Tuesday, February 8, 2011

Therapy versus Life

Much in this article by Dr Harris to make you think, evaluate, agree with or not and for sure consider.


from PāNu Blog by Kurt G. Harris MD

I mean, when did this happen, really? When did our default self-concept make the turn from life to therapy?

I used to think this was a narcissistic "American" trait. Maybe we yanks spread it to the rest of the post-industrial world, but it seems to be everywhere now. And in the nutrition blogosphere I think it is the biggest dividing line - magical (bs) and neurotic yearning for immortality on one hand and the simple desire to live a good life without premature crippling diseases on the other.

We have people who want to eat healthy, and we have people who are living some perpetual existential crisis where they think you can cheat death and all disease if you just get all the numbers right. I confess these latter people drive me nuts. A huge contingent who think there is a "secret" to health and longevity the way there must be a secret to wealth, early retirement, being happy and finding love. They want to believe none of these worthy things are as hard or elusive as thousands of years of history, if not our own lives, have taught us.

These are the people who buy "The Secret" and books by Tim Ferriss. People who fantasize that life is all about "tricks" and "hacks". Perpetual youth and effortless happiness. Little study or real work required. Everyone can outsource everything and no real value need ever be produced.

Go through your blogroll of nutrition websites and books, and for each one, count how many special supplements are recommended. Then add the number of numerical recommendations for dietary parameters (wide ranges don't count) that are presented as if you might come to harm if you don't follow them. Then add the fraction of food items in our environment that are portrayed as being problematic, if not deadly. Then, add up the annual number of laboratory tests that are described as being critical to monitoring your health and square it. Then, add the total number of drugs that are suggested for otherwise healthy people who have never had a heart attack, cancer or a stroke, intended to treat these laboratory numbers as if they were diseases (they are not), and square that.

Then add them up S + DP + % F + Labs*Labs + Drugs*Drugs = TI

We can call this the "therapy index". I suggest that this therapy index will give you a good insight into the way the writer envisions health. A high TI means the writer thinks you are sick. That we are all sick. That anyone who has ever lived is born sick and needs therapy - their therapy - to be fixed. A catalogue of tricks and hacks and supplements and drugs and obsessive monitoring.

The writer has a weltanshaaung - a world view - that is Cartesian and mechanistic in proportion to the TI. Thinking about health like an engineer or keynesian economist instead of a biologist.

Now if the human diet in the 21st century were just fine, then a score of 0 on the TI might be achievable. PaNu certainly makes proscriptions, but the default stance is life, not therapy. You don't need fixing so much as to just stop injuring yourself.

A Cartesian view of the human organism is most opposed to the primary evolutionary assumption that should inform our thinking - the baseline assumption of a biologically informed view of humans. That there is a dietary metabolic milieu that we are adapted to, and the best chance we have of optimizing our health is to try and emulate it, not arbitrarily "improve" it.

The likelihood that we can "improve" upon this EM2 by doing something or adding something that was not a part of it already is similar to the probability that adding novel organic compounds to the gas tank or oil pan of my Porsche will "improve" its performance.

Not bloody likely.

Living in ketosis 24/7 - even though this requires persistent avoidance of starches or peculiar amounts of coconut

Multivitamins - even though you eat real, whole foods

Antioxidants - even though there is not a shred of evidence for a benefit, and some evidence of harm

Prebiotics and Probiotic supplements - even though you already eat real, whole foods

Fish Oil, Krill Oil, or even copious fish - even though a minority of hominin evolution could have had an excess of marine n-3s and grass fed beef fat and butter is all you need if you avoid TemPOs

Iodine - even though humans evolved the capability to live with a huge range of iodine in the diet - a nonsense book by Brownstein claims that 90% of the population is iodine deficient - actual science shows that iodine downregulates thyroid hormone synthesis and can flare Hashimoto's

Eating well beyond satiety - even though you are getting fat and feel like shit, you have been told by someone that this will "heal" your metabolism

Thyroid hormone - You feel fine and have normal thyroid labs but you take thyroid hormone from pigs every day to "improve" your LDL levels

Here is how it works in my world. When you come to me and tell me my car will last longer if I put some new compound in the gas tank, and the engineers in Stuttgart have never heard of it, and the manual tells me the car was not designed for it and doesn't need it, I say "prove it". Don't theorize, actually prove it. The burden of proof is on you to prove your artificial maneuver that defies the design of the car will make it "better". I have no similar burden - you are the one claiming magic, not me.

PaNu is the precise opposite of this totally speculative therapeutic approach. The car comes into the shop. The owner tells us about how it ran fine until he bought some (bs) elixir and started adding it to the gas tank a few years ago. The first thing we do in my shop is stop adding the elixir.

Here is the important part. Even if we stop adding the damaging elixir, and we are still a bit broken, it does not follow that any other (bs) elixir added to the tank will fix any damage. It might, but there is no more evidence for that than there was for adding some (bs) elixir to the car when it ran fine.

Of course, the car metaphor is apt but incomplete. The human body is not a machine, it is self-regulating biological system. So the fact that this is biology means there is even less reason to add unproven nonsense to our tanks.

My car cannot fix itself. The human body often can if we just stop ruining it.

So I would encourage you to ask yourself, what are you looking for? Do you think there is a "secret"? Are you fantasizing about immortality? Is everything a tweak or a hack or a trick? Do you think every problem in your life can be fixed by changing your diet?

Or do you see life as complex and tragic but sweet and rewarding, and are happy just to stack the odds in your favor with diet and then get on about your other business?

You do have other business than obsessing about what you eat, don't you?

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