other day: "We got here somehow." Yes, we did, and many of our extant ancestral lineages got here by consuming considerable amounts of animal and other (like coconut) non-refined/non-processed lipids in their diets. Personally, my German-Polish-etc. ancestors in my working nutrition story certainly did!

I'll see if my body proves the associated hypotheses wrong. So far, so-unfalsified.

In the meantime, I'll keep imagining that I am one of Dr. Pottenger's lucky patients way back in the day: more prescription cultured butter, please!

At least that's a Patient of One Rx that I can test on my own body safely; that's taking m=1 personal my-thology and subjecting it to empirical scrutiny (putting Theory to Practice).

Perhaps, one day, as Dr. Donald W. Miller, Jr., MD, a contrarian cardiologist at the University of Washington, predicts, "pure butter will once again be viewed as the number-one health food" (thanks to Dave Lull).

I won't hold my breath, but I will hold out hope, since I suspect that the only certainty in life is uncertainty.

To good health,

Brent

Nutrimicrobiomics & Epimicrobiomics: Two new frontiers in human health & nutrition thinkering

(Above: Dennis Green, former head coach of the Arizona Cardinals, talking about human biology dogma prior to recent advances in genomics and in microbiomics)

Turns out, we aren't who we thought we were.

Awhile back, like in 2003, the central dogma of biology (DNA --> RNA --> Protein) still ruled the day and Lamarck was considered crazy. Like most extant models of homeostasis (physiologies are nonlinear and fractal, in reality), this cellular reasoning followed linearly.

And then the flood gates opened.

Finally.

From the Human Genome Project (hat tip to Dave Lull) and associated efforts, we realized that this genetics business is a bit more complicated and messy than we predicated a priori. We realized that we are still human beings trying to understand our own beings, our own biological underpinnings. We realized that trying to understand physiology is humbling, yet exciting and empowering. And that's a good thing.

And we were just looking at our own genomes, our own DNA.

Fast forward a few years to today, and it appears that experts from various disciplines are starting to say more regularly and persuasively that we'd be wise to examine those symbiotic micro-organisms (or anti-symbiotic "weeds") that inhabit and interact with our bodies. In short, the central dogma of biology is evolving rapidly as we speak. And we're responding swiftly, I think. Recently, fields like nutrigenomics and epigenetics have emerged with promising perspectives, offering insights on how our environments and other external factors interact with our primal blueprint genetic makeups to produce body tissues and regulate biochemical functioning. In parallel, from the Human Microbiome Project and associated efforts, we are realizing that those micro-organisms in our bodies that outnumber us 10:1 (based on cell count) determine our phenotypic destinies quite dramatically. From this view, the Personal Genome encompasses both human and non-human genomics because we carry all these other cells (and their DNA/RNA) around with us all the time.

Here are a few working definitions for this area of inquiry:

Microbiota: The collection of micro-organisms in a particular environment, such as the human body, e.g. the human gut microbiota.

Microbiome: The collection of genetic material (all the genomes) in a particular microbiota.

Gnotobiotic: Describes a microbiota with a known set of micro-organisms.

Agnotobiotic: Describes a microbiota of unknown or poorly defined composition.

In an anti-Dennis Green fashion, these threads suggest that we aren't who we thought we were. It appears that we really are meritages of cells that change dynamically across our lifespans (just consider how antibiotics wipe out our gut microflora or how the atoms that constitute our bodies turn over entirely every seven years or so).

So, to this list of terms, I would like to add the following memes:

1. Nutrimicrobiomics: The study of the multi-directional interactions between microbiomes and diets.
2. Epimicrobiomics: The study of the multi-directional interactions between microbiomes and environments.

