Entropy Awareness

Thought for the day ... (via Frank Wilson; thanks to Dave Lull)

"Whenever a theory appears to you as the only possible one, take this as a sign that you have neither understood the theory nor the problem which it was intended to solve."

- Karl Popper, born on this date in 1902

Primo: Happy Birthday to Sir Karl Raimund Popper, the critical rationalist who thinkered about fallibilism, evolutionary epistemology, hypothetico-deductivism, and the problem of induction for many years, advancing Philosophy of Science in many valuable ways. He wrote about the importance of ensuring falsifiability when making scientific (empirical/testable) claims. He was also an anti-justificationist: from his perspective, the process of conjecturing and refuting hypotheses should not be constrained by justifications adhering dogmatically to singular theories (nor by what seems 'reasonable/rational' a priori). In a sense, all claims morph into mythology rather shortly--scientists, in essence, posit myths--because data points that emerge tomorrow could turn any current 'fact' into an artifact just like that.


Segundo: Note the low-entropy motion in the video above (thanks to Dave Lull), and see this Tweet from Twitter today:

RT @mdizwan -- http://youtu.be/TBvF6r6DOvc -- Oriental Barbell strategy: when slow = tai chi; when fast = kung fu -- @nntaleb @epistemocrat @johndurant

Kung Fu is high-entropy energy expenditure (higher-intensity, lower-duration). Tai Chi is low-entropy energy expenditure (lower-intensity, longer-duration). Combining them in a Power-Law, Nassim Taleb Barbell (asymmetric: 80/20) manner produces another bimodal approach to moving about to exercise, condition, meditate, and reflect. I suspect there are a number of crossover points between these two modes, though, to facilitate transition states rather seamlessly. In my own n=1 energy-expenditure clinical trial, I enjoy studying different Barbell approaches and then self-experimenting with the spirit of their notions. For example, the kickboxing bag work that I do at the gym is certainly Kung-Fu-esque (and it's also like kicking a side-volley in soccer; it's a hybrid of sorts).


Tercero: Entropy is a fascinating scientific concept. From an information content perspective, entropy describes the spread or distribution of information in a system. High-entropy implies more diffuse information: fat/long tails, increased kurtosis, Extremistan, et al., while low-entropy indicates clustered information: precision, Gaussian, Mediocristan, et al. Under fixed path-length constraints, animals have evolved Levy-flight behavior in the wild for foraging in patchy information environments. A Levy-flight model constitutes a Barbell approach that resembles the aforementioned combination of Tai Chi and Kung Fu, producing the following pattern:

This nonlinear pattern generates nodes of localized high-intensity (Kung Fu) in the time- / resource- / energy-expenditure map, followed by flights of diffuse low-intensity (Tai Chi) movement.

The intuitive takeaway is that we can search and act intently in one domain, but we need Levy-flights to help us hedge against tunneling too deeply (read: repetition injuries) and getting caught up in activities like Mark Sisson's 'Chronic Cardio'. For instance, my favorite workout in the summer is riding my bike to the gym (visualize this as a Keith Norris-spirited Levy-flight); lifting and working out, perhaps mixing in a swim (visualize this as a Dr. McGuff Body-by-Science-spirited localized node of high-intensity); and then, riding my bike back home with some interval sprints mixed in to cap things off nicely in concert with a natural Vitamin D bath in the sun.

Entropy awareness appears important for health considerations because biological systems go awry when entropy levels get too high. As biological systems, our bodies are constantly conducting processes to reduce the entropy levels in our cells in order to synchronize biochemical reactions in concert to regulate physiological parameters. However, one of the most critical aspects of this concerto is fluid flow: enhanced fluid flow in the body permits toxin removal and disposal, resulting in a net entropy reduction. Toxin build-up is one of the most dangerous high-entropy conditions that can spur diseases and illnesses. So, in order to aid fluid flow in our bodies, we need high-intensity, low-duration energy expenditure moments that help our natural pumps--such as the muscle-contraction-induced vasoconstriction of the veins in our legs (read: edema-avoidance)--function to perfuse our organs with fresh blood full of oxygen, minerals, nutrients, etc. For example, I self-experiment with inverted exercises, such as handstand pushups and upside-down hamstring stretches, in order to prime the pump that circulates my spinal fluid. This also engages gravity's assistance. The goal is paradoxical because a short-term high-entropy process facilitates long-term entropy reduction for health maintenance and enhancement. In the physiological headroom equation, the width between the least you can do and the most you can do, low-entropy activities 'lower the floor' and high-entropy activities 'raise the roof', so we want to spend most of our time in touch with the ground, coupled with bursts here-and-there of reaching for the sky.

Life is full of paradoxes.

It's about harnessing entropy.

C'est la vie.

To good health,

Brent

Fixed Path-Length Constraints

"Fixed Path Length Constraints"

There's only so much time in a day.
There's only so many things we can say.

Sometimes it's best to just get out of our own ways.

I move right.
There's new light.

I move left.
I feel bereft.

I'm searching under uncertainty.

I take a Levy flight.
I see a new site.

It's fascinating yet intimidating.

There's so much to see,
But yet so much remains unseen.

How best can we search semi-practically?

Our senses could prove useless;
Sometimes it all proves fruitless.

Fixed path-length constraints make me feel so scrupulous.

