HN Theater @HNTheaterMonth

It might be worth understanding the mechanism of damage in order to self-attempt reparative therapies (however theoretical or experimental).

For example: Dr. Terry Wahls‘ Anti-MS diet:

https://www.youtube.com/watch?v=KLjgBLwH3Wc&feature=emb_titl...

Or BDNF-boosting strategies.

Or strategies such as IF to tamp down overactive microglial cells that afflict nearby neurons with inflammation.

https://onlinelibrary.wiley.com/doi/10.1002/jmv.26984

https://jneuroinflammation.biomedcentral.com/articles/10.118...

⬐ avgcorrection

Why anti-MS diet?

⬐ mrtesthah

While it seems rare for covid to cause MS itself, there might be a link between neuroinflammation and demyelinating damage.

https://www.msard-journal.com/article/S2211-0348(20)30400-4/...

An interesting talk about someone who was able to reverse a lot of her MS symptoms with a change in diet: https://www.youtube.com/watch?v=KLjgBLwH3Wc

⬐ epgui

Biochemist here: I would advise to exercise strong caution when looking at dietary changes in the context of MS.

A lot of advice gives people the illusion that they have more control over their illness than they actually do, and a lot of the diets cause unnecessary harm (as a heuristic: the more things you cut out, the higher the potential for harm).

That said, healthy eating and regular physical exercise is always a good idea, and even more so if you have any existing illness.

⬐ Broken_Hippo

Thank you!

A lot of scam diets promise to cure MS. Books are sold. But the only real way to lessen the harm of the disease is through a combination of a modern medicine and luck (I've had both).

Agree on the general healthy eating and activity, though.

⬐ Broken_Hippo

The Wahls protocol is a scam. It is not a cure for MS.

Most folks with MS have RRMS - RR stands for relapsing remitting. Basically, you have a "flare" - when your body attacks your nerves. You have symptoms for a while, and then they start to go away. For context: I woke up one morning half blind. I could tell if there was a red object, but I couldn't make out what it was. Everything I could see out of my left eye was fuzzy. I couldn't make out the big "E" on the eye chart.

But then, the lesion heals. You might be left with some damage, but a lot of it goes away. My vision returned and the optic nerve healed well. My vision is actually better in that eye than the other one. I have lingering numbness in my hands from time to time, but nothing like the fingertip-to-elbow pins and needles from a flare (I barely notice).

All this means that a change in diet might seem to make your MS better. It definitely makes folks feel like they have control. But clinically, it does nothing. You are taking a big risk by doing this. What does work are modern DMTs - disease modifying treatments.

⬐ garganzol

It is not a scam. As you said, it is just not the ultimate treatment for MS. But it is a tool for MS management.

Protocols like this are important parts of treatment for many people with similar conditions: T2DM, neuropathy, CFS/ME, Alzheimer, Parkinson, POTS.

I want to stress that many people with conditions adjacent to MS do not experience that relapsing-remitting nature of a disease. And they confirm an immediate improvement when they swap junk processed foods with more natural choices.

⬐ garganzol

According to numerous observations, neurodegenerative diseases and the lack of energy (adenosine triphosphate, ATP) are tightly interconnected.

Thanks for posting. And yes, there is mitochondria involved, once again.

⬐ moneywoes

So basically no wheat, milk and processed foods?

⬐ omreaderhn

I skimmed through the presentation and I'm not sure how you arrived at that as your takeaway. The dietary advice given in there is much more complex than that.

⬐ DantesKite

Anecdotally I’m aware of someone who was able to reverse a lot of their symptoms with high doses of Vitamin D.

There’s a biochemist here giving advice about being cautious. That goes without saying, but it always strikes me as disingenuous careerism to recommend people with terrible illnesses to not experiment. That’s the bedrock of scientific inquiry.

It may be the case there’s nothing out there that can help alleviate MS even a little, but it’s worth trying, especially if the cost is low and the burden of the disease is high.

⬐ garganzol

I confirm the effects of vitamin D3 with my own observations.

Vitamin D3 is an adaptogen for the immune system, it is an antioxidant in mitochondria, it plays so many different roles.

No wonder it has such a beneficial effect on MS and CFS/ME patients who suffer from autoimmunity and mitochondrial manifestations. Vitamin D3 alone is not the ultimate cure per se, but it is a part of a possible cure for sure.

Note of caution to those who supplement vitamin D3 for more than 2 months: always add vitamin K2 MK-7 to the mix to avoid the possible development of arterial calcification.

⬐ epgui

The biochemist isn’t a doctor, but there’s a reason the old hippocratic oath begins with “First, do no harm. Then, do good.”

When you’re talking about your own health, you’re an adult and you’re free to do what you want. When you’re talking about other people’s health, a more cautious approach is appropriate.

⬐ Broken_Hippo

There’s a biochemist here giving advice about being cautious. That goes without saying, but it always strikes me as disingenuous careerism to recommend people with terrible illnesses to not experiment. That’s the bedrock of scientific inquiry.

It isn't a bedrock of scientific inquiry if you aren't actually studying things. In fact, with MS it can make you so much worse off than you would be. People start the diets as a substitute for proven medicine. No diet has been proven to prevent a relapse, lessen their impact, nor cause you to have fewer relapse. With MS, every relapse you have increases your chances of disability and most relapses leaves effects. I lost hand strength and my fingertips have different feeling, for example, even though most of the numbness went away. Proven medicine has lessened the number of relapses folks have and often makes them milder: With the best medicine, we haven't prevented relapses entirely - though a lot of neurologists treat a single relapse as a sign to switch medications to something that'll work better for you.

I'll add that it isn't always worth trying. You aren't doing science unless you are part of a trial. Eating a strict diet isn't generally cheaper and takes time that you might not even have the energy for - all for something science hasn't been able to prove works. Just ancedotal stuff from random people without anything to back it up. I suspect the diet might just have a similar effect that weed does with spasticity: It doesn't medically cure some it, but people report being less bothered by them. And if that's the case, any dietary change would work and you probably shouldn't give money to the ones claiming miracles.

Here’s a talk by Dr. Terry Wahls, who reversed her MS through diet: https://www.youtube.com/watch?v=KLjgBLwH3Wc

My wife has an auto immune disease and we have both switched (through progressive stages) to the Wahl's Protocol. I've never felt healthier and her symptoms are improving--she's also on disease modifying treatment, so we're doing this in addition to medication, not instead of it.

The Wahl's Protocol is designed for cell and brain health, so it may be exactly what you're looking for.

See Dr. Terry Wahl's Ted Talk here: https://www.youtube.com/watch?v=KLjgBLwH3Wc

⬐ fefb

Nice that you are improving together. I will give a look. thanks for sharing.

I risk getting downvoted for this, but have you tried any dietary changes? There are cases of people with MS who have seen tremendous improvement on a low histamine or paleo style diet. There are no guarantees, of course, but what do you have to lose? I would think it would be worth the inconvenience of trying it out for a few months even if the odds of success are very small.

Here's an example: https://www.youtube.com/watch?v=KLjgBLwH3Wc

⬐ sago

MS responds very well to a whole range of therapies that have no proven disease modifying abilities. It is an almost perfect disease for a methodology to claim success on. The Relapsing Remitting course is variable, so people with the condition are likely to seek new treatment during worse periods, and thereafter regress to the mean. The knock on effects of the lesions in brain and spine can often be self-limiting (tiredness, pain, lack of coordination, mood changes, diminished vision), so are very conducive to placebo effects. MS can in some patients plateau and relapse rates drop off or cease (not often, but sometimes), so it is perfect for testimonials of dramatic benefits, if you don't systematically count the failures.