That's a start, at least, to defining these new fields of inquiry (which may fall under the umbrella term "Functional Microbiomics"). I'm imagining things like metabolomic profiling for microbiomes too. For example, inulin is a fermentable fiber that acts as a prebiotic that 'feeds' gut flora. As inulin is metabolized in a person's body, it influences that person's 'human' genome and his/her 'non-human' microbiome simultaneously. This simple interaction with our intimate micro-organism neighbors represents nutrimicrobiomics in action. Chris Kresser of The Healthy Skeptic (who recently conducted an awesome interview with Stephan Guyenet), has an excellent series on 'acid stopping drugs' that speaks to this too. I've long stood against widespread use of Proton Pump Inhibitors (PPIs) as pharmacological agents because they increase susceptibility to Clostridium difficile infections dramatically (thanks to Dave Lull) and create grounds for extensive bacterial overgrowth in the lower intestinal tract. Clearly, the choices that we make about dietary intake shape the environments of our microbiomes directly (see Dr. Ayer's recent Cooling Inflammation post on human milk as prebiotics) and thus influence our n=1 set of micro-organisms through epimicrobiomics in the process.

Which adds another layer of plasticity to our health optimization functions!

So, when it comes to optimizing health, given both the inherent variability in people's genomes and microbiomes and the plasticity considerations of epigenetics and epimicrobiomics, it seems reasonable to conclude that we each won't be who we think we are going to be in the future because our experiences today will lead us down unpredictable phenotypic expression paths in powerfully fractal ways.

Embrace this uncertainty and listen to your body respectfully to see where this path may lead you serendipitously (and, I suspect, nonlinearly).

On this Memorial Day weekend, I'm thankful for where my path has meandered unexpectedly.

Find peace as a deductivist by recognizing that you don't have to be all things to all people at all times: be yourself (in harmony with all those micro-organisms you carry around with you as co-pilot allies) and be your best.

That's the best we can do.

That's what I (try to) do.

To good health,

Brent

PS. One of my favorite prebiotic/probiotic/synbiotic meals is onions (inulin source), mushrooms (fungi source), and meats cooked in cultured pasture butter with FAGE Greek yogurt (bacteria source) as a side. That 'feeds' my GI system symbiotically! While alive, animals work actively to remove toxins from their bodies (save rare evolved examples like tetrodotoxin depositing), so we benefit from their efforts when we eat their tissues. On the flipside, while alive, many plants and fungi actively produce and store toxins in their tissues to deter herbivory. The takeaway: we each, individually, have to work strategically (via self-experimentation, as one mechanism) to figure out which types of tissues and in what amounts and with what constituents we should eat and drink to mesh well with our own distinct beings (and to enjoy while living). That's my working conjecture, at least, that I'm trying to falsify actively.

In Search of The Perfect Human Diet

It's one idea: Ancestry

Searching throughout our ancestral heritages respectfully for pearls of wisdom to apply gracefully in our modern ecologies.

Update on the all-things-Ancestry-front: We officially started the formal incorporation process with the Secretary of State in California to create Ancestry Foundation as the 501(c)(3) non-profit umbrella for the Ancestral Health Symposium, the Ancestral Health Society, and all-things-Ancestry that bubble up spontaneously like a school called Ancestry (m=1 + n=1 = School of One), a publishing wing called Ancestry Press (redefining the meaning of "AP" with publications like The Journal of Ancestral Health), and/or an Anti-Health Insurance Co-Op healthcare financing entity (we're envisioning a platform that supports practical efforts to operationalize serendipity in local communities). We're actively crafting By-Laws behind the scenes, and we're finalizing the exact location and dates for the 2011 Symposium (thanks to the awesome 500+ people from all over the world who have filled out our Attendee Survey thus far with brimming interest and excitement).

In the meantime, as these pieces fall into place, we have partnered with CJ Hunt and his team to help support their In Search of The Perfect Human Diet film project. Many of the Ancestral Health Symposium presenters are featured experts in this film, and Loren Cordain posted about this fundraiser effort the other day as well:

The Ancestral Health Society & Foundation has launched a fundraiser for post-production work on the international documentary series In Search of the Perfect Human Diet™. The four-part series features the world’s leading scientists and advocates in human evolutionary nutrition.