But I have faith in the process;
Trust in the underlying dynamics.

What's fixed becomes fluid,

And those path-length constraints
Seem to fade away into a haze.


To good health,

Brent

Comment Highlight: LeonRover says, "Not Unhealthy"

In response to my previous post on The Problem of Induction ...

Note the negative empiricism spirit in LeonRover's thinkering:

I have begun to find that invocation of the notion of "optimality" has become bogus as far as my eating decisions are concerned.

Back in the day, I use to do LP - Linear Programming - not LipoProtein. The solution space was defined by a set of values on a convex set, and the Optimization Function, either a Linear Cost Minimization or a Linear Profit Maximizing function found a set of values on a vertex of the convex set of solution values.

A Solution Space is a set of statements about an individual's diet consisting of sets of maxima and minima of variable values, such as amounts of micronutrients, macronutrients etc., while one's problem is to pick amounts from a set of available foods, each of which contributes an amount of macro- or micro-nutrient per 100 gram. A solution is a vector of amounts of the foods which fall within the boundaries of all the maxima and minima. The solution set is all those vectors - this is a large number.

There is, however, no definition of health which is a function of amounts of macro- and micro-nutrients in any particular vector in the Solution Set.

Thus there can be no optimization.

I do think each of us has some goal: to be an athlete and win some events, to live without disease, to live as long as possible, to live as long as possible without disease, to live as long as possible without disease and to be happy, etc. etc. etc. It has not been possible so far to construct the diet conditions for even the simplest of these on a population basis, never mind on an individual basis.

Only successive generations can tell whether our choices have been successful, but it will not help them in their dietary intakes. Why? Because they will not know which of our genes did not get expressed in their generations. They will only know those which did get expressed in those who reproduce.

I suggest the notion of Health, never mind Optimal Health, is not a useful concept.

The best that I can come up with is: Not Unhealthy.

Any vector of food amounts is then looked at and judged whether it is allowable - Not Unhealthy - or not allowable - Unhealthy.

Rather, complexity gets complex pretty quickly. Meta-Rules rise to the surface as an attempt to deal with the fact that we know, based on physiological feedback, more about what our bodies don't like than we do about what they do like. There's an inherent asymmetry in uncertainty, it seems.

I like to say that we can approximate 'health' in our own Patient of One n=1 cases.

When 'health' fails, 'reality' changes rapidly.

To good health,

Brent

David Trejo's m=1/n=1 Meta-Rules

Note the homoplasy below in David's 'walking' meta-rule that correlates with Nassim Taleb's aphorisms about thinking while moving.

Some would say, "How can God enter your reflections if you always have music playing?"

I like music. But I also like some silence.

Either way, enjoy what the ever-epistemocratic DT has to say:

As Brent may have mentioned before, meta-rules help you decide how you want to live your life, and help you make decisions about habits and the ways you comport yourself. In reality, they are more like rules for rule-making. Here are a few of mine. They serve mostly to help me enjoy life.

- I Smile. It makes me feel better. People smile back. There's so little effort and so much upside.

- I don't listen to music while I walk places. This allows me to think more, and gives my brain space to solve my problems (same thing happens when I'm in the shower).

- When I have a free moment, I make sure to take a step back and appreciate the freshness of the air, the smells, the stars, or whatever else catches my attention. This lifts me up and breaks me out of my current train of thought. This is especially helpful when I find myself thinking thoughts I'd rather not think.

- When I take a step back to appreciate life, I take a deep breath. This helps me appreciate the beauty of my surroundings and also makes me feel more alive (some say oxygen is healthy for the brain).

- Certain motions make me happy: when I raise my arms like Atlas and hold the world like I own it, or when I stand in a certain way.

- I only let people annoy me three times. You're familiar with that annoying person in the movie theater who hits the back of your chair with his/her foot. On the third infraction, I let them know I don't appreciate it. In situations where I can predict future problems, I cut off annoyances more quickly.

- I find it is much easier to create a new habit than break an old one. By making the above bullet point a habit, I prevent others from engaging in habits that annoy me. Because such habits are generally circumstantial, I can generally nip them in the bud. For example, a person who loses respect for you and continues to disrespect you will quickly stop if you make your boundaries clear. If this fails, ruthlessly cut them out of your life, as they are doing you no good. Litmus test for when change needs to happen or you need to cut someone out of your life: "On average, how do I feel after I've spent time with this person?"

- I appreciate the thoughts that bubble out of my brain. To help these thoughts along, I write three pages a day using 750words.com. The idea is that tons of interesting things pass through my head each day, but I will lose or forget the interesting ones if I don't spend time brain dumping. This is generally a cathartic process which leaves me feeling better, allowing me to spend more brainpower thinking about the things that give me pleasure. This helps me defuse any feelings I'm having and offers an opportunity to step back and look at problems from a distance.

- I seek out interesting people.

- I keep in touch with people I find interesting, and intellectually stimulating (Hi Brent).

- I build habits that make me feel better about life, and build my confidence in my abilities. For example, every day I add at least one chunk of code to mixest.com, write 750 words*, and do push ups. Of course, I also work and do other things, but that is more mechanical and easy to maintain.

Thank you for featuring me, Brent; I appreciate it.

Have a good day everyone,

David

*PS. I also find that some of my most natural writing comes out of these 750 words. I really enjoy how the words just flow.