If you check out just about any 'alternate' modality, you'll have a very good chance of finding it claims high success on MS. In comparison, most modalities don't tend to claim success rates on amputations. Though both involve the destruction of tissues.

It's a great case study in science based medicine.

"what do you have to lose?" - in general time, often money, and a demonstrated reduced likelihood of pursuing scientifically valid treatments. The more claims of beneficial treatments adding to therapeutic noise, the harder it is for individuals to assess treatments properly. On aggregate, we're worse off for the claims of well meaning (and hucksterish) folks.

"it would be worth the inconvenience of trying it out for a few months even if the odds of success are very small." - isn't that the sales pitch of every snake oil salesman or true believer?

FWIW: I have PPMS, and I've heard literally hundreds of claims, ranging from many different (and contradictory) diets, through 'eastern medicine' to revival prayer meetings. The details of the method change, but the structure of the claims, and the way they use evidence, are remarkably similar.

⬐ ulysses

Thank you very much for this, it is concise yet thorough. I'm going to use this link as a boilerplate reply.

⬐ EarthLaunch

> In comparison, most modalities don't tend to claim success rates on amputations. Though both involve the destruction of tissues.

That comparison deliberately wipes out the actual differences between immune disease and amputation which give rise to the idea that the immune system can be affected by diet in ways amputation cannot. If you want to be scientific, use reason.

> "it would be worth the inconvenience of trying it out for a few months even if the odds of success are very small." - isn't that the sales pitch of every snake oil salesman or true believer?

That is an invalid answer to that pitch. There are many times that pitch is completely valid, too; when a small inconvenience is worth trying even if the odds of success are very small (such as this article's study itself!).

I still can't understand why there's so much anti-reason surrounding "defense" of "science-based" medicine. If it's an overreaction to quackery, then it's an ineffective one.

⬐ sago

> a small inconvenience is worth trying even if the odds of success are very small

Pascal's wager works the same way. And it would be a reasonable argument if you forget to multiply by the number of such claims.

⬐ MrBunny

I actually have changed my diet and take drugs that help prevent more events. Additionally its really hard to track the progression since you can have an event (damage) without actually knowing (mild issues). However the damage is there and IMO is what produce the most day to day trouble. Tricking your brain into thinking your feet are on fire or your arm is weak weird shit like that. When I finally got MRI they found 7+ lesions in the brain and spine. For me to be honest most days I'm ok but it really sucks take these crazy expensive drugs every day. It's a very expensive disease that produces lasting damage even if a cure is to found.

Sorry don't mean to rant.

⬐ BadCookie

I'm sorry. I have a different condition that has responded to dietary changes, which is why I mentioned it, but I realize that I may just be very lucky in that regard. I wish you well.

⬐ MrBunny

No worries I took no offense.

⬐ BadCookie

For what it's worth (and perhaps it's worth nothing), I also experience the burning feet feeling that you describe, although it's usually just a tingle. My arm also goes numb sometimes. My neurologist says that I am having silent migraines, which is a type of migraine consisting of just the aura with little or no head pain.

For me, these silent migraines seem to occur after I eat a meal high in histamine. (A salad with balsamic vinegar produces a reliable, strong effect within a few hours.) There is some recent research coming out of Europe that suggests that histamine intolerance is very real, but doctors and researchers in the US haven't caught up to this yet.

Overview of the research on histamine intolerance can be found here: http://www.aerzteblatt.de/pdf/103/51/a3477e.pdf

Histamine has been implicated in the pathogenesis of MS: http://www.sciencedirect.com/science/article/pii/S0028390810...

Anyway, if you ever want to chat about this stuff (even if it's just to commiserate!), feel free to contact me using the email in my profile.

⬐ SwellJoe

"I risk getting downvoted for this, but have you tried any dietary changes?"

Because you should be downvoted for this.

People who have long-standing health conditions, that they have perhaps battled their whole lives, don't need people on the Internet arm-chair quarterbacking their treatment. They have medical professionals that they've worked with for years and trust, they have almost certainly done more research than you or I about their condition, and they have heard the latest fad cure-all from everyone, everyday, for years. They get it on their facebook wall, they get it from well-meaning (but poorly informed) friends and family, and they get it from strangers on the Internet.

Don't be that stranger on the Internet. Your intentions are positive and laudable, your actions are not.

In short: Unless someone has asked for advice about treatment options for their chronic condition, it is probably impolite to offer it.

Source: Conversations with friends with MS, CP, disabilities, autism spectrum disorders, and various trainings in how to provide safer spaces for people with a variety of conditions.

⬐ gregpilling

Thank you so much for this. I have a chronic condition and I assure you that discussing it is the least exciting thing possible for me, and for the last 7 years the doctors and I have tried every damn thing at least twice. Everybody tries to help with concerned advice, but they don't get the pain of discussing the paleo diet for the 300th time (which didn't help the 3 times I tried it).

⬐ pmh

This reminds me of an NPR story[1] I heard a little while ago about Empathy Cards. Specifically http://emilymcdowell.com/products/treatment-on-the-internet-...

[1] http://www.npr.org/sections/health-shots/2015/05/07/40497653...

⬐ collyw

I don't think there is a problem suggesting changing diet in addition to "proper" medical treatment. Its when people are encouraged to use it in place of other treatments it becomes a problem.

Research into ketogenic diets is pretty new, (and as far as I am aware, has been shown to have positive effects on neurodegenerative diseases in rat studies). There is a possibility that it may help.

⬐ SwellJoe

My opinion about offering unsolicited treatment advice has nothing to do with whether the suggested treatment is effective or not. My suggestion to not offer treatment advice to people with chronic conditions comes from a recognition that most people with chronic conditions receive exhausting amounts of advice from folks every day, and it is often not what they want to talk about, but politeness dictates they not simply say, "stop talking, you're not helping".

Certainly there may be gems of valuable input that may come from strangers on the internet, but with no other signals indicating quality, it is just more noise in an already complicated topic.

Again: In conversations with someone who has a chronic condition, unless the person has asked for advice (in some way) about their treatment, it is generally rude to offer your thoughts on the matter. Just as I wouldn't suggest you go on a diet if I think you're a little overweight or that I think you should be on antipsychotic drugs because I saw you get angry one time, your knowledge of a strangers situation is too low to be helpful. And, they hear it all the time, and most of the time the advice they get is bullshit.

⬐ BadCookie

I have a health condition that is just as serious as MS (and is similar to MS in some ways). None of my doctors (over a 20 year period) ever suggested that I change my diet, but for me, changing my diet is the closest thing to a treatment that I will ever see. I WISH that somebody had suggested that I change my diet, because if I had done it years ago, I might not have progressed as far as I have. So I'm sorry if the guy I responded to has had tons of people suggest to him that he should change his diet, but for me, it was the opposite. No one suggested it. I tried it on my own, out of desperation and despite my doctors poo-pooing the idea. And it worked. I guess I got lucky, but there are lots of stories just like mine.

The fact is that doctors are often NOT that helpful for people with complicated neurological conditions (no one knows this better than I do!), so some of us are left to fend for ourselves. Given that that's the case, I don't see what's so terrible about asking someone whether they have tried a treatment that some people have found to be effective. My perspective is that an elimination diet is worth a try for anyone with an autoimmune or difficult-to-diagnose neurological condition. That opinion is based on a lot more knowledge and personal experience than you have assumed it is, but it's true that I didn't make that clear in my comment.

The only reason I even responded to MyBunny was that he said that he was having "a hard time finding hope." I thought that if there was even a sliver of a chance that my suggestion could help him find hope, then it was worth getting downvoted to oblivion. But if my voice is merely one of a chorus that have suggested the same worthless idea to him, then for that I am sorry.