Donations of $100 or more will get a Special Edition DVD set and Film Credit for their support.

Distribution of this series will create important ongoing financial support for the Ancestral Health Society's non-profit foundation and educational mission via direct financial contributions from all DVD sales.

The four-part series features the world’s leading scientists and advocates in human evolutionary nutrition, including:

• Dr. Loren Cordain (author of The Paleo Diet, Colorado State University)
• Dr. Michael Richards (Max Planck Institute for Evolutionary Anthropology, Leipzig, Germany -Department of Human Evolution)
• Dr. Jay Wortman (Inuit Diet research, Canada)
• Dr. Steve Phinney (Professor Emeritus of Medicine, UC Davis)
• Gary Taubes (New York Times science writer and author of Good Calories, Bad Calories)
• Dr. Michael R. Eades (author of Protein Power)
• Barry Sears Ph.D. (author of The Zone)
• Dr. Leslie C. Aiello (President, Wenner-Gren Foundation for Anthropological Research, New York)
• Robb Wolf (Research bio-chemist, author of The Paleolithic Solution)
• Professor Richard D. Feinman, PhD (Downstate Medical Center (SUNY) in New York)
• Professor Craig Stanford (Chair, Department of Anthropology, USC)
• Dr. Lane Sebring (Sebring Clinic, Wimberley, TX)
• Eric Schlosser (author of Fast Food Nation)

And many more … (including David Getoff of PPNF)

This fundraiser will enable Hunt Thompson Media, LLC to finish the international documentary series post-production work by Thanksgiving 2010, and release it for the 2010 Christmas and the 2011 New Year's resolution season. For more information on the documentary series visit: www.perfecthumandiet.com.

To make a donation, click the 'ChipIn!' button below:

Support Ancestry Foundation in the future by 'chipping in' to In Search of The Perfect Human Diet today: I did!

And so did Richard Nikoley (Free the Animal) & Brian Geremia (Living by Bliss).

To good health,

Brent

Food & Western Disease: Health & Nutrition from an Evolutionary Perspective by Staffan Lindeberg

Should humans eat plants?

View more presentations from Brent Pottenger.

I'm not a Kitavan.

Nor are you.

But I am a Staffan Lindeberg fan.

And I bet you are too.

If not, you will be soon.

Through The Kitavan Study, which provides most of the clinical basis for his book, Food and Western Disease: Health and Nutrition from an Evolutionary Perspective, Dr. Staffan Lindeberg (MD/PhD) collected (hunted and gathered) information and epidemiological data about human ancestral diet and health that illustrate the wide range of nutritional solutions that people have engaged to exploit various ecological niches successfully (see Don Matesz's "Paleo Diet Analysis: Kitavan Analogue Diet"). And, most importantly, in the case of the Kitavans, unlike far too many modern Americans, people have consumed these real foods nutrients healthily, avoiding chronic diseases and metabolic syndrome maladies (coronary artery disease, stroke, obesity, diabetes, etc. and the list seems to be expanding daily, unfortunately).

Above all, though, Staffan Lindeberg's tremendous book--a magnum opus that reads like Stephan Guyenet's exemplary Whole Health Source blog, full of detective-like inquiry, sharp thinking, and extensive referencing--abounds with valuable philosophy of science material that I suspect trumps all the nutritional science details (see his "Problems in nutritional science" notes). From the excellent Foreward by Loren Cordain to the 2034 references that end this work, Dr. Lindeberg's book provides many insights that resonate with the n=1 modus operandi. But how did he arrive at his current state as a physician practicing and advocating evolutionary medicine? Well, as he states, he "stumbled upon Boyd Eaton's paper about foods that were consumed during human evolution, including a brief note on the absence of Western disease among hunter-gatherers" (xi). This type of Happy Accident is something that I can relate to closely since Nassim Taleb tipped me to Art DeVany (who then tipped me to Mark) in a similar manner, serendipitously. Once infected with the Primal health bug (a meme, really), Dr. Lindeberg's thoughts couldn't stop connecting-the-dots: the implications of his findings were mind-blowing. In response, Dr. Lindeberg realized that deeply-rooted biases and shortcomings, such as confounders in epidemiology studies, have plagued nutritional science for decades. Today, he respects the complexity of human physiology and hints at the need for self-experimenting with all things lifestyle:

"Hypotheses regarding lifestyle are even more uncertain since they cannot be tested in double-blind studies, where no one knows who changed what until after the study. A myriad of intricate networks with thousands of enzymes, coenzymes, receptors and transcription factors, many of which have yet to be discovered, are included in those parts of the metabolic system (the construction, utilisation and breakdown of substances) that are thought to affect the development of cardiovascular disease. Once food is broken down and absorbed, its later metabolic fate is largely unknown, which is why its role in chronic disease is highly uncertain" (16).

No sweat; we already know what to do in the face of opacity (imperfect wisdom): we conduct our own Patient of One clinical trials using epistemocratic maps like Dr. Lindeberg's book as our thinkering guides. But, as he reminds us by invoking Descartes and Karl Popper, when we test conjectures on our own bodies, we must maintain awareness of the self-deceptive and always-lurking confirmation bias:

"An important source of inspiration for researchers themselves is the hope that their own hypotheses will be confirmed. It has long been known that this hope can affect the interpretation of study results, and early philosophers like Descartes and Bacon embraced doubt and critical examination. For the same reason, the philosopher of science Karl Popper felt that each researcher should try to discredit their own hypotheses" (19).

For this reason, as I've developed my personal m=1/n=1 Ancestral Health paradigm, I've embraced negative empiricism and have tried to honestly and openly falsify various hypotheses via deductivist decision-making (by taking general concepts that seem logical and tinkering with them to see how they apply or fail to apply in my own specific case, letting--as Karl Popper famously stated--"my hypotheses die in my stead"). For example, I am currently conducting a small-scale cultured butter self-experiment--I eat slices of cultured butter regularly (see Seth Roberts' post)--and I have yet to falsify (prove wrong) my underlying suspicions (that cultured butter is anabolic and fosters healthy gut flora), but I will continue to look for negative results (such as facial inflammation) as my trial-and-error effort unfolds before me unpredictably. Where did the idea to eat cultured butter come from anyways? My friend recommended it. I evaluated his suggestion for its merits and its potential drawbacks, and I then opted to integrate it with my working story system (I told myself, "good hyperlipidity + fermentation = a cheap health option with tremendous upside payoff potential"). From Dr. Lindeberg's vantage, I am not alone in trying to link nutrition choices to mythology: he suggests that we (even "experts") all do this daily when it comes to forming our nutritional bricolage execution frameworks:

"Ideas are strongly linked to stories or analogies. The power of stories in human culture can be enormous and academia is no exception. Once you start to think about it, you find experts telling tales everywhere. Analogies help us to understand new thoughts, but our sense of 'knowing' is thereby easily overestimated" (20).

Whether it's Nassim Taleb warning about the narrative fallacy or Brian Geremia considering personal m=1 my-thology, storytelling is undeniably human: we theorize, explain, rationalize, and narrate our ways through this world each day as we live by fiction and do a lot of 'sense-making'. Given this human condition reality, Staffan Lindeberg offers the following:

"Thus, there is considerable amount of room for personal interpretation when viewing previously completed studies, an interpretation that may be a potential source of errors. All of us interpret the results of dietary studies based on our own personal ideas of what constitutes wholesome food. A common preconceived notion, which is based on generations' understanding of the benefits of vegetarian cooking, is that meat is less healthy than vegetables" (20).