The Problem of Induction: Dietary Caveat Business Card

Everything has a caveat.

A warning.

(Or is it a forewarning?)

My blog has a caveat; it's a Warning located in the upper right-hand corner.

The Problem of Induction requires caveats; elegant caveats that celebrate individuality.

For instance, my friend, Jeff Erno, picked up a bunch of Vibram Five Finger business cards to hand out to people who asked about his uncommon minimalist shoes. This saved time.

When it comes to dietary questioning, we may well need business cards with the following conjectures printed on them (thanks to Dave Lull):

My dietary self-experiments are guided by two conjectures of Roger J. Williams:

"The existence in every human being of a vast array of attributes which are potentially measurable (whether by present methods or not), and often uncorrelated mathematically, makes quite tenable the hypothesis that practically every human being is a deviate in some respects"—Roger J. Williams, Biochemical Individuality, 1956, p. 3.

"The genetotrophic principle, as the author conceives it, is a very broad one encompassing the whole of biology. It may be stated as follows: Every individual organism that has a distinctive genetic background has distinctive nutritional needs which must be met for optimal wellbeing"—Roger J. Williams, Biochemical Individuality, 1956, p. 167.

Today, decades after Roger J. Williams' time, when we recognize that this 'genetic background' encompasses both human and non-human information (genome + microbiome), we realize more and more that it's quite plausible to suspect that translating knowledge gained from experience from one person to another person is a clinical process full of caveats.

Roger J. Williams referred to this dynamic as: Biochemical Individuality.

Cheers to m=1/n=1 caveats.

We need them.

To good health,

Brent

Theory

"Theory"

A theory is just a theory.
Well at least it is in theory.

They say theory informs practice,
But what about practice informing theory?

The theory says one thing;
But my experiences say another.

Am I wrong?
Or is the theory?

How do I validate my experiences,
Without sweeping my intuitions under the rug?

Because validation is important;
Say scientists looking at child development.

Children need validation.
They need feedback pairing feelings to concrete experiences.

But all this theorizing makes an adult wonder;
Wonder what to do with all these inconsistencies.

Fit the theory to the experience.
Or fit the experience to the theory.

Neither seems healthy.
Neither seems validating.

"It's just a theory," they sometimes say.
But it seems like so much more than that.

It seems like a valid justification;
Like scientific reasoning that is so convincing.

They say, "It's where the rubber meets the road."
But maybe the tread on my tires is wearing.

Making me weary because I keep staring.
Caring about whether experience has anything to do with all this theorizing.

So I'll theorize, "Yes," and continue to jest:
It's just a theory. At least it is, in theory.


To good health,

Brent

Where's my Brain?

"Where's my Brain?"

I can't figure this out.
But surely you can help.
I've lost my brain,
And I'd love to know where it's hiding out.

Is it in my head?
That's certainly long been said.
Is it in my heart?
I definitely can feel it play a part.
Or is it buried deeply within, underneath my viscera and skin?
The 'gut brain', they say, is a powerful thing.

They say these types of things more and more these days.
They being scientists, I have to say.

Whether 'heart brain' or 'head brain', it seems like everything constitutes my brain.

Neurons exciting, firing, and sensitizing throughout all parts,
Composing a multifractal concert of course. A concerto of sorts.
Leaving me wondering where this line in the sand, if ever, stops moving.

Because all things have a say.
And if the brain does all the thinking,
All that information processing,
Then I cannot rule out that Mr. Pinky Toe
Has something to say when it comes to good old reasoning.

It's all terribly confusing, this neuroscience of choosing.
So I'll leave it to you to answer with some amusing.

I've lost my brain;
But where it is, I cannot say.


To good health,

Brent

Five Random Thoughts: What I've Learned from Three Years of Blogging

Dr. Atul Gawande says, "Whatever you do, write something."

Something.

Blogging, in some way, is something: a healthy hobby, perhaps.

Writing is a way to test things; to try things out; to work through things: it's meditative, maybe.

Three years of writing by Blogging have revealed the following, randomly:

(1) Lots of people are thinking, wondering, worrying, and considering similar things. The power of the Internet is that people can connect about these things in potentially beneficial ways that were not possible previously. Spontaneously, themes emerge when sharing in the Blogosphere collides and thinkering intersects: I often refer to this as homoplasy. However, Blogging biases things; publishing biases things; the voices of those who compose and publish things become concrete (we may perceive them as real), but that does not mean that these voices represent things properly (beware of the Problem of Silent Evidence). Blogging, thus, is a responsibility to honor because by electing to publish your thoughts, feelings, and inklings about the world, you are biasing (shaping) reality in some small way for others as well. I've tried to respect this dynamic graciously, but I've surely failed from time to time too, and for those instances of misplaced modifiers, I apologize with genuine regret and an ongoing commitment to improvement.

(2) No matter how much you write about something, acting on all that 'searching' is still challenging. The saying, "Living ain't easy," comes to mind, initially. The hope is that by writing, by thinking, by tinkering, and by listening semi-openly we will somehow, collectively, stumble upon practical approaches to making living a bit more fulfilling (maybe a bit more 'easy'). 'Searching and acting', a paradox of choice that I've considered for the past three years, is a simple admission that the process of learning, growing, and maturing never ends, and the key is to commit to a process with diligence and honesty because we cannot always control outcomes but we can do our best to create conditions that may produce intended results at times: habit formation. Self-experimentation with Meta-Rule formation, for instance, is a process built on the premise that we do not know everything (though we do know things), and we can operationalize lack of knowledge into practical approaches to living.