Ultimately, I do see your point, and thank you for your perspective, but I don't think that I can entirely agree with you.

⬐ msie

From my experiences in a hospital I've seen doctors that can hardly spend any time with a patient and it's really up to the patient and their advocate to look out for themselves.

⬐ SwellJoe

Apologies for making assumptions about where you were coming from. I may have gotten a bit preachy and reactionary. We're both obviously coming from a place of wanting to be helpful.

Though I still think the advice to only offer treatment suggestions when asked is always sound. The Internet seems to exacerbate the problem of overwhelming amounts of unsolicited advice, which can breed its own sort of despair.

Less than 2 years ago, my wife was diagnosed with MS (Multiple sclerosis). As soon as we found out, I started digging like crazy to learn more about why this happened and what we could do to prevent it from progressing. I'm a big believer in that the body has the ability to heal itself by avoiding certain foods and intaking others. I mean, food is fuel we put in our body.

After digging for a while, I came upon some staggering discoveries. First, there are people who have reversed their MS almost completely on diet alone. The diets consist of A LOT of high-nutrition fruits and vegetables along with Omega 3's, organic meats, etc. These Paleo-like diets also forbid gluten with the main reason being that it causes serious inflammation in some folks. This TEDx video by Dr. Terry Wahl was very helpful (http://www.youtube.com/watch?v=KLjgBLwH3Wc). I read her book and it literally laid the foundation for which changed our eating habits entirely.

A month or so after, we flew out to Massachusetts to a well-known wellness center where they performed various blood and stool tests. The Dr's (including a Nutritionist) sat down with us for the entire day and asked about daily habits from what our work days were like to what we ate. Without mentioning my own research, they also said that gluten is something we should completely remove from our diet.

There's a ton of other stuff out there, but since removing gluten entirely, my wife has felt great. We just did an MRI and she has no new lesions. She no longer experiences blurriness or weakness which is great. It may not be completely because of Gluten, but removing seems to have seriously made a impact.

⬐ gphilip

All of this seems to be anecdotal. Do you know of any research (as in, studies) which support any of this?

⬐ gamblor956

Google returned this:

http://www.ncbi.nlm.nih.gov/pubmed/19758171

and a quasi-bibliography:

http://www.celiac.com/articles/124/1/Multiple-Sclerosis-and-...

⬐ msandford

I love that anecdotes are considered worthless in medicine when in fact they're very clearly good places to start.

Take an anecdote and do a small population study to try and find correlation. Then if there are any significant results, start looking for causation.

In history nothing is legit except for primary sources. In medicine, it seems, primary sources -- no matter how compelling -- are worth a damn. Hilarious.

⬐ saraid216

> I love that anecdotes are considered worthless in medicine when in fact they're very clearly good places to start.

They're a great place to start for a scientist with training in conducting medical research and the resources to carry it out.

They're a terrible place to start for an internet forum reader who has neither.

⬐ illuminate

Because isolated anecdotes aren't necessarily the same thing as "medicine".

⬐ bronson

No. Medicine is so broad and subjective that it's easy to find an anecdote implying almost anything. That's why expensive double blind is so important -- even doctors fool themselves.

How many "carrots cured my cancer" wild goose chases would it take to bankrupt even the biggest company? Whatever that number is, it's smaller than the number of wild-ass medical anecdotes rolling around out there.

Of course, everybody thinks that their own anecdote is compelling and obvious and all their friends on carb-free diets are idiots...

⬐ kzrdude

I'm diagnosed since 3 years and have a similar (in some ways) story.

I've removed Gluten and all Dairy, all due to advice from my parent who was frenetic in researching prior studies, books, anecdotes etc.

I've certainly been depressed for a long time, but I'm making recovery.

⬐ marcosdumay

Well, it quite well known that gluten creates several problems for SOME people. That's quite a different argument from the over generalization you did at the GP.

It's indeed something to keep in mind, but the good news is that it's easy to test for.

⬐ dhoulb

Gluten intolerance isn't a binary state, it's a scale. Everyone's on it somewhere, but unless it's REALLY bad, you'd probably never get diagnosed or even tested.

Main benefit of avoiding gluten though is it's a simple rule that helps you avoid a lot of bad foods, and excuse it socially.

> You sound like an industry-insider explaining why a new startup will fail.

I certainly don't want to rain on some new visionary's parade, but I spend a lot of time tracking folks who I consider to be the real visionaries in this field. As in we are currently in the midst of the greatest revolution in human health of our lives, and this guy is running in the wrong direction. We're seeing astonishing results with dietary remediation of a vast array of conditions that were previously considered unrelated. And this isn't just "remedial eating", it's discovering that our current ways of eating are killing us but that diet can likewise help heal us. It's a Khunian revolution out of "the pill and the scalpel" mindset and into a deeper understanding of root causes of wide classes of disease and general unhealthiness in 21st century society. I must certainly be writing in an aggressive posture, for which I'll apologize. I'll have to account my overenthusiasm to the long-term health and well-being of literally everyone I've ever met being at stake.

Current research is showing that we are only just beginning to gain understanding of the complexity and health of the GI. An analogy is that our GI and GI microbiota are essentially a recently discovered vital organ. One which the industrialized western diet (now well exported globally) has been systematically destroying. Diet has direct and immense impact on GI health, which in turn impacts such matters as: chronic systemic inflammation, autoimmunity, hyperinsulinism, neurotransmitter production (a vast amount of which happens .. in the gut!), hunger signalling, and more.

I don't have time to put the references in here that this deserves, but I'll leave you all with this to whet appetites, as it were.

Dr. Terry Wahls, "Minding Your Mitochondria":

https://www.youtube.com/watch?v=KLjgBLwH3Wc

Watch that, so my bluntness to follow makes sense. I see this guy's protocol as nothing but poisonous in the long run. He's off and created yet another processed food product that must be assumed to fail to meet the needs of the human body. Current research hammers home the idea that we don't yet have a complete and constructive model of nutrition, so why in the heck should I believe a nonspecialist that claims otherwise? Extraordinary claims, extraordinary proof, or GTFO.

⬐ pbreit

Jeez, man, chill out. History is littered with amateurs making breakthroughs. You're take down is uncompelling. Processing for health is a bit different from processing for cost.

⬐ zorpner

> Processing for health is a bit different from processing for cost.

In the sense that history is littered with people attempting to apply cross-domain knowledge to processing for health and failing utterly, that's absolutely true.

⬐ pbreit

A citation would be nice.

⬐ jfoster

Ninety-nine times out of one hundred, you'll be right about this. Then that one time out of 100, someone will advance the field in a way that the doubters never could.

⬐ benatkin

Hmm, you do have a point. What this world needs most is billions of people eating a pound each of fresh leafy green vegetables every day.

⬐ hyperbovine

That is not such a bad idea.

⬐ joering2

> I certainly don't want to rain on some new visionary's parade,

so stop.

⬐ criley

>"Extraordinary claims, extraordinary proof, or GTFO."

>"I see this guy's protocol as nothing but poisonous in the long run."

You place a burden of evidence on him that you yourself in this very post violated on a number of occasions. You CANNOT call his diet poisonous simply because you disagree with it.

You admitted it yourself:

>"Current research is showing that we are only just beginning to gain understanding of the complexity and health of the GI."

So no offense, but you have literally no ground to say that this is poisonous in the short OR long term, no evidence to back that up, and you cannot rely on a field that cannot support your view.

You have a view on this, congratulations, but it is nothing more than a well-informed opinion. It is not fact, it is not supported by fact and as you've admitted -- it CANNOT at this point be supported by fact that does not yet exist.