Personally, as implied by my short slideshow above, I practice a primarily carnivorous (high animal lipid) eating schema (I eat plants selectively and cook them properly when I do because I reason that animal tissue trumps plant tissue when it comes to safe toxicity avoidance behavior: consider that a survivor lost in the wild would die much more quickly by eating plants than by eating animals), but I do worry about the problem of induction (the limits of knowledge, really) and want to avoid generalizing from specific (me) to general (you and the rest of the world's populations), so the most I can do is nudge you gracefully (in sharing "how I get to the freeway") and recommend that you test vegetarianism against meat consumption by self-experimenting with Meta-Rule formation: let empiricism rule the day, I say. I feel strongly that we can never account for cultural diversity by reasoning inductively. Evidently, Dr. Lindeberg suggests this much too:

"Each country has their traditional dietary customs. These affect the dietary recommendations from experts on every level, something which seldom appears in writing" (21).

Worldwide, as citizens of countries have broken ties with their traditional dietary customs, cultural degeneration has ensued through the rise of a global mono-diet dominated by soy, wheat, corn, vegetable oil et al. processed junk that our metabolisms have no idea what to do with, displacing our connections with the nutritional conditions under which our physiologies co-evolved over the course of millions of years. Given this troublesome malaise, Dr. Lindeberg recognizes that cultural revolution is needed to turn the tide in positive ways:

"Nutritional science is intrinsically biased because epidemiology is confounded, physiology is complicated and randomised trials usually cannot be placebo-controlled. As as a consequence, non-scientific influence may play a substantial role in shaping the concepts of diet-health realtionships" (21).

Hopefully, the Ancestral Health Symposium, the Ancestral Health Society, and the over-arching Ancestry Foundation can help contribute to turning the tide positively in all facets of everyday life. Staffan Lindeberg, thankfully, will be presenting at the Symposium, and his conclusions about nutrition capture the core mission of and motivations behind the soon-to-be-formed Ancestral Health Society (AHS) nicely:

"Nutritional recommendations for public health are resting on such unstable ground that evolutionary medicine may provide an important complement to traditional scientific methods" (29).

When it comes to selecting a default perspective for health science, defaulting to ancestry and using evolutionary timescale weighting to consider what we should eat and drink to fuel our bodies seems valuable to Dr. Lindeberg. However, in light of the problem of silent evidence, predicting the past is just as difficult (impossible) as predicting the future, so we have to look back at our heritages cautiously:

"Attempts to determine food patterns of prehistoric hunter-gatherers are fraught with considerable methodological problems. There is already great uncertainty in terms of which dominant edible animals and plants were present in the ecological niches in Africa where Homo sapiens evolved from 2 to 0.2 million years ago" (31).

This is why Stephan Guyenet conceived the subtitle--"The Human Ecological Niche and Modern Health"--for the Ancestral Health Symposium: he understands fully that we must confront our health problems in light of our current environments, reasoning, as Staffan Lindeberg emphasizes, that:

"[H]uman beings are apparently omnivores who are well adapted for a diet based either on animal or plant foods, the relative proportions of which have been highly variable depending on habitat. The discussion about human's ancient diets is often misdirected to a debate on meat versus plant foods. Thereby, the main point is missed: most of the calories in Western countries are provided by foods that were practically unavailable during human evolution" (34).

So, after attempting to wet your appetite with some philosophy of science considerations (hint: read his book!), I'll leave the rest of the book for you to peruse, but the take-home message is clear: if you want to avoid Western diseases, reconnect with your ancestral nutrition heritage right away!

In Staffan Lindeberg's view, when it comes to creating a starting base, our best bet is to begin with a paleolithic platform--"humans are genetically suited to lean meat, fish, vegetables and fruits. ... The optimal human diet is more than just the diet of our ancestors; it appears to have the potential to prevent many of the common public health problems of the West" (224). Which sounds a lot like CJ Hunt's perspective in his awesome In Search of the Perfect Human Diet film project (that I encourage folks to support today). Of note, Dr. Lindeberg recommends to avoid grains, legumes, refined fats, sugar, beans, milk, and a few other things. That's the summary of his negative advice for 2010 and beyond, which I'll leave you with to reflect on indefinitely.