(3) Mythology, words, stories, and narratives are important aspects of the human condition. Over the past three years, particularly by studying traditional dietary wisdom, I've grown more and more concerned about the loss of small-scale, local, multi-cultural diversity. Large-scale mono-cultural convergence (I suspect as a result of technology) has supplanted some of these important, nuanced parts of our heritages. In response, given that mythologies, narratives, words, and stories evolve, change, and experience editing constantly, I see tremendous hope in scientific conjectures that suggest how our words can shape our thinking in far-reaching ways (thanks to Dave Lull). This notion of neural and cultural plasticity permits the possibility that by writing and sharing stories we can re-craft hybridized myths that combine the sage insights of our ancestries with the promising breakthroughs of modernity.

(4) Dream. Dreams need to be aired out, tested, examined, and considered. Without allowing them to bubble up and experience some climate changes and environmental fluctuations at some minimal level, these processes will never play out. Sure, dreams lead to dead ends. Many dead ends, indeed. But, a priori, no one has any idea where dreams will lead, ultimately. Whenever a dream gets close to becoming a reality, Nassim Taleb's dentist-writing-novels-on-the-weekend model appears to be one relatively safe and sustainable bridge for testing the waters with novel options. Interestingly, the more I've thinkered with my own dreams, the more I've noticed that they converge on several themes, eventually unifying under one central idea that I call Ancestry.

(5) Engage online tools to connect with people on the ground. By Blogging, I've met so many awesome people that I suspect I would never have met otherwise. The list seems endless, thankfully. Luckily, by trying to engage the power of the Web in positive ways, I've been nudged gracefully by others to learn new and exciting things. The Internet is the land of the Catch-22 because it provides so many opportunities that bring value and hope into people's lives, such as an online group for mother's with children struggling with autism spectrum disorders (as just one example), but it can also tax and challenge our natural instincts and healthy social interactions if we engage its elements improperly. But, as is the case with dreams, I suspect that, in the long-run, there is value in confronting this challenge and trying to figure out ways to incorporate and integrate modern technologies professionally and sustainably into living each day.

For instance, I initially resisted starting a Twitter account, unsure of what it was all about. However, since I work with many high school students, and since high school students seem to have a pulse on social networking, I started Tweeting to test out, weigh, and consider how this Haiku-like technology interacts with and shapes the human condition today, for better or worse. The same perspective applies to my use of and experimentation with other online modalities like Facebook, LinkedIn, et al. Human beings are naturally curious creatures, and we learn through trial-and-error doing, so by doing things like Blogging and Tweeting, my hope is to learn how to engage them properly, professionally, and sustainably, if possible. I guess I'll never know if I am succeeding, but at least that's what I'm attempting.

MeetUp groups are another classic example of this dynamic. Say you have an interest in hiking, and you are looking for other hikers who share your micro-interest. The macro-love of walking in nature can turn into a micro-exploration of a trail in the Sierra Nevada mountains quite quickly via a new MeetUp group that hits the trails every weekend. Similarly, if you have an interest in Paleo-inspired eating, you can check out the MeetUp page that Patrick created to connect with folks you may not cross paths with otherwise. This type of use of online tools to spur interactions with people in the flesh, face-to-face, seems valuable to me for many reasons.

Thus, when it comes to harnessing the power of the Web, three years of Blogging have taught me that it can be done strategically and properly, and writing is one such example of how serendipity can emerge from sharing ideas, concepts, hypotheses, and conjectures online openly and freely.

But it's still a responsibility.

A responsibility to honor.

A honor to respect.

I suspect.

To good health,

Brent

Comment Highlight: Skyler asks, "Why a Master of Health Administration (MHA) degree?"

At times, I feel as if I have been a "Pre-Med" student forever (and it's a feeling of patience and perseverance that I am thankful for experiencing). I entered the University of California, Davis in Fall 2002, and I finished my undergraduate studies in Spring 2007. As indicated in the Graduation Ceremony video above, I then went on to pursue a Master of Health Administration (MHA) degree, which I completed in 2009.

Recently, in a comment to a previous post, Skyler Tanner asked me about my decision to complete a Master of Health Administration (MHA) graduate degree at the University of Southern California (USC). To start, here is the Program's description:

Our healthcare system is undergoing profound change unlike any experienced before. Access, quality, and cost of healthcare are critical issues that affect all citizens, residents, and communities. Healthcare and the healthcare industry – which account for more than 16 percent of the entire U.S. economy – involve complex and fast-moving developments in technology, economics, ethics, finance, policy, and management.

As an issue and as a sector, healthcare requires an understanding of public, private, and nonprofit interactions. Visionary and effective leadership is needed to improve management structures in a highly competitive, market-driven environment and to find place-based solutions to the unique challenges facing each community. Tomorrow’s healthcare leaders must address such pressing issues as:

• How will we control healthcare costs as baby boomers become senior citizens and medical technology continues to advance?
• How will healthcare dollars be allocated across generations?
• How can we measure quality of care?
• How can we assure that all U.S. residents have access to healthcare?