Even your link to a TEDX (aka, unvetted content) states upfront: "This talk is a personal narrative and is not yet backed by larger experimentation."

I'm sorry, but you've been consistently and narrow-mindedly against what the OP has put forth. You dismiss his views for their lack of credibility but turn around and post sources that themselves have no credibility (admit to being anecdotal).

You seem to have picked what is correct and are now looking for evidence to support your preconceived notion. You also seem to be falling for the naturalism fallacy by pretending that since his food is "pill and scalpel" it is therefore wrong/bad.

Just my conclusions: obviously he hasn't posted data or even analyzed it, but you present many issues in your posts that I disagree with more strongly than what he puts forth (and I'm not a layman).

⬐ acgourley

The burden of evidence should be on the person claiming to have a miracle drink. The burdon of evidence should be even greater when it's a non-natural source, as Nassim Taleb argues in Antifragile, "The "non-natural" has to prove its harmlessness." If you don't take this viewpoint, you end up with cigarettes, transfat and radium jewelry.

⬐ Dylan16807

But he doesn't have a 'miracle drink'. He has a generic food mash and his only claim is 'contains basic nutrients and calories'.

⬐ droopyEyelids

It's a curious statement about our society where the idea that the fuel for the human body could be simple. "Basic nutrients and calories"

It's all produced by self replicating lifeforms we've only begun to comprehend, right?

⬐ Kim_Bruning

Right, but those sophisticated replicators are so sophisticated that they tend to be rather tolerant of their input.

There's no reason to think we can't science out what that input needs to be, or at least to be able to find one or more valid subsets of input.

This is a rather large improvement over what most people do; one typically applies little to no science whatsoever. :-P

⬐ pyre

The liver is pretty tolerate of alcohol, but a lifetime of alcohol use can cause liver issues.

⬐ Kim_Bruning

Right; the downside of a tolerant system is that it does not fail hard. This does not, however, preclude finding the system limits by use of the scientific method. It just makes it a tad trickier at times.

I'm getting the idea that people profess a "belief in science" in the general case, but then absolutely deny its applicability in the specific case here. ;-)

⬐ damoncali

He says it contains all the nutrients the body needs. That is a big claim.

⬐ krenoten

No, he says it has all of the ones we know about. He emphasizes the fact that there stands to be a lot of learning to do and bugs to work out.

⬐ vidarh

Given that he is asking for feedback from others who decide to try it, and on his blog warns that he is not sure how it might work for others, and is offering to provide samples to people who agree to have blood work done before and after trying it for a week, he seems acutely aware that while he thinks it contains all he needs, he does not yet have sufficient evidence to be sure.

He's not written a scientific paper - don't assume that every single word he has written is meant to be interpreted in the strictest way possible.

By all means be sceptical, but while he might very well be wrong, at least he appears to be earnestly looking to identify and correct any flaws which already puts him far above a lot of charlatans selling risky diets.

⬐ theyare

What is not natural with cigarettes?

⬐ vidarh

He seems to be very conscious that this is in effect an experiment, that might be risky as well. E.g. from his site ( http://robrhinehart.com/):

"I am reticent to provide exact brand names and instructions because I am not fully convinced of the diet's safety for a physiology different than mine. What if I missed something that's essential for someone of a different race or age group"

But he is interested in actually gathering more data, even if not exactly formally enough for a proper study:

"So…I'll just ship you some of my batch. If you are willing to consume exclusively soylent, and get a CBC, chem panel, and lipid blood test before and after the week and share your results with me it's on the house. Bonus points for getting a psych evaluation before and after. The brain is an organ. I can ship it worldwide but it would be nice if you were in San Francisco so we can meet in person."

Further down on his blog, he has also posted PDF's of his bloodwork.

While he certainly does not have sufficient evidence of general safety and effect, he is aware of that and seems to be actively interested in learning about any flaws in what he's done so far.

> The burdon of evidence should be even greater when it's a non-natural source, as Nassim Taleb argues in Antifragile

This, to me, is ridiculous. A vast range of dangerous poisons are readily avaiable in nature.

I used to pick a lot of mushrooms, and can safely identify perhaps a dozen types common where I grew up. But every year there are people who die agonizing deaths from consuming various nasty toxins because they didn't pay close enough attention to what they picked. And the safety of most mushrooms is unknown - we simply don't have data, and the effects can take a long time to show.

In some cases, popular mushrooms are known to be toxic, such as false morels that contains gyromitrin. They are seemingly safe after boiling. Except there is still gyromitrin in the mushroom, just in small enough quantities that you're ok as long as you don't ingest too much. It's typical to recommend no more than one meal per season, as the poison is stored. But many mushrooms contains compounds we don't know the effect of, and where it is perfectly possible that no effect would be noticeable for a very long time - properly cooked false morels for example, might have no effect on you for years, until you get a bit careless with the cooking (a common way for people to get poisoned by false morels is to stand over the pot while boiling it...)

Nature has an abundant supply of horribly nasty toxic substances that might pass for food for a while.

This is before getting into what "natural" even means.

Everything has to prove its harmlessness. It's just that some things we have a lot of existing data for that at least demonstrates a certain level of safety.

But in the absence of data, I'm no more going to be willing to chew on some random "natural" substance than I'd be willing to ingest some random synthetic substance.

⬐ bgilroy26

This might be a different tack, but what if you take Mr. Taleb's "nature" to be human nature [1]? People don't tend to eat poison mushrooms as a rule.

In that case, his rule would be a good one. If you drift in to a new area of human endevour, the people who follow you out there are taking a risk until the area is well-traveled

[1] In the Aristotelian sense: human nature is the proportionate sum of all human activity. We mostly eat, drink, sleep, walk, talk, etc. so that makes up the bulk of our nature. Cannibalism and incest are acted out much, much less often, so that is a much, much smaller part of our nature, though it is tucked in there.

⬐ FooBarWidget

You define nature as activities that people perform most? By that reasoning the culture with the largest population is representative of typical human nature. That just seems wrong.

There are almost 2 billion Chinese. They love to eat chicken paws and cow intestines. So that is human's natural diet?

⬐ bgilroy26

Yep, I'm saying if you generalize about all of us, that's how you'd do it.

Your point is dead on: if you make a generalization that broad, you lose a lot of information.

⬐ yuvadam

Not sure what makes chicken breast better than paws and cow rump better than intestines. All are animal parts.

⬐ vidarh

Chicken feet and cow intestines taste great. I'm not Chinese. My favorite dish when visiting Beijing a few years back was spicy duck intestines. Looked like noodles.

⬐ acgourley

I really must defer to Taleb on this, I'll simply say he means natural in a more specific way than "all substances that exist in nature," and something more like, "the culture and patterns mankind has successfully practiced in relationship to nature for thousands of years with proven success."

⬐ vidarh

That doesn't sound specific at all to me, but rather extremely vague and open to whatever interpretations might suit... What "culture and patterns" have we "successfully practised" "in relationship to nature for thousands of years"?

Diets vary crazily much, even within small geographical areas. Things like lactose intolerance is something we only "recently" started seeing on the wane, and it is wildly dependent on your heritage. I'm Scandiavian, and growing up I didn't even know there were people who had problems with dairy, as it was a total non-issue. I used to drink about a litre a day of milk on average growing up.... It was first as an adult I realised there are large parts of the world where people pretty much don't drink milk.

At the same time, I also consumed vast quantities of Scandinavian salted licquorice candy. Except most of if is ammonium chloride based. I doubt that would fit very well into the idea of something "natural", but it is an integral part of Scandinavian culture.

As is fish dissolved in caustic soda an integral part of Norwegian culture, and something we have "successfully practiced" for a very long time.