Since we could thinker infinitely about nutrition and health interactions, I'll switch gears swiftly and leave you with a Comedy, Conjecture to close this book review of Dr. Staffan Lindeberg's epic work:

"What do you call a Power Forward who gets six rebounds in a game? A Small Forward." - Charles Barkley

I'm a Point Guard, Charles.

But I'm not a Kitavan.

And that's alright: I have my own ancestry to respect and cultivate.

It's continual self-discovery.

I hope that you now are a Staffan Lindeberg fan too!

To good health,

Brent

PS. Dr. Staffan Lindeberg, MD, PhD, is also a fan of my forward-thinking ancestor: Dr. Francis M. Pottenger, Jr., MD

"Each athlete is an experiment of one" - An Interview with David Epstein of Sports Illustrated

I'm not you, and you're not me, and that's why we need an Ancestral Health epistemocracy.

I started thinkering with epigenetics a few years ago--see my essay, "MemBRAIN - It's all about ENERGY FLOW"--and I have experienced the concrete, tangible manifestations of epigenetic mechanisms in my own health improvements--see the poster that Aaron Blaisdell and I presented at UCLA: We both cured ourselves epigenetically through ancestral nutrition remedies, despite being told for years that our conditions were essentially immutable genetic maladies.

Keith Norris (@KeithNorris) of Theory to Practice blogged about David Epstein's (@SIDavidEpstein) recent article in Sports Illustrated, "Sports Genes," the other day in his post, "The Yin-Yang of Genetics and Epigenetics," and I had the awesome opportunity to interview David this morning.

Like Mark Sisson (see my review of his epistemocratic book, The Primal Blueprint), I find an intuitive understanding of epigenetics and human plasticity to be empowering. In a similar spirit, David investigates and speaks to the complex, inseparable interactions between our genes and environments in his excellent article, showing that the frontiers of this emerging area of science are quite exciting and potentially uplifting (if engaged properly).

Of note, as a highlight, when I read David's recent article, I really enjoyed this great close to his piece (bold = emphasis mine):

Genetic research has also suggested that some athletic phenomena that appear to be entirely genetic may have critical environmental factors, while others that appear to be entirely feats of will may have important genetic components. Scientists are rapidly identifying more performance genes and working to tease apart their subtle influences.

In terms of coaching tips, however, the scientific work has yielded little practical advice beyond what we already knew: Each athlete is an experiment of one, sports are good for all of us, some of us might be more motivated to practice than others, and the only way to find out how good each of us can be is to cross our fingers and train. Even though genes are critically important to an individual's athletic potential, at this point in sports-science history we are left in the position of Greek tragic heroes: circumscribed by nature, but with ill-understood wiggle room to direct our fates.

This may change, of course, as scientists now know that the path between genes and behavior is a two-way street. One study found that when people habitually lifted weights, a gene that codes for a muscle-growth-inhibiting protein became less active. And scientists studying epigenetics are beginning to learn how our behavior might alter the expression of our children's genes.

In the near future the study of genetics promises to tell us more about who we are as individual athletes, how much we can change and how best to go about it. "Genes do not act in a vacuum," notes Bernd Heinrich, a biologist and author and the 1981 North American 100K champion. Heinrich, who grew up running to school, insists that "genes are very plastic. They can be turned on or off. Look at a caterpillar and a butterfly: They've got the same genes. One flies, and one can barely crawl."

As David notes, the n=1 Patient of One manifests on the athletic field too.

With that introduction, here is a transcribed lead into the interview (listen to the entire interview by clicking here):

BP = Brent Pottenger

DE = David Epstein

BP: In your article, you write that "each athlete is an experiment of one." I coined a term, Patient of One, to recognize biochemical individuality and the epigenetic factors that influence health. Can you explain this phrase as a way to summarize what you learned while writing this piece?