As the delivery system changes, career opportunities abound. The field needs leaders and managers – in hospitals, health plans, medical practices, health-related enterprises, and community health organizations – who have the passion, knowledge, and skills to shape the future of healthcare.

Personally, thinkering about all these considerations resonates with me deeply, which is why I truly enjoyed pursuing my MHA degree at USC. Every medical decision is also an economic choice with costs, benefits, and uncertainties. So, here is an essay my-thologizing attempt to answer Skyler's question semi-succinctly:

Social justice is important to me.

It's embedded within the fabric of the Jesuit educational philosophy, and my learning experiences at Jesuit High School were valuable for me.

Over a decade ago, as a student at Jesuit, I realized that I have two passions that I suspect will define my life: child development and health(care)/medicine. In children, I see tomorrow's future. I see promise, hope, and inspiration. In health(care)/medicine, I see ways to enjoy life maximally and to cope with life during difficulty. I see powerful approaches to helping people live daily, both in health and in frailty.

But I didn't know how to blend and integrate these two areas.

Now I do: Pediatric Medicine*.

But how did I get from Jesuit to here?

Simple: Nonlinearly. Unexpectedly. Serendipitously.

Like Dr. Sandeep Jauhar did.

As I progressed through my Pre-Med studies at UC Davis, spending many hours volunteering in the Emergency Department at the UC Davis Medical Center, I tapped into one of my strengths: listening. I listened to physicians. I listened to patients. I listened to nurses. I listened to technicians. I listened to administrators. And all this listening suggested one thing to me: The practice of medicine does not occur in a vacuum. Instead, medical services are delivered within the context of a complex, dynamic, and multi-faceted healthcare system. The more I listened, the more I realized that numerous non-clinical factors influence the provision of medical services. The more I listened, the more I understood the important effects that healthcare policy and administration decisions have on efforts in the clinic and at the bedside. The more I listened, the more I grasped the social justice implications of healthcare management: Given limited resources, healthcare leaders, in partnership with patients, must figure out how best to provide medical services to those in need in a timely manner. In healthcare, we cannot pay for everything, so we must pay for quality while ensuring equitability. From there, I realized that linking clinical research and medical empiricism with healthcare economics, financial management, and health policy perspectives could be important to pursuing social justice considerations in the context of a healthcare system facing significant resource constraints. In short, the more I listened, the more I realized that, in the long-run, I could benefit from taking a few years of graduate school study to grapple with the health policy and administration challenges that influence the practice of medicine in profound ways.

In the future, if I were lucky enough to develop into the physician leader who I hope to become, I hope to draw on my MHA studies to integrate the financing and delivery of medical services efficiently and effectively, in the spirit of this Annals of Emergency Medicine piece, "Regionalization of Care for ST-segment Elevation Myocardial Infarction: Is it Too Soon?":

Ann Emerg Med. 2008 Dec;52(6):677-685. Epub 2008 Aug 27.

Regionalization of care for ST-segment elevation myocardial infarction: is it too soon?

Pottenger BC, Diercks DB, Bhatt DL.

School of Policy, Planning, and Development, University of Southern California, CA, USA.

Abstract

Interest in regionalization of the care of acute ST-segment elevation myocardial infarction (STEMI) has gained momentum recently. Optimal treatment of STEMI involves balancing time to treatment and reperfusion options. Primary percutaneous coronary intervention, when performed in a timely fashion, has been shown to be more effective than fibrinolysis. However, numerous practical barriers prevent many STEMI patients from receiving primary percutaneous coronary intervention. In an effort to increase beneficial primary percutaneous coronary intervention administration to STEMI patients, health care leaders have proposed regionalized STEMI care networks with advanced emergency medical services (EMS) involvement. Constructing regionalized STEMI networks presents a policy challenge because this shift in STEMI care would require changes in current EMS and emergency medicine practices. Therefore, we present various perspectives and issues that decisionmakers and system organizers must address properly before deciding whether to adopt this new model of care. Reorganizing STEMI care in a manner analogous to how trauma and stroke care are currently triaged and treated appeals intuitively; however, given the absence of evidence that STEMI regionalization actually improves patient outcomes and is cost-effective, more research is needed to determine whether STEMI regionalization is an efficient model for providing evidence-based care. The concept of STEMI regionalization represents an effort to inform policy according to evidence-based medicine, but real-world quality, geospatial, financial, cost, business, resource, and practice barriers present obstacles to implementing this concept efficiently and effectively.

+++

When we improve the healthcare system, we increase the resources that we have available to treat diseases and maintain/enhance people's health states preventively. To me, that's one beneficial way to advance medicine's social justice mission. To me, that's exciting and fulfilling.

If I had to pinpoint one thing that helped me find my way, I would identify listening: listening to clinicians in the trenches; listening to mentors in my classes; listening to friends and family members in the community; and then, ultimately, listening to my inner-calling while not being afraid to follow my intuitions to their logical conclusions to figure out what all these healthcare professionals and patients keep talking, writing, and debating about when it comes to the art and science of medicine.

Thankfully, serendipity struck one day in Fall 2006 when I was waiting in the Pre-Med advising office at UC Davis: I saw a note about an information session with the Director of USC's MHA program on campus that night; I went to the meeting; I knew it was the right "next step" for me; and, the rest is history.

Who knows where the next step of this journey will lead me.

The best I can do is to just keep listening.