And processing such as hanging/drying, burying (until half rotted in some cases) and salting various types of food have been an essential part of human culture for a very long time.

And, yes, picking mushrooms and facing the risk of poison have been integral to our culture for a very long time as well, even though many of the most poisonous mushrooms keep claiming deaths up to this day.

Many of the traditional "natural" foods I grew up with are significantly less healthy than a modern heavily processed microwave meal, or the protein powder I use to supplement for my weight lifting.

⬐ acqq

Please read this to understand: https://news.ycombinator.com/item?id=5370816

If nobody has a right nutrition model today(1), including exeprts doing this whole life, somebody who just read a few books has no chance to cover everything that has to be covered long term. Or in other words, don't you think that military with practically infinite funds wouldn't already use his drink or equivalent for all extreme circumstances, if something like that were enough?

(1) Because biology is darn complicated, like in "we still don't even know all the bacteria that live in our bodies." Not to mention organic chemistry 3-d effects like in http://folding.stanford.edu/

⬐ axelf

I don't see why this has to be perfect. I know a lot of people who live off of potato chips, cookies, and soda. Surely this diet would be better than that.

⬐ criley

This is one of the weakest defenses I've seen yet. It's complicated so we shouldn't try is basically the excuse.

In my opinion: the use of supplemented food like this will only improve our understanding and increase the speed at which those models are made.

By approaching the problem from BOTH sides we can create the most full expression of what is needed and why.

Still I dislike this excuse because: you run the risk of missing micronutrients every single day on a traditional diet, too.

Your body doesn't care if you forgot a micronutrient due to carelessness or if it simply wasn't in the profile of the whole foods you ate. Missing is missing. Eating popcorn, soda and fast food for a week straight means you miss a lot of important nutrients. And yet you survive.

Let the pioneers have fun and play and learn, that's what I say!

⬐ roc

> "It's complicated so we shouldn't try is basically the excuse."

I think the actual criticism is more along the lines of "It's so complicated that it's incredibly unlikely this guy has been truly successful."

> "Let the pioneers have fun and play and learn, that's what I say!"

Which is all well and good when they're merely experimenting on themselves. But this guy has gone from tinkering to claiming success and safety and begun distribution.

That's beyond tinkering and well into tampering.

He should absolutely feel free to tinker and explore and even publish his recipes and personal data for anyone similarly-motivated to build upon. But there's a line between doing that and doing what he's begun, the way he's begun it.

⬐ acqq

Or even "It's so complicated that it's certain this guy fails." We know for sure that he can't include all the stuff that we know that exists but for which we absolutely don't know how we can avoid eating the real things.

⬐ Kim_Bruning

Well, that's what science is for. If something is complicated and we don't understand it, we need to develop hypotheses and experiment. Over time our understanding grows.

What we don't do is go all "hurr durr it's too complicated, let's not even try".

⬐ aetherson

If human GI systems are so fragile that this shake could conceivably be considered "poisonous," how come people aren't dropping dead all over the world from such "poisons"?

The shake may well not be an optimal awesome diet -- I'd bet it won't be -- but billions of humans survive on non-optimal, awesome diets. The idea that the incredibly varied, constantly evolving, often appalling diets of the whole world all fulfill whatever criteria are necessary for human survival, but that this shake doesn't is magical thinking.

Especially when you consider that -- thread title notwithstanding -- the guy eats a few regular meals a week. What are these magical micronutrients that we don't know about, that are present in sufficient quantities to sustain humans in all traditional diets, but which are needed in such quantities that shake guy isn't going to get them?

⬐ acqq

> but billions of humans survive on non-optimal, awesome diets

Billions of people get sick because they don't have a diet varied enogh. Specific, well studied examples abound.

⬐ tracker1

Historically speaking, I don't think that man ate too much of a variety over the course of a given day, maybe weeks... And the guy mentions he does eat a couple times a week. I couldn't do it... but without high yield GM crops, we couldn't even feed 1/2 of the world's population, anything that stretches that isn't a bad thing...

⬐ aetherson

Sure. Specific, well-studied examples abound. You can get scurvy, or gout, or type II diabetes, or other problems from your diet. But "billions" of people don't get scurvy or gout.

If you want to use some kind of idiosyncratic definition of "sick" that pronounces somewhere between a substantial minority and a majority of the world as "sick" at any given time, I guess I can't stop you. But as a practical matter, we're comparing shake-guy's food to the other foods that people actually eat, not to whatever your idea of the best diet in the world is.

⬐ tracker1

I have to agree.. there are people that go for years on Mountain Dew and Top Ramen... I don't think the shake is any worse.. and probably could be as cost effective, and far better.

I, personally love food way too much for this to work for me... I've been working on my diet, and getting to a point where some of my Metabolic Syndrom issues are now getting better (can feel my feet again)... most of that has been from a pretty high fiber, low carb intake. Almost no processed sugars or rich starches (bread/pasta/rice/potatoes). I do have a savory crepe a couple times a week (essentially a low-carb sandwich wrap. I also eat lots of greens, and have been eating 2-3 pieces of fruit a day. It's hard enough not binging out on pasta, let alone only eating a couple times a week.

⬐ lyudmil

I'm not a person whose opinion on the subject matter should matter to anyone, so I'm not commenting because of a vested interest in this argument. I'm commenting because I think you're misapplying the principles of the scientific method, which makes your criticism unfair.

> You place a burden of evidence on him...

It isn't saidajigumi placing the burden of proof on him, it's the scientific method. Everything we know about nutrition tells us that we don't understand it enough to pull something like this off. It would be a breakthrough if it turned out we can, but the null hypothesis is that it won't work, so that's what our position should be.

If our default position is that this doesn't work, and the guy is really relying on his mix for most of his sustenance, that means we think he's going to experience adverse health effects because of his diet. Perhaps we have no evidence to suggest they'll be adverse enough to qualify his diet as "poisonous", but the assumption isn't completely baseless, as you've asserted.

Again, I have no idea who's right and who's wrong, but the two claims are certainly not equally likely.

⬐ orclev

The problem was in how the argument was stated. The post essentially claimed that his diet is dangerous until proven otherwise and therefore everyone should follow a "natural" diet of whole foods instead. It's a false dichotomy, even if his diet proves to be lacking or unhealthy in some way that does not make a "natural" diet automatically healthy.

Furthermore he makes the mistake of assuming correlation is causation. I.E. he claims the recent rise of processed foods and the increased incidence of poor health are a cause and effect relationship when in fact no evidence to such a connection exists other than the very weak correlation between them. He then goes on to extrapolate from this false causation that what he perceives as the opposite of processed foods, I.E. whole foods, are therefore inherently healthy.

The fact is whole foods are not special in any regard, being unprocessed does not magically confer health benefits on them. There are plenty of unprocessed substances, including various plants that are unhealthy or in many cases poisonous.

What the man in the article is attempting is a vital first step in better understanding human nutritional requirements. By breaking down nutritional inputs to carefully controlled individual compounds and then monitoring the results we can gain a much better understanding of what the real nutritional requirements of the human body are.

⬐ dpatrick86

As services like services like WellnessFX become more sophisticated (NOT affiliated) it will ultimately lead to people being better able to both self-experiment and provide evidence after an initial baseline to demonstrate what they're arguing. Exciting times ahead, I think.

⬐ dasil003

> You place a burden of evidence on him that you yourself in this very post violated on a number of occasions. You CANNOT call his diet poisonous simply because you disagree with it.

