Sunday, November 29, 2009

Scientists Behaving Badly

The premise of this blog is that the scientific method can be used to support or invalidate the tenets of the low-carb lifestyle. While science can never claim to establish the final truth of a particular hypothesis, it is the best instrument we have to approximate the truth of something that is falsifiable, that is, something that is capable of being tested by experiment or observation.

Although science is an excellent tool, we must be careful to remember that science is performed by human beings who are not perfect. Low-carbers are already aware of the problematic work of Dr. Ancel Keys. Among Dr. Keys' most important publications was the Seven Countries Study. This study helped establish the diet-heart hypothesis when it found that in seven specific countries, the cardiovascular disease rate was positively correlated with average serum cholesterol and per capita intake of saturated fatty acids. In 1957 two scientists, Jacob Yershalmy and Herman Hilleboe, noted that data were available from 22 countries, not just seven. They published a paper showing that when all 22 countries were analyzed, the cholesterol/saturated fat correlation to heart disease became much weaker, and the incidence of heart disease was more strongly related to sugar intake. Even though it seemed that Dr. Keys might have cherry picked his data, his diet-heart hypothesis has nonetheless prevailed over the years.

The science of Anthropogenic Global Warming (AGW) doesn't have much to do with low-carbing, but it does have a great deal to teach us about the practical aspects of whether to believe or disbelieve a particular scientific finding. In November 2009, a series of e-mails was made available on the internet, purporting to be from the Climate Research Unit (CRU) at the University of East Anglia in Norwich, England. As of this writing, their authenticity has not yet been denied, and these e-mails now form the heart of what has been termed Climategate.

What does Climategate have to tell us about how to evaluate scientific claims with a skeptical eye?

First, if the scientists refuse to release their raw data, it's not a good sign.

Phil Jones (head of the CRU) and Tom Wigley (University Corporation for Atmospheric Research in Boulder, Colorado) discuss here how to avoid releasing data in response to a Freedom of Information request. Dr. Jones is so averse to scrutiny of his data that he admits to clearing e-mails off his computer here and advises his colleagues to do the same here. (AR4, referenced in this link, is the Fourth Assessment Report of the UN's Intergovernmental Panel on Climate Change (IPCC), released in 2007. The AR4 allowed AGW supporters to claim a consensus in favor of anthropogenic global warming.)

Second, if the scientists select or massage their data to make it obey their hypothesis, it's a bad sign.

Dr. Jones has a problem because his data shows declining recent temperatures rather than rising ones. Here he tells three of his colleagues, "I've just completed Mike's Nature trick of adding in the real temps to each series for the last 20 years (ie from 1981 onwards) amd from 1961 for Keith's to hide the decline." Trick? Hide the decline? What might that mean?

"Mike" is Michael Mann, the creator of the Hockey Stick graph that used tree ring data to show no warming in the Medieval Warm Period, but a sudden, dramatic increase in global temperature in the late 20th century. In this article, Stephen McIntyre and Ross McKitrick show that the hockey stick graph is the result of overweighting data from American bristlecone pines and from using a non-centered principal component analysis that will almost always produce a hockey stick endpoint, even from random numbers.

"Keith" is Keith Briffa, whose tree ring data from the Yamal Peninsula of Siberia also showed a hockey stick pattern of recent global temperatures. Except that when Briffa's 12 tree cores (the red line on the graph below) are compared with 34 cores from the same area analyzed by Stephen McIntyre (the black line), the larger sample does not show the hockey stick pattern, suggesting that Briffa's 12 tree cores were unrepresentative of the local tree growth patterns and should not have been used to infer patterns of climate change for the Yamal region of Siberia, let alone for the whole planet.

Finally, if the scientists collude to allow some points of view to pass the peer review process while preventing other points of view from being expressed, it's a very bad sign.

Scientific journal editors decide which submitted papers will get reviewed, who the reviewers are, and whether the papers eventually get published. Here Tom Wigley tells Timothy Carter that they must get rid of an editor of the journal Climate Research. The man subsequently resigned. Here Tom Wigley and Michael Mann discuss a troublesome editor at Geophysical Research Letters (GRL) and whether he could be ousted because his presence may bring other AGW skeptics on board. Several months later the editor has left his post and here Michael Mann says, "The GRL leak may have been plugged up now w/ new editorial leadership there." Here Phil Jones is also having trouble with a new editor of the journal Weather, published by the Royal Meteorological Society (RMS). Dr. Jones says he has complained about the editor to the RMS chief executive, but if that doesn't work, he will not send any more papers to the RMS and will resign from the organization. When a group of scientists consciously engages in encouraging some editors and intimidating others, it's not particularly surprising if their papers tend to get published in the peer-reviewed journals while those of the scientists with opposing views do not.