To keep thinkering.

To good health,

Brent

*I also have a long-term dream of being involved with a school (called Ancestry). My work mentoring youth through Academic Impact (Ai) and Game Plan Academy (GPA) has cemented for me my interest in contributing positively to the education of tomorrow's leaders, to the next generation, as so many wonderful mentors have done for me, thankfully.

Ancestral Health presuppositions

Primo: Michael Allen, Grumpy Old Bookman, composed his 40-year m=1/n=1 nutritional bricolage journey as an essay, "Is it Safe to Eat Breakfast? One man's search for a healthy diet" (thanks to Dave Lull). Several fascinating themes emerged in this essay: (1) human fallibility in nutrition science; (2) self-experimentation as a necessary process for stumbling upon a pretty decent diet; (3) meta-rule formation, without too much rigidity, as a deductive tool for developing healthy lifestyle habits; (4) respect for ancestral wisdom and our diverse multi-cultural heritages as human beings; and, (5) awareness of the age-old Problem of Induction. Also, in this essay, Mr. Allen discusses the contemporary work of Art DeVany, Doug McGuff, Nassim Taleb, and Barry Groves, while paying homage to several other scholars from decades ago. For me, I suspect that Mr. Allen's excellent essay is a compilation of grace nudges; it's full of conjectures that emerged following hard knocks; it's a tale in health that many people might be able to relate to and subsequently operationalize to avert similar missteps.

Segundo: While riding my bike today (in the Keith Norris spirit, of course), I naturally started to write.

Ancestral Health is an open-source approach to thinkering (thinking + tinkering) about health built on a balance between Science and Philosophy of Science; that is, it's a bottom-up, iterative process with several presuppositions:

Science says: Each person possesses a distinct genomic and microbiomic makeup.

Philosophy of Science says: Each person must test health conjectures on his/her own body cautiously to deduce what works (yet-to-be-falsified) and what doesn't work (falsified) in his/her own specific case. This is the land of epigenetics, nutrigenomics, and epimicrobiomics, et al.


Science says: Each person descends from a distinct ancestral lineage and cultural tradition.

Philosophy of Science says: Each person must respect his/her ancestry to integrate its practices, wisdom, and history into his/her modern-day living in order to approximate health sustainably.


Science says: Each person possesses sensory systems shaped by evolutionary processes capable of providing real-world feedback about some underlying physiological 'truth'.

Philosophy of Science says: Each person has unique access to information about his/her body that no one else will ever experience; thus, each person should respect his/her intuitions, gut feelings, and mind-body experiences, and should not sweep this information under the rug, in order to learn by grace rather than by hard knocks.


Science says: Human beings think and reason heuristically, non-rationally, and emotionally.

Philosophy of Science says: Self-experimentation with Meta-Rule formation is a process that anyone can engage to create simple yet valuable heuristics for making decisions about health and well-being. Herbert Simon conceptualized this notion as Bounded Rationality, and since then, Michael Pollan and many others have implemented concepts from this philosophical perspective by collecting 'Rules to Eat By' from various cultural traditions to nudge folks gracefully.


Tercero: At some point, I suspect, we have to be aware of what we presuppose when it comes to thinkering. I've learned from my own health struggles with migraines and sinus infections that I should listen to my body closely because it knows more than me in most cases and is often trying to tell me something important via negative feedback information cycling. Personally, from what I have observed in the clinical setting, seasoned healthcare professionals know to respect patients' complaints, feelings, and inklings, at least by practicing epoche, even when they don't understand or agree with what the patient is saying currently, because it could turn out in the end that the patient was onto something revealing about his/her body but might not have been able to communicate this information properly.

The Patient of One archetype has infinite, ever-changing faces.

One-size-fits-all is a size that fits no One, I suppose.

To good health,

Brent

Hunter-Gatherer Origins of the Job Interview

(Hat tip to Pradeep)

Circadian Rhythms m=1/n=1 Thinkering

http://en.wikipedia.org/wiki/Circadian_rhythm

m=1 My-thology: Three of my mentors, Mark Sisson, Seth Roberts, and Marc Simonson, conjecture that daily setting of circadian rhythms is foundational to health. Given my interest in nonlinearities, multifractal relationships, and the power-law mathematics of information cascades, the simple notion that we need to get our hormonal systems firing on all cylinders in synch with Mother Nature from the outset of each day seems logical and potentially beneficial.

n=1 Self-Experiment: Sit/walk/sprint/be in the sun (outside) first thing in the morning (as close to sunrise as possible), then again around mid-day (whenever the sun is at its highest point in the sky), then again around sunset, with each session lasting 5 to 25 minutes (or longer, if time permits).

Data Measurement: Assessment of mood and energy levels throughout the day. Both Qualitative Self (ask, "How do I feel?") or Quantitative Self (rate energy on a 1-10 scale) approaches could work for capturing feedback.

My m=1/n=1 Results: So far, so un-falsified.

Conclusion: Keep thinkering. As always.

To good health,

Brent

Dave Lull's m=1/n=1 Meta-Rule for Meta-Rules

A Meta-Rule for Meta-Rules ...

Don't neglect to look continually for error (criticize, falsify) and weed it out of your garden of meta-rules. - Dave Lull

How?