DE: The first thing that brought that phrase to my mind was looking at the genetic data that showed how different people were in terms of their trainability for different types of athletic traits, which was amazing to me because I was used to, having been an athlete, thinking that certain people have a gift: they have a certain nature that they can work with, and the training response will be, more or less, directly proportional to the training that they do, and they will just improve from their baseline. That turned out not to be the case at all. It turned out that some people will start with a really low baseline, such as in aerobic capacity for endurance sports, and then improve by leaps and bounds using the same training that other people who start at a higher baseline use but do not improve at all. So, I found it interesting that we really don't know how much we can improve until we start training.

... Listen to the entire interview by clicking here.

I would love (and be honored) to have David cover the Ancestral Health Symposium (AHS) and the general Primal / Paleo / Evolutionary / Hunter-Gatherer / Whole / Ancestral Health movement for Sports Illustrated in some way: I'm imagining an alternative universe where ancestrally fit and healthy athletes take the public health stage and say loudly and proudly, "Just say NO to Gatorade!"

At the close of my interview with David, I mentioned the Human Microbiome Project. A few years ago, I wrote an article modeling gut microflora as a 'lawn of bacteria':

"Clostridium Difficile: A Weed Inside Your Digestive Tract"

In healthy, properly developed digestive systems, 'good' bacteria form a thick 'lawn' that covers the walls of your intestines completely. Antibiotics act like weed killers: they (may) kill targeted pathogens ('weeds') but will also decimate and disrupt healthy gut microflora (good 'grass') in the process, creating spaces in your GI system for infectious agents like C. Diff to move in, colonize, and wreck inflammatory havoc on your body (see Mark's, "Putting out the Fire: Gut Flora and the Inflammatory Cycle"). 'Reseeding' this bacterial 'lawn' after antibiotic consumption is challenging: it usually takes prebiotics, probiotics, other antibiotics, and patients with patience.

In light of this microbiomic model and the Human Microbiome Project, which I see as just as important as the Human Genome Project, here is an updated version of our working self-experimentation hypothesis, based on "Black Swan Logic for n=1 Health" (thanks to Dave Lull for helping shape this conjecture, built from Roger Williams' work on biochemical individuality):

'Every individual organism that has a distinctive genetic and microbiomic background has distinctive nutritional needs which must be met for optimal wellbeing.'

Adding 'microbiomic' to this statement makes sense, I suspect, given the individual differences that research has found among people's microfloral makeups (microbiomes). And, given the fact that the number of human cells in our bodies are vastly outnumbered by those of other micro-organisms, it just may be that our microbiomes trump our genomes when it comes to unravelling the underlying dynamics of our modern health challenges.

More and more, one of Marc Simonson's Meta-Rules rises to the surface as critically important to consider daily:

"Don't neglect to help your friendly bacteria / micro-organisms thrive; they are your closest allies in health."

Who knows, maybe David Epstein will one day write an article about microbiomics and sports performance that parallels his recent look at genomics.

I hope you too enjoy David's writing and thinking like I do!

To good health,

Brent

Tyus Edney at GPA, Seth Roberts on Ancestral Health, Living Prehistorically, Self-Experimenting with Vitamin D, and Cognitive Bias Musical Melody

Uno: I had the opportunity to kick off the first week of Game Plan Academy (GPA) in Compton yesterday with Tyus Edney. Tyus' son (pictured above wearing his dad's #5 jersey; his name is Tyus too) is already showing promising signs of basketball stardom (he has a nice knee bend in his jump shot, for starters).

Here's one of Tyus Edney's memorable highlight clips from his playing days at UCLA:

I always enjoyed watching Tyus play for the Sacramento Kings when he was just starting out in the NBA. As a point guard, he's a mature, energetic, and perceptive floor leader. Now that he is back in the US (after playing overseas), he's sharing his professional wisdom with students in Los Angeles. At GPA, the student-athletes from Compton, Centennial, and Dominguez high schools enjoyed their time in the classroom preparing for college and out on the court playing basketball with Tyus and friends.