Presumably scientists who hide data, who change data to fit their preconceived ideas and who conspire to see that only their data is published may nevertheless have reached correct conclusions. That would be the "fake but accurate" defense. However, it is much more likely that scientists who behave in this way have something to hide. Whenever you learn that a scientist in any field has engaged in one or more of these questionable activities, be very careful of whatever that scientist has to say.

Sunday, November 22, 2009

Narcissism: When Low-Carbers Hurt Other People

Narcissus, a young hero in Greek mythology, saw his image in a pool of water, fell in love with it and was unable to leave the beauty of his own reflection. He has given his name to an Axis II personality disorder described in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), narcissistic personality disorder.

There is no laboratory test for the diagnosis of narcissistic personality disorder. Typically a trained psychiatrist or psychologist will evaluate a patient who, by early adulthood, demonstrates grandiose thinking or behavior, has an unusual need for admiration, and shows a lack of empathy for other people. These maladaptive patterns must be present in a variety of contexts.

In addition, a person with narcissistic personality disorder will demonstrate five or more of the following criteria (taken from the DSM-IV):

  1. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

  2. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

  3. Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)

  4. Requires excessive admiration

  5. Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

  6. Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

  7. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

  8. Is often envious of others or believes that others are envious of him or her

  9. Shows arrogant, haughty behaviors or attitudes

While it is tempting to do amateur psychology, that is not the point of this blogpost. Only a professional can diagnose and treat narcissistic personality disorder. Nevertheless, it is important for laypeople to be aware that this condition exists, and that it exists in the low-carb community in particular.

Low-carbers are vulnerable. Typically they have been overweight for many years and have a poor self-image as a result. Many have tried and failed at various weight loss schemes. Couple those experiences with the societal stigma against overweight people, and self-worth becomes almost nonexistent.

Along comes low-carb. For once, these formerly-obese people find themselves successful at something. They are able to move their bodies, to buy clothes, and to go out in public without a sense of shame. And, in some cases, they find a mentor who is able to take advantage of all their vulnerabilities.

The mentor provides a diet outline that seems to work. The mentor creates an internet community that gives support and a place to belong to people who were formerly outsiders. All of that is good.

But if the mentor has narcissistic personality disorder, the mentor starts to overstate the benefits of his or her diet plan without commensurate proof (Point #1). The mentor sets himself or herself up as the ideal example of the diet plan (Points #2 and #4). The mentor begins to lay down specific rules that require either automatic compliance or, failing that, expulsion from the community (Points #3 and #5). The mentor may show friendliness, charm and empathy when it provides an advantage (Point #6), but in the end will behave in an arrogant, abusive manner toward people who have disappointed him or her in any way (Point #9).

In my experience, low-carbers tend to think the best of people, even of people who abuse them. When they encounter a person with narcissism, they often hope that by careful reasoning or sympathetic friendship, they can help that person see his or her problem, deal with it, and adopt a more successful style of living. Unfortunately, the treatment of narcissism requires psychotherapy (see this PDF for a fascinating outline of what's involved), and even then the treatment is unlikely to be successful if the patient is not a willing participant in the therapy.

In the meantime, when you encounter another low-carber who is self-absorbed, who believes himself or herself to be superior to others, who belittles others, and who is willing to manipulate others to achieve his or her own ends, recognize that this is a person who can derail your journey into good health. It may be difficult, but if the person is harming you while he or she claims to be helping you, it may be time to end this relationship and develop new ones in the low-carb community.

Sunday, November 15, 2009


For low-carbers, the design of an eating plan often focuses on carb counts, calories, and essential vitamins and minerals. With the array of tasty and nutritious foods that are available to low-carbers, it's easy to overlook another important aspect of low-carbing--water intake.

Water keeps our tissues hydrated, provides an environment for enzymatic reactions to occur, and in the form of blood, water carries vital nutrients to cells that need them. Water also dissolves and removes the toxins from our bodies in the form of urine--1.5 quarts a day in the average adult.

One of the interesting aspects of Dr. Atkins' New Diet Revolution and Protein Power by the Drs. Eades is that both call for the daily intake of at least eight 8-ounce glasses of water per day. In Dr. Atkins' case, he says that only water counts as water for the purposes of the diet (page 230 of the paperback version of the book). The Eades say that any water-based fluid will work, as long as it doesn't contain calories (pp.103-105 of the paperback version of the book). Their counsel is, in fact, "Drink Till You Float." Whichever guideline you choose, if you decide to drink coffee or tea, remember that caffeine is a diuretic, and you will need to drink extra fluid to compensate for this. Both caffeine and artificial sweeteners can slow weight loss in some people, and if you are one of them you may wish to make other choices for your fluid intake.

One of the unique reasons for monitoring water intake during low-carb dieting is that most low-carb weight loss comes from the breakdown of body fat. Some of the body fat is burned to create ATP through the TCA cycle and oxidative phosphorylation, as was described in the previous post. However, some of the fat will be burned incompletely and will be converted to molecules called ketones. Ketones are also able to be used for the production of ATP, but if an individual is not totally keto-adapted, the body will allow some of them to be breathed out, or excreted in the urine and the stool. Drinking plenty of water makes it easier for the body to get rid of the excess ketones.