'While nothing can ever be justified in any ultimate sense, certainly we can see error and weed it out. This is true whether we are dealing with empirical science and perhaps even knowledge of what is ethical. An important part of [W.W.] Bartley's thinking could probably best be summed up in this quote, “How can our intellectual life and institutions, our tradition, and even our etiquette, sensibility, manners and customs, and behavior patterns, be arranged so as to expose our beliefs, conjectures, ideologies, policies, positions, programs, sources of ideas, traditions, and the like, to optimum criticism, so as at once to counteract and eliminate as much intellectual error as possible, and also so as to contribute to and insure the fertility of the intellectual econiche: to create an environment in which not only negative criticism but also positive creation of ideas, and the development of rationality, are truly inspired.”' (*see, "What is CR?")

To me, this challenge sounds like Nassim Taleb's Barbell approach to epistemology: How to account for the unseen while simultaneously acting on the seen.

It's challenging, indeed.

To good health,

Brent

See Spot Live Longer: Unlocking the Canine Ancestral Diet

"Animals have ancestors too," as my friend, Professor Aaron Blaisdell of UCLA, would say.

That's true.

And Steve Brown honors this reality in all the passionate work that he does to improve canine health via ancestral nutrition considerations.

Steve's Web site is SeeSpotLiveLonger.com, and one of his published works is the following book:

In Unlocking the Canine Ancestral Diet, Steve provides practical tips for dog owners who are looking for ancestral health guidance. Steve reached out to me a few months ago about the Ancestral Health Symposium, and I am happy and grateful to say that he will be presenting a poster at the gathering. In addition, Steve is a fan of my ancestor, Dr. Francis M. Pottenger, Jr., MD. Dr. Pottenger is a celebrity of sorts in the pet food industry, evidently.

I recently asked Steve a few questions; here are his thoughtful responses:

1) What are your thoughts on dogs eating plums?

At times, I feed plum extract to my dogs. They seem to like the taste; I mix it in with their fresh-meat diets so it’s hidden. Plums contain a variety of potent antioxidants, which I think are great for dogs. I recommend plums in moderation, in addition to green plants in an ABC day.


2) What do you think of Orijen brand dog food?

I think Orijen is one of the better dry foods. I know several people who have visited the plant and have been most impressed. But no dry food can be complete; we still need to add some fresh foods as discussed in the ABC day in Unlocking the Canine Ancestral Diet.

As with all dry dog foods, the more recently produced, the better, and once the bag is opened, it’s best to use up the food within 14 days, as described in Chapter 7 of Unlocking the Canine Ancestral Diet.

I question the inclusion of fish, fish meal and fish oils in their foods. I wrote to them several years ago asking about what happens to the DHA once the bag is opened; I did not get a return note (no dog food manufacturer answered the question). A friend of mine, who sells a lot of Orijen, also asked the same question and has not yet received an answer.

Given that, when relatively fresh and used up quickly once opened, in my opinion, Orijen is certainly one of the best dry foods available.


3) Please summarize your book, Unlocking the Canine Ancestral Diet, and your ABC plan.

The best answer to this question may be from the introduction. Here is a short answer, and below is the introduction.

Unlocking the Canine Ancestral Diet describes the canine ancestral diet with an emphasis on fats, and offers suggestions on how best to mimic the ancestral diet, whether one feeds dry, canned or frozen dog foods. One ABC day a week for dry food feeders adds high-quality protein, balances the fats, and completes the nutrition with some fresh, whole foods.

Introduction:

“The ABC day made a huge difference,” Dr. Doreen Hock told me when I informed her I was struggling to complete this introduction and finish the book. “I could see the improvement in my dogs—and it’s easy,” she said. “Just tell people to follow the ABCs.” What do the ABCs stand for?

A stands for the amount of fat, protein, and carbohydrate based upon the ancestral diet of the dog. This means adding protein to most commercial and homemade foods.

B stands for balancing the fats. My view is that the health of a dog is dependent on the fats she eats—more than any other nutrient. The importance of the role of fats is something that nutritional experts have just recently established. Unfortunately, some important fats are either left out of commercial dog foods or deteriorate when included in processed, long shelf-life foods.

C stands for completing your dog’s nutrition needs by feeding some fresh, whole foods.

Follow the ABCs for whatever type of food you feed—dry, canned, frozen, or homemade—and you’ll significantly improve your dog’s diet, which will increase the odds that your dog lives a healthy, happy life. No doubt about it, and it’s as simple as ABC.

The canine ancestral diet

You may have heard of the “Cave Man Diet” as it applies to humans, the theory being that unprocessed fresh foods high in protein and low in carbohydrates are best for people who evolved successfully over thousands and thousands of years consuming just such a diet. The concept of the “Canine Ancestral Diet” for dogs is similar in nature. Dogs and other canids evolved successfully through hunting and scavenging, consuming foods that were not at all like the kibble so many are fed today. Recent nutritional science increasingly supports an ancestral-type diet—high protein, balanced fats, and at least some fresh foods—as the healthiest approach to feeding most dogs.

While in theory one can feed a dog the ancestral diet, in practical terms—given modern lifestyles and busy schedules—it is just not realistic for the vast majority of pet owners. However, there are steps you can take to alter or augment what you currently feed your dog to make it more like the ancestral diet and thus improve the nutritional content of your dog’s diet.