Nutrition science is in its infancy. It's clear that the complexity of the interaction of food as it is digested and interacting with our organism has barely had the surface scratched. Also, if you look at the rise of processed foods along with obesity, diabetes, and other health problems that have increased over the past century it's clear that there are some serious problems, and they haven't been explained conclusively by this or that macro-nutrient trend.

So given the state of the evidence, a vague evolutionary assertion that whole foods are generally healthier than a distilled diet of completely isolated nutrients is not granola flag-waving woowoo nonsense, it's a perfectly reasonable belief based on imperfect evidence.

Put another way, the idea the ability to construct a perfect diet given the knowledge we have is likely to fail due to the overwhelming number of unknown details that simply aren't an issue when you're eating whole foods.

If this guy wants to experiment on himself than I'm happy to reap the benefits, but I do believe it's risky. Let's not whitewash common sense just because of "a lack of data". The fact that we have imperfect data does not make all approaches equal, and the fact that this guy is an engineer and wants to follow a scientific approach does automatically make his ideas superior to someone who holds certain nutritional beliefs for slightly more hand-wavy reasons.

⬐ A1kmm

It sounds like the drink is made from natural sources, so it probably contains compounds that he isn't aware of. The risk (and the value of the experimental results) would probably be higher if he had found a way to isolate the compounds in the drink so he could enumerate the exact chemical composition.

If there is a risk, it is that his diet is potentially more homogenous than a typical diet, and doesn't include anything from some class of foods that nearly everyone on a more heterogeneous diet eats occasionally.

⬐ marknutter

But he said he does eat out occasionally.

⬐ mikkom

> If this guy wants to experiment on himself than I'm happy to reap the benefits, but I do believe it's risky.

What I'm wondering is is this any more risky than, let's say - eating at McDonalds instead of drinking this stuff?

⬐ None

None

⬐ gph

>Also, if you look at the rise of processed foods along with obesity, diabetes, and other health problems that have increased over the past century it's clear that there are some serious problems, and they haven't been explained conclusively by this or that macro-nutrient trend.

>So given the state of the evidence, a vague evolutionary assertion that whole foods are generally healthier than a distilled diet of completely isolated nutrients is not granola flag-waving woowoo nonsense, it's a perfectly reasonable belief based on imperfect evidence.

Isn't it possible that this is more indicative of the rise in an imbalanced diet? Processed foods may have lead the majority of people into having an imbalanced diet, but if they were instead eating a perfectly balanced diet of processed materials like this man is doing, isn't it possible there wouldn't be the whole diabetes, obesity, etc. health crisis?

To put it bluntly, is there actually evidence that a balanced processed diet is any worse than a balanced whole foods diet?

If not, I think professionals should attempt to recreate this type of experiment to find out, obviously safely on animals first. The whole principal of science is that you don't hold onto preconceived opinions when testing theories. Holding onto a "processed foods are bad, because look what's been happening" POV is very unscientific and harmful.

⬐ tassl

I don't think you can't really establish a correlation between animal and human diet, and how a specific "balanced" diet might affect them. The difference in diet and life span are two important factors that might affect any study.

⬐ chadillac83

This guy lost 27lbs on a balanced diet of nothing but junk food snack cakes, cookies, and Doritos.

http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/...

⬐ jtheory

Ahem:

> Two-thirds of his total intake came from junk food. He also took a multivitamin pill and drank a protein shake daily. And he ate vegetables, typically a can of green beans or three to four celery stalks.

And of course, "he lost weight" doesn't unequivocally mean "he got healthier".

⬐ DanBC

> Dr. Terry Wahls, "Minding Your Mitochondria":

She needs some reputation management, because at the moment there's a bunch of flags that make her sound less than reputable.

1) "Mitochondra" - unless this is a peer reviewed respected journal most people using htis word are cranks.

2) TEDx - Sadly, now tainted as home of cranks.

3) Cured MS through diet - ridiculous claim

etc etc.

⬐ nitrogen

Why is 3 a ridiculous claim? I agree that there should be evidence presented that the demyelination of MS has been reversed, but why do the words "Cured MS through diet" alone constitute a "ridiculous claim"?

⬐ mamoswined

Because MS, like most autoimmune diseases, is known to go into spontaneous remission even in people without a special diet.

⬐ DanBC

You're right. The phrase "Cured MS through diet" alone could be a true statement. But to be a true statement it needs to be tested by science. And this doctor isn't doing any real science.

In general when someone says "I cured this chronic, uncurable, disease through diet" I need to read what they say very carefully. At best it's an overblown claim and they actually mean "this food has a strong evidence base to help you manage your illness and reduce relapse". At worst it's evil people cynically cashing in by selling nonsense to desperate dying people.

⬐ Goronmon

There is no cure for MS, so if the video does make that claim, it's pretty ridiculous.

It's the equivalent of saying you could cure cancer with diet.

⬐ dougk16

You can cure cancer with diet, along with generally healthy living. "Cure" perhaps isn't the best word though, because bad diet (combined with other things like stress, lack of exercise, etc.) is frequently the cause of cancer in the first place.

EDIT: I didn't mean to say that changing to a healthy diet/lifestyle after being diagnosed will magically cure you (if that's why I'm being downvoted) but I believe it certainly can in some cases. If it's for lack of references, well, when it comes to cancer, you can find a study to support just about any view you want.

⬐ robotresearcher

Steve Jobs observed very strict diets which he believed would keep him super healthy. Result: dead at 56 despite essentially unlimited resources.

⬐ zwischenzug

His cancer was caused by his diet? Or are you saying that choosing diet over medicine killed him earlier than could otherwise have been the case.

⬐ cbennett

From the article stratoscope (one comment tree down) links to: "My pancreas levels were completely out of whack, which was really terrifying … considering everything.” (Jobs died after a long battle with pancreatic cancer in October 2011) Food for thought..

⬐ chousuke

His diet probably wasn't the cause for his illness, but as far as I understand, he refused ordinary medical procedures (surgery) that had a good track record against his particular type of cancer, in favour of observing a special diet. The diet didn't help and the cancer progressed to the point where surgery was no longer an efficient treatment.

⬐ Stratoscope

It didn't work out that well for Ashton Kutcher either:

https://www.google.com/search?q=ashton+kutcher+fruitarian+di...

⬐ pifflesnort

No, you can't. This is quack science.

⬐ dougk16

Well, I could link you to a bunch of studies that say otherwise, but then you would tell me all the reasons that those studies are bogus, and then show me a bunch of studies that show there is no connection (probably sponsored by those peddling chemotherapy et al.), so I guess we'll just avoid the rathole and stay convinced of our own opinions :)

⬐ lupatus

Don't worry, I've got your back; I'll do it for you, dougk16.

http://www.ncbi.nlm.nih.gov/pubmed/?term=turmeric+cancer

http://www.ncbi.nlm.nih.gov/pubmed/?term=piperlongumine+canc...

http://www.ncbi.nlm.nih.gov/pubmed/?term=bromelain+cancer

http://www.ncbi.nlm.nih.gov/pubmed/?term=frankincense+cancer

⬐ DaemonXI

Link me to some peer-reviewed studies that show that cancer can be cured with only dietary changes.

⬐ Volpe

Link the (peer-reviewed) articles, rather than guessing peoples responses to the hypothetical articles.

⬐ None

None

⬐ robotresearcher

"peddling chemotherapy"

This is the most stupid and obnoxious thing I've ever seen on HN. Chemotherapy saves lives every day. You can believe that good diets are healthy and helpful for sick people without insulting people that sell nasty but powerful medicine that is proven to work.

⬐ dougk16

Agreed. Posting those two comments was a mistake.

⬐ jlgreco

Dangerous quack science. Convincing people of it has the very real potential to kill people.

