Evils of Peer Review

Interesting post:

“The most exciting period in science was, arguably, 1895-1945. It was marked by discoveries that changed the foundations of modern science: X-rays, quantum mechanics, superconductivity, relativity theory and nuclear energy. Then, compare this with the next 50 years in science. Incomparable. Nothing of that scale or impact. Yes, technology has advanced, but fundamental science – has come to a crawl. Have you ever wondered why? What changed as the 20th century grew older? Among other things, research budgets and the number of PhDs increased exponentially. This cannot be bad.

“Well, it can. All depends on the rules of the game. And they have changed. The change went largely unnoticed by the general public. In this article I will try to bring everyone up to speed. I will explain to non-scientists the “business model” of modern science. People may want to know. After all, scientists are burning public money, billions a year. And, I am quite sure, those who get my message will react with “you cannot be serious!” And leaders of organized crime will be pulling their hair out in despair: “why did not we think of this first?”…”

I think blaming all lack of progress in Science on peer review is a little extravagant.  Some fields, like physics, have essentially reached the limits of what we can learn with the technology available to us.  That doesn’t have anything to do with peer review.  In other fields, like human nutrition and climate science, I think the author’s spot-on.  As I recall, Steve Phinney mentioned that this problem was one of the reasons he moved out of academia and into industry in his book.

Master Sgt. Mike Morton: Ketogenic Ultrarunner

There’s been lots of speculation about how suitable a ketogenic diet really is for athletes.  Some folks (Robb Wolf) have gone back and forth, but my understanding of physiology leads me to think that it should be superior most of the time. 

Well, now we’ve got an interesting guinea pig:

• “1994: Old Dominion 100 — 17 hours, 40 minutes — first place
• “1995: Old Dominion 100 — 16 hours, 55 minutes — first place
• “1995: Vermont 100 — 14 hours, 8 minutes — first place
• “1996: Massanutten Mountain 100 — 20 hours, 21minutes — first place
• “1997: Western States 100 — 15 hours, 40 minutes — first place [course record]”

That’s nice, of course, but what’s he done lately?

He won the famed Badwater 135 race, setting the course record last year.

Then he broke Scott Jurek’s record at the International Association of Ultrarunners Ninth Annual 24-Hour World and 18th European Championships, setting a new record for an American.

And now he’s done this:

“I have made some big changes in my fueling plan over the last five months. Prior to the changes, I was a high carb and low fat eater. I was consuming a large volume of food each day. Large volume in, means large volume out! At Badwater and the World 24 hour Championship, I spent too much time with natures [sic] business. Looking for efficiency, and a more stable energy curve, I researched several different options for fueling. Ultimately, I chose a high fat, moderate protein, low carb diet. This was a tough transition, since I rarely ate meat or fatty foods. I had been avoiding cheese and dairy for years... except for cottage cheese.
“I committed to myself and made the switch. After about four weeks of eating a high fat diet I was "keto adapted" meaning that my liver was making Ketones and the body was using them for fuel rather than glucose. Making that change was tough because I was addicted to sugar and grains! By being in Ketosis, I have made myself "bonk" proof  because I'm not using glucose for my primary fuel. Also, on race day, I can use carbs as a high octane fuel. I will list some reference material that explains the science behind a ketogenic diet. Since switching, I have ran two 100's and they went great; recovery is much easier on a high fat diet!”

He won the Rocky Racoon 100 race on a ketogenic diet, and soon he’ll be running Western States again:

“iRunFar: According to your blog, you’ve been honing your diet in the recent year or so, and you now do a very low-carb regimen. What does this actually mean for WS100 fueling? What will you be eating and drinking during the race? 

“Morton: The low-carb diet is working great for me. Really, the diet is more about eating high fat and being in ketosis. That does away with spikes in energy and reduces the volume of food that has to be physically eaten. Less in means less out and that equals efficiency during races. I will eat whatever looks appetizing during the race, including carbs. That is another benefit; I use carbs like a high-octane fuel during races. I’ll drink what is provided as well but avoid consuming huge amounts of sugar drinks to keep the stomach happy. My crew (wife Julie, daughter Bailey, and Eric and Noni) will have some of my favorite stuff so, when I’m feeling sorry for myself, I can cheer up looking forward to something.”