The ABC way of feeding is based upon detailed analyses of the dog’s ancestral diet, supported by up-to-date nutritional science, and my twenty years experience in developing foods for national pet food companies. The ABC plans laid out in the following chapters focus first on correcting the weaknesses associated with modern dog food which generally contain not enough protein, too many carbohydrates, unbalanced fats, and lack the complete nutrition that can only be provided by fresh foods.

There is no need to dramatically change the type of foods you’re feeding. If you feed dry foods, for example, you can make significant nutritional progress if you make one day a week an ABC day. It’s easy, and you’ll probably see the difference in your dog within two to four weeks. If you are more ambitious, I have included additional strategies that involve preparing food for your dog that will take you even closer to the ancestral diet. Whatever you choose to do, the ABC way will help improve your dog’s diet and overall health.

How this book is organized

This book is intended for a wide audience: dog enthusiasts, veterinarians, and professional dog food formulators. For dog owners wanting a quick and easy way to improve the food they feed their dogs, I have included simple explanations and plans to do so. For veterinarians and professional dog food formulators wanting to know the “why” behind the ABC concepts, I have furnished all the details.

The first three chapters are must-reads for anyone interested in the subject. Chapter 1 details the canine ancestral diet. What dogs ate in the wild prior to the advent of modern dog food represents an ideal diet—primarily consisting of high levels of protein, balanced fats, and fresh foods. This is the gold standard that modern feeders should try to replicate. Chapter 2 compares and contrasts modern dog foods with the ancestral diet with a focus on where modern foods come up short. Chapter 3 provides information on the health benefits of improving the ABCs of your dog’s diet, making it more similar to the ancestral diet.

Chapters 4, 5, and 6 are the ABC plans. Chapter 4—designed for dry, canned, and frozen food feeders—presents the ABC day concept. These are relatively simple and easy one-day-a-week plans to make your dog’s diet more like the canine ancestral diet. Chapter 5 is designed for readers who are interested in and are willing to devote more substantial amounts of time to preparing meals at home for their dog(s) and who want to understand the underlying science. This chapter provides step-by-step instruction on how to make balanced-fat, ancestral-type diets. Chapter 6 includes three detailed recipes that will help you replicate the canine ancestral diet for your dog(s).

The last two chapters focus on providing more detailed information to readers such as those involved in the dog health and food formulation industries. Chapter 7 discusses in more detail the important topic of proper storage of dry and frozen dog foods. The best dog foods in the world can be ruined, and even become unhealthy, by improper storage. Chapter 8 provides an overview on a variety of subjects including the chemistry of fats for dogs, the dog’s need for carbohydrates, high protein diets and their impact on the kidneys, and an introduction to pet food math. I have also included, in the appendices at the back of the book, additional recipes for dogs requiring low fat diets, sources of information, and a recommended reading list. Appendix C includes a list of all abbreviations used in the book.


4) How did you hear about the Ancestral Health Symposium, why are you interested, and what will you be presenting in your Poster?

I read The Paleo Diet newsletter from Dr. Loren Cordain. I’m interested for two reasons: first is to share my knowledge of the canine ancestral diet and the importance of balanced fats; second is to increase my knowledge and understanding of the ancestral human.

In the Poster Session, I will present my analysis of the canine ancestral diet (Chapter 1 of Unlocking the Canine Ancestral Diet), recipes for full-time feeding of ancestral-type diets, and the ABC day for those feeding primarily dry foods.


5) What can humans learn about our own health from your insights on ancestral canine diets?

Humans can learn about the importance of balanced fats in our diets. Humans will also learn about the importance of protecting those fats with antioxidants from whole foods.


6) What do you know about my ancestor, Dr. Pottenger, and how has his work influenced your thinking about diet and health?

Pottenger’s Cats was one of the most influential books in my life. Many years ago, at the beginning of my dog breeding program, I was puzzled by my not finding hybrid vigor with some my mixed breed dogs. That led me on a search to understand why, and Pottenger’s Cats was one of the keys to my finding the answer.

Pottenger’s Cats discussed intergenerational effects of poor diets. The more I learn, the more I understand how correct he was. The new science of epigenetics explains some of the findings from Dr. Pottenger. My own breeding program shows the flip side of what Dr. Pottenger found: my dogs get healthier each generation because of proper diet and plenty of exercise.


7) Final notes ...

My new booklet is entitled “See Spot Live Longer for Dry Food Feeders.” It’s about how one can help his/her dog live longer by making two small changes in the way one feeds: add fresh food once a week with an ABC day, and use dry foods wisely to get the best out of them.

... thanks, Steve!


To good health,

Brent

Game Plan Academy (GPA) in Compton

I co-founded Game Plan Academy (GPA) with my friends in Sacramento a few years ago. After replicating the model in Sacramento successfully, we were lucky to expand GPA into a new neighborhood this past May 2010 by partnering with Revolution Test Prep, Compton Unified School District, and the University of Southern California. GPA is a collaborative volunteer effort, a Private/Public/NonProfit (3P) response to local community needs.

Check out my buddy, Lincoln, and the other students, in the video above.

I'm thankful for the positive role that athletics have played in my life, so I'm thankful for the opportunity to give back in some small way through GPA.

I've said this before, but I'll say it again: GPA is awesome.

It's Ancestral Education in many ways, linking movement and play with test prep and tutoring.

To good health,

Brent