⬐ hirenj

I would appreciate it you'd elaborate on your first point about mitochondria here. I'm intrigued to find out why this term is highly suspicious. Are there other organelles that are less crank-like to you?

⬐ DanBC

The word mitochondria is just a personal flag, a smell, that I use as part of a warning.

Mitochondria raise flags because of people like the UK Dr Ruth Myhill. She claims to be a researcher on chronic fatigue syndrome. CFS is real, but sadly is an area rife with cranks. Myhill appears to have a lot of crank-like beliefs. Her "research" is hopeless, and amounts to unlicensed unethical experimentation on desperate people.

I guess, although I have no supporting evidence, that the word mitochondria is used more often by cranks than other organelles.

⬐ hirenj

Mitochondria are pretty important (as is most of the junk in our cells for that matter). I'd be less wary of the use of mitochondria in popular science - it's shorthand for talking about the energy metabolism pathway, and doesn't indicate one way or another whether we're looking in the right spot for the causes for particular diseases / syndromes.

On a tangential note, I haven't read it, but http://www.ncbi.nlm.nih.gov/pubmed/21792218 might be an interesting review on CFS. Also, I assume you are referring to Sarah Myhill rather than her daughter.

⬐ XorNot

Cellular organs are a pretty untouchable class of things for anything humans are going to do on a macro-scale. If you're proposing to achieve a big effect from say, a diet, then focusing on more then 1 bodily component is suspicious because there's a huge range of barriers you need to get through to get to it (without damaging, generally).

There are lots of drugs, for example, which are useless because although they target the right protein and have the desired effect they can't actually get to it via normal metabolism and the like.

⬐ cma

Maybe he was thinking of midi-chlorians? Those are totally legit when they show up in a peer-reviewed journal.

I can agree with him on that specific point, but beyond that there's the issue of people he calls pseudo-scientists (who are actual scientists that do actual academic research on the topic), that are linking degenerative diseases and grain consumption. http://thepaleodiet.com/published-research-about-the-paleo-d.... That and the accompanying evidence on actual people http://www.youtube.com/watch?v=KLjgBLwH3Wc.

⬐ None

None

I've been transitioning to the troglodiet (tm): fresh veggies, legumes, meat. More or less the caveman diet, Atkins, paleo, Eat to Live, etc.

This Dr Terry Wahls TEDx talk has been very motivating.

Minding Your Mitochondria http://www.youtube.com/watch?v=KLjgBLwH3Wc

Dr. Wahls is mitigating her MS thru nutrition. For me, eating lots of vegetables makes my chronic psoriasis go away. When I slack on the nutrition (eg traveling), my psoriasis comes back.

I believe, but cannot prove, that psoriasis is basically external arthritis. I figure better nutrition is improving my health overall, including brain function.

One side effect I did not expect: I now crave hearty kale salads. Years ago I had a gf who was really gunghu for kale, chard, sorrel, and other leafy greens. I could handle it once or at most twice a week. Blech.

Now things are different. Better recipes certainly help. I think once my body got used to the good stuff, it demands more.

Moderate exercise and plenty of sleep too, of course.

Good luck.

⬐ uberc

Motivating video indeed. The slide showing what percent of Americans fail to get the RDA for various nutrients is eye-opening. Thanks.

⬐ spiffistan

That video was intensely great. Personally, when I'm unable (or rather, too lazy) to eat a lot of veggies, I just pop a couple of spirulina and chlorella (algae) tablets, which have all the vitamins except D and B12, if I remember correcly.

Specifically, these ones: http://www.swansonvitamins.com/swanson-greenfoods-formulas-c...

⬐ bernatfp

I appreciate this point since I really hate vegetables. Can these tablets replace them?

⬐ debacle

No.

Just one anecdote on that point. I'm pre-med and I recently shadowed the director of cardiac research (a cardiac surgeon) at the big hospital/medical school in this area. He was asked point-blank by a patient, "I've been reading that with diet and exercise I might be able to reverse my heart disease. What do you think?"

The doctor's answer was, "Absolutely not."

This is one data point, so it's hardly conclusive, but coming from a doctor who (a) teaches doctors and therefore plants seeds for the next generation and (b) should be an expert on new medical treatments with his position as the director of research, it's troubling.

Meanwhile, there is a growing minority of doctors who take patients through an eating "bootcamp" where they help them take out processed foods/white-flour/high-fructose corn syrup from their diet, teach them how to shop and cook plant-based foods, etc. I saw a documentary on it, "Forks Over Knives" I believe. Fascinating stuff.

In the documentary, they take a man with advanced heart disease, cut out all meat/dairy/processed foods from his diet, and take before-and-after blood readings (cholesterol, blood pressure, etc.). It was surprising how quickly the intervention reversed his numbers.

There are other pioneers working in this area. There's Dr. Terry Wahls, an MD who reversed her multiple sclerosis by eating what some would call a "paleo" diet (only vegetables, fruits, nuts, meat). Here's her TED talk if you're interested: http://www.youtube.com/watch?v=KLjgBLwH3Wc She's currently working on human clinical trials to test this diet-intervention in other patients.

To your point, "all doctors say eat better, etc." I have two thoughts.

1. I'm glad you have doctors who have mentioned that but I've never had that experience.

2. A doctor who says, "You really need to eat better," is not quite what we need. For reversible conditions like heart disease, diabetes, (MS?) etc we need doctors who say, "Your next appointment will be with a food specialist/nutritionist. He will help you completely change your eating habits, go shopping with you to get new staple-foods, and you will stick to this new lifestyle for x months. Here's a list of foods you must not eat and here are x great-tasting recipes that are easy to make. Come back in 6 weeks and we'll do another round of blood-tests to see how it's working. If you're not willing to do this I can give you [statins, etc. fill-in-the-drug] but they won't actually treat the disease and may not make you feel better. They will keep you alive though. It's totally up to you and I'll support you in either decision."

Just my 2 cents. I think medicine will eventually look more and more like this, but it will take time to change the culture and the traditions of western medicine.

⬐ carbocation

By the time a patient is seeing a cardiac surgeon, it's extraordinarily unlikely that it would be remotely responsible to advise a patient to try to treat their condition by using diet and exercise without medication.

⬐ adammichaelc

I think that's mainly because of tradition and the difficulty involved in getting people to make a wholesale change in their diet, not because of the superiority of the medication in reversing the condition.

See my other comment for sources: http://news.ycombinator.com/item?id=3709426

⬐ carbocation

Your link shows a study comparing diet to placebo. In contrast, your comment talks about diet vs medication. A nuanced but important difference. To the best of my knowledge, diet-vs-medication has not been tested systematically in a high quality trial.

Another study that you might like, and which is potentially more relevant by the point you're talking with a cardiac surgeon, is the Lyon Heart Study, which actually looks at secondary prevention:

Easy to digest article: http://circ.ahajournals.org/content/103/13/1823.full

Original study: http://circ.ahajournals.org/content/99/6/779.full.pdf

⬐ pdx

Heart disease can be plaque, which, theoretically, might be removable with some diet change. It can also, however, be hardening of the arteries, which is a loss of elasticity of the artery walls. We don't know how to reverse tissue loss of elasticity do we? So when he said it could not be reversed with diet, that seems to be correct to me.

⬐ liber8

In no way do I mean this as a personal attack, I simply find this comment fascinating, and it's a good example of something I see more and more of.

You basically say heart disease is either A or B. Because we don't know how diet effects A, and doctor says diet wouldn't help, doctor is right. (Notice the fallacies [false dichotomy, jump to conclusion, circular logic] become very clear when we simplify the wording.)

What I find interesting is the way we all seem to work to show that what we believe in must be right or that what we don't believe in must be wrong. Diet can't magically cure heart disease, and [logical fallacies], so diet doesn't cure heart disease. The Earth isn't warming, and [conspiracy theory], so the Earth isn't warming.

Again, I don't mean this as a personal attack (maybe your post was just had a few typos), but it's something that I see more and more frequently, even places like HN. Instead of being more like Feynman, our technology seems to be prodding us to be more like rush-hour talking heads.

⬐ pdx

I'm still trying to digest your argument, but my point was a simpler one.

I am very interested in whether or not we can restore elasticity in tissue, such as the lens of your eye, the skin on your face, or the walls of your arteries.

When a medical student, who doubtless has more knowledge than I do implies that heart disease can be reversed in any manner, diet or not, I'm interested and wanted to move the conversation forward in order to clarify.

⬐ pradocchia

To quote:

> We don't know how to reverse tissue loss of elasticity do we?

Ok.

> So when he said it could not be reversed with diet, that seems to be correct to me.

Doesn't follow. If something has certain effects, that reality necessarily precedes our knowledge of it. Our discovery necessarily follows the reality.

⬐ arn

Note, he's pre med, not in med school. Pre med doesn't give you any specific medical knowledge.

⬐ None

None

⬐ None

None

⬐ carbocation

When people talk about ischemic heart disease, they mean atherosclerosis. If they mean arteriosclerosis (e.g., Monckeberg's calcific sclerosis) they will call it out explicitly.

⬐ adammichaelc

Here's one of the placebo-controlled studies that suggests lifestyle can reverse coronary artherosclerosis (hardening of the arteries): http://www.ncbi.nlm.nih.gov/pubmed/1973470

And for something more digestible, here's Dr. Dean Ornish's TED talk discussing his research on the same:

http://www.ted.com/talks/dean_ornish_on_the_world_s_killer_d...

⬐ surement

"This is one data point, so it's hardly conclusive, but coming from a doctor who (a) teaches doctors and therefore plants seeds for the next generation and (b) should be an expert on new medical treatments with his position as the director of research, it's troubling."

Why should this be troubling? Why do you presume to know more as a pre-med than this director of cardiac research does?

⬐ Groxx

There's another reason that this general mindset exists: think drug interactions are poorly understood? Try researching nutrition and food interactions.

People eat thousands of chemicals daily, and we still haven't figured out if something as superficially simple as, e.g., the "food pyramid" is a good thing or not. What you eat is massively more complex than the drugs you are prescribed. The biggest difference there is that (most of) the chemicals have been around and in our diet for quite a long time, so they're evidently not (very) dangerous (to most. see also Celiac / Coeliac disease for an example of how long problems can exist)

Holistic approaches may be good; they may even be the best approach. But due to the insane amount of variables, they're also about the furthest from science as it's possible to get, and the least actionable in a specific sense. Everyone knows they should "eat better". Well... define "better". And be sure it applies to everyone, or be able to know who to apply what advice to.

⬐ arn

Just to add.

Depends on why he was seeing a cardiac surgeon (who usually sees patients that have had or need surgery), and what his heart disease is. I don't think you have enough medical knowledge to assume the cardiac surgeon was, in fact, wrong. The question could easily have been interpreted as:

"Will diet and exercise reverse my [multiple 95% blocked coronary arteries before I die from a massive heart attack]"

or

"Will diet and exercise reverse my [dead heart tissue from my heart attack]"

Both answers are reasonably close to "absolutely not".

You seem to equate 'heart disease' to high cholesterol levels, and blood pressure readings. It is not. And if he "just" had high cholesterol and high blood pressure, he would not be seeing a cardiac surgeon.

Meanwhile, the answer to "Will diet and exercise reverse my [high cholesterol and high blood pressure]" The answer to that is sure, definitely possible.

⬐ adammichaelc

Great points! Wish I had time to respond.

Edit: Meeting got out early so I have a minute.

You're right. Surgery is the only option in some cases. The question to the surgeon was about heart disease in general, or hardening of the arteries.

The doctor and I had a chat about it after the patient left. He said, "There are some researchers whose studies show that you can reverse heart disease with lifestyle changes, but when you look more closely at their data you can't tell which interventions actually help. The bottom line is that most people need the drugs and surgery to help them."

To me, it seemed like the doctor had a bias against non-drug or non-surgery options, and he didn't want to explore it with an open mind. Makes sense for him. His entire practice was based on surgery and drugs. If I were in his shoes I'd want to believe that drugs and surgery were the best option.

⬐ arn

You seem to have the opposite bias, no?

Do you believe that diet alone is better than diet + drugs? Do you believe that diet alone is better than drugs alone?

⬐ adammichaelc

I think it's fair to say that I'm biased against drugs, yes.

To your second set of questions, it totally depends on the situation (patient's willingness to change, type of disease, science of drug-based vs non-drug-based interventions, whether the illness is acute or chronic, etc). It's really impossible to make blanket statements about which interventions are most appropriate.

Related to this topic I think you might find Dr. Terry Wahls' story fascinating, she pretty much 'cured' herself from Multiple Sclerosis by adopting a 'paleo' diet. She presented her findings at the 2011 Neuroscience conference ("Effects of intensive directed nutrition, progressive exercise program and neuromuscular electrical stimulation on secondary progressive multiple sclerosis (PDF)[1]") She also had a TED talk[2] taking us through the process of getting out of her wheelchair and the specific food she ate.

I know this immediately turns on your B.S. sensors, but she changed her lifestyle after spending hours on Pubmed doing research on nutrition's impact on the brain and specifically the mitochondria. I highly recommend the talk, it is both very informative and very moving. And there are some saddening statistics about the lack of vitamins and minerals in the American population.

[1] http://www.sfn.org/am2011/pdf/prelim/SUN_Poster_PM_v2.pdf [2] http://www.youtube.com/watch?v=KLjgBLwH3Wc&feature=playe...

⬐ Shorel

As a Paleo eater, I'm happy to see this in the research.

(also replying as a form of bookmark)

⬐ js2

http://www.terrywahls.com/about-Terry-Wahls

⬐ None

None

⬐ YuriNiyazov

Eat food, not a lot of it, mostly plants.

⬐ balsam

Roy Walford "proved" that calorie restriction with nutrient supplementation does nothing for ALS. So I'd want to look at the details.

⬐ tehayj

This should stay on the front page!

⬐ pg

Wow, I feel like this is the most interesting thing on HN right now by far.

⬐ rms

I'm extraordinarily impressed by the paradigm of functional medicine. I went so far as to buy this book to figure out how to interpret my own comprehensive nutritional testing results. http://www.metametrix.com/learning-center/books/2008/leifm It seems like functional medicine basically has the right answers, but is still broad and vague enough that alternative practitioners can wrongly use the paradigm to make whatever conclusions they want.

I'm 5 days into a post-paleo diet of the type described in this video and have never really felt better, happier, or more energized. I also have an auto-immune disease that might make me respond unusually well to this kind of dietary intervention.

⬐ replicatorblog

It is amazing how many major medical breakthroughs come through physicians experimenting on themselves. For instance, 2 doctors shared the 2005 Nobel Prize for proving that ulcers were caused by bacteria by first infecting themselves with bacteria and curing it with an antibiotic.

http://www.nobelprize.org/nobel_prizes/medicine/laureates/20...

⬐ replicatorblog

It is amazing how many major medical breakthroughs come through physicians experimenting on themselves. For instance, 2 doctors shared the 2005 Nobel Prize for proving that ulcers were caused by bacteria by first infecting themselves with bacteria and curing it with an antibiotic.

http://www.nobelprize.org/nobel_prizes/medicine/laureates/20...