As the body adapts to a ketogenic diet, or as carb intake increases, fewer ketones will be produced. Even so, long-time low-carbers will continue to spill ketones if their fat intake is high and their carb intake is low, and they will benefit from an increased water intake.

Water has a few other properties that make it an important part of a low-carb diet. If plenty of water is ingested every day, less water will need to be reabsorbed from the colon, making it easier to have bowel movements. Some people have a propensity toward urinary tract infections. Drinking lots of water prevents urinary stasis and makes these infections much less likely. Similarly, although kidney stones have many causes and many treatments, in a person with a history of kidney stones, a universal preventive strategy includes drinking well over three quarts of water per day. Finally, low-carb dieters freqently begin to do more exercise as a result of having enough energy to resume physical activity, or in order to improve their overall health. Because less water is retained on a low-carb diet, those who engage in strenuous exercise programs need to be sure that they drink plenty of water so that they do not inadvertently become dehydrated.

Often, thirst alone is not a good indicator for drinking water. This is especially true as people age and their bodies are less able to sense dehydration. In order to keep water intake at an optimal level, it may be necessary to fill a container or a set of containers in the morning and consume the water throughout the day, so that by bedtime all that day's water has been consumed. It may take a while, but drinking lots of water will eventually become a habit. Be sure to drink extra water when you engage in vigorous exercise, on days that are hot and humid, during the winter heating season, when you are at high altitude, and when you are sick.

Water is an important part of a low-carb diet. And the best news of all? It doesn't contain a single carb!

Sunday, November 8, 2009

Cancer and Carbs

Cancer has numerous causes, including ionizing radiation, cigarette smoking, infection with the Epstein-Barr virus, and overexposure to the sun, among many others. When a cell becomes cancerous, it faces several challenges. One of these is energy production.

The molecule called ATP (adenosine triphosphate) is called the energy currency of the cell. Energy is stored in the phosphate bonds of ATP, and when these are broken in a controlled manner, the energy can be used to fuel metabolic reactions, to replicate DNA, and to permit cell division. Much of our cellular machinery is devoted to the production of ATP. As illustrated above, the high energy bonds of ATP can be created using reactions that involve the breakdown of glucose molecules. Even better substrates for ATP energy storage are the acyl groups of fatty acids. (Energy can also be stored in ATP from the breakdown of amino acids and several other types of molecules, but for simplicity's sake, those pathways have been omitted here.)

Once the raw materials (pyruvate from the glucose and acyl groups from the fatty acids) enter the mitochondria, they encounter a very complex network of enzymatic proteins that function to produce most of the ATP for the cell. To give an idea of what this involves, the picture below shows the complexes required in the mitochondrial membrane just to accomplish the oxidative phosphorylation part of the ATP production process.

Normally the cells of the of a mature organism are differentiated into particular types that are specifically associated with various tissues such as brain, skin, and bone. They are strictly regulated with respect to their division and growth, and they require oxygen for the production of the majority of their ATP. By contrast, more primitive cells such as embryonic cells, are able to multiply rapidly without constraint and are mostly anaerobic. While cancer typically begins in differentiated cells, as those cells start to divide in an unregulated fashion, they start to de-differentiate and begin to resemble more primitive cells. As the cancerous cell mass grows, it may begin to be cut off from the oxygen supplied by the blood. This in turn can cause it to adopt a less complicated way of producing ATP, anaerobic glycolysis, which is also called fermentation.

Anaerobic glycolysis provides much less ATP than could be obtained from aerobic glycolysis plus the TCA cycle plus oxidative phosphorylation, but it has the advantage that it does not require oxygen. All it requires is glucose. Fat cannot feed into the anaerobic pathway. Protein can, but it is a fairly complicated process. It is therefore logical to speculate that a very low-carb diet might slow the growth of cancers, particularly the ones that are highly de-differentiated and rely mostly on anaerobic glycolysis.

This idea is far from proven. However, there is some interesting information in a review article recently published in the Journal of Cancer Research and Therapeutics, Targeting energy metabolism in brain cancer through calorie restriction and the ketogenic diet. (To get to a free PDF version of the entire article, click on the link. When it opens, click on the little Adobe Acrobat icon that follows the words "To download PDF version of the selected article click here.") The authors present evidence that a ketogenic (i.e., low-carb) diet can be of value in slowing the growth of cancer, both in mice with implanted brain tumors and in two children with advanced stage brain tumors.

Do carbs cause cancer? No, probably not. But they might contribute to cancer growth, and it is conceivable that in the future, a ketogenic diet might be considered along with resection, chemotherapy and radiation as part of a treatment plan for cancer.