Dos: Seth Roberts posted the following series on his blog recently:

1) "Brent Pottenger and the Benefits of an Ancestral Diet"

2) "Positive Side Effects"

3) "Brent Pottenger Comments"

Tres: Fellow Ancestral Health Symposium (AHS) co-organizers, Michal Naisteter and Nate Rosenberg of the "Living Paleo in Boston" MeetUp group, were featured in this recent NPR piece:

"Living Prehistorically in A Modern Age" by Andrea Shea

Cuatro: If you're self-experimenting with vitamin D supplementation (like I am presently), then you may want to check out Dr. James Dowd's book, The Vitamin D Cure. He's a practicing physician, an Associate Clinical Professor of Medicine at Michigan State University, and his book also advocates a diet informed by evolutionary concepts (a la Loren Cordain).

Dr. Dowd was kind enough to send me an autographed copy of his book, and I asked him a few questions after I finished reading it:

Pottenger: "Is vitamin D anabolic?" (Dr. Doug McGuff shares this suspicion as well)

Dowd: "Vitamin D does have some mild anabolic properties, particularly when blood levels are below 20 ng/mL to begin with. Once your level is above 32 ng/mL, this effect is probably minimal with additional D. Vitamin D may also enhance insulin release and sensitivity, and insluin related growth factors can have anabolic effects."

Pottenger: "Are there long-run risks of vitamin D supplementation in that your body would start producing less of it on its own with prolonged external (oral) consumption (as seen with other steroids)?"

Dowd: "The evidence suggests that vitamin D is absorbed in the distal ileum. This is why we see vitamin D deficiency refractory to supplementation in bowel resection patients and many gastric bypass patients. There are also a handfull of studies looking at lipid profiles in patients before and after vitamin D. Some studies show no change in total [cholesterol], HDL or LDL. Some show some increases in LDL. Vitamin D probably increases insulin release overall in response to stimulus. It is not known if this is due to increased phosphorus absorption or unrelated to a dietary component. Higher insulin levels may be responsible for alterations in lipid metabolism.

I am not aware of a study looking at dermal production rates relative to oral supplementation. Dermal production is more effecient and greater in the deficient state than in the replete state. This is part of autoregulation of vitamin D production from the sun. I would guess that as tissue levels of 25(OH)D rise, skin production falls to keep the blood level from overshooting.

Any resistence to vitamin D I think would be manifest at the receptor. Down regulation of receptors and enzymes for conversion or inactivation are where most resistance to vitamin D would be found. Some if not all of the initial WOW effect of vitamin D supplementation occurs because of over production of 1,25(OH)2 D (overshoot from upregulation of 1-alpha hydroxylase in the deficient state). This can take several months for the system to rebalance. Then, if you drop your supplements, you feel lowsy.

The whole idea behind supplementation is to make sure there is always adequate substrate, not to provide some excessive amount of substrate. There should still be seasonal rise and fall of substrate levels; it's just that most, if not all, of the year you remain above the threshold of compensation for inadequate substrate. Should we let our levels drop below normal periodically? Do primates in the wild sometimes have levels below normal? The indirect data would say maybe. Seasonal deficiency in post-menopausal women in Maine contributes to falling bone mass. Dr. J Adams published primate vitamin D levels in the 70s and found them to be in the 40-60 ng/mL range. I did a study on Yellowstone wolves and found that some of the yearlings, mostly females, had levels below 32 ng/mL, but the winter averages for males and females were about 32 ng/mL, which is the low threshold for normal. So, in wolves in North America, vitamin D levels seasonally often drop below 32 ng/mL. I do not know what summer averages are because they do not trap wolves in the summer.

There are always more questions than answers. With as little sun as I get here in Michigan and with my job, I know I need to supplement year round."

When we conduct n=1 clinical trials, as we do when we try to dial in our vitamin D levels to optimize health within an ancestral paradigm, it could help to have a map like Dr. Dowd's book as a companion resource.

Cinco: And, speaking of maps, if you enjoy Daniel Kahneman's work (see his Prize lecture, "Maps of Bounded Rationality") like I do, then you will probably love this (thanks to Dave Lull):

Good self-awareness reminders for the intuitive Qualitative Self.

To good health,

Brent