He’s racing against the current course record-holder Tim Olson, who also eats a low-carb paleo diet.
Obviously Morton has had most of his success on a high-carb, low-fat diet.  What’s interesting is if he’s able to continue his success with a high-fat, low carb diet.  He’s already noted that he recovers more quickly, we’ll see if he can set a few more records.

Interesting times.

Thanks to Sean.

P.S.  On the second-hottest Western States on record, Morton finished third, setting the Master's course record, Olson finished first, just failing to break his previous course record.

"Eight Toxic Foods: A Little Chemical Education."

Great post, as usual.  Puts food additives in perspective.

P.S. Eight Toxic Foods: The Aftermath"

"I spent the weekend, by the way, being called a paid shill for Monsanto, DuPont, and all the other evil monied interests. It made a refreshing change from being called a paid shill for Big Pharma."

Read the whole thing. He's got a great blog...

“The Monetization of Obesity”

Spot-on:

“…In other words, while it is being cast as something being done for the public good, the motivation is more likely to be . . . money: Bariatric surgeons gain by expanding the market for their procedures to patients who previously did not have insurance coverage for this “non-disease”; operating room supply manufacturers will sell more equipment for the dramatically increased number of surgical procedures; obesity drug manufacturers will have the clout to pressure health insurers to cover the drugs for this new disease….

“…Doctors blame us for gluttony, failure to exercise enough, too many snacks, etc., then thoughts of drugs and surgery start to be entertained.

“Treating obesity as a disease allows this condition to be subsumed under the domain of healthcare. After all, “healthcare” is nothing of the kind: It has nothing to do with health. Consistent with much the way healthcare is conducted nowadays, I call the healthcare system “The system to maximize profit from sickness.” And so now it goes with obesity.”

Follow-up to “Cholesterol-Lowering Medicines To Bite The Dust?”

I guess not.  Original post here, in which I quoted:

“By contrast, the ATP IV committee has pledged to hew strictly to the science and to focus on data from randomized clinical trials, says committee chairman Neil Stone, a cardiologist at Northwestern University School of Medicine in Chicago. If so, Krumholz argues, LDL targets will be cast aside because they have never been explicitly tested. Clinical trials have shown repeatedly that statins reduce the risk of heart attack and stroke, but lowering LDL with other medications does not work as well. The benefits of statins may reflect their other effects on the body, including fighting inflammation, another risk factor for heart disease....”

That would have the effect of killing the market for statins, and likely make doctors look a bit foolish. Hence the title of that post.

Today on Twitter I read:

"What a joke: MT @lipoprotein Current ATP IV efforts have been terminated. Evidence review, but no guidelines, will be published."

— Thomas Dayspring (@Drlipid) June 20, 2013

The doctors’ guild has struck back: “NIH says ATP 4, JNC 8 guidance out "in a matter of months" (with a twist)”:

“…News that professional societies like the [American College Cardiology] and [the American Heart Association] will be involved was a surprise to many who have actively been working on the different guidance documents. Dr Roger Blumenthal (Johns Hopkins University, Baltimore, MD), who is a member of the National Program to Reduce Cardiovascular Risk (NPRCR), says the NPRCR has had two face-to-face fly-in meetings with the writing group over the past few years. He only learned of the NHLBI decision yesterday.

“"It's very unclear what the next step is. I think clinicians will be very disappointed by this decision because there is very strong need to synthesize all the information that is out there about risk assessment, cholesterol, high BP, and obesity, and we would have hoped that there would have been a well-laid out plan. I can understand politically if the NHLBI thought there were certain reasons why guidelines shouldn't be under their auspices, but it would have been better if the ACC and AHA would take the mature drafts of all the guidelines that have already been done and give us some kind of time frame."

“It's also unclear whether the AHA and ACC form separate panels for the four major guideline areas and just how the "state-of-the-art" reviews will be linked with recommendations and level of evidence in the guidelines, Blumenthal noted….”

Protecting the medical guild is of the utmost importance, and being forced to back down from cholesterol guidelines would have been humiliating.

Can’t have that.  Science, and patients, be damned…

"What We Can Learn About Running From Barefoot Running"

Prof. Daniel Lieberman at the Massachusetts General Hospital, Boston, MA:



P.S. If you ever have the opportunity to hear Prof. Lieberman speak, take it. I posted this before listening, and I am in the middle of listening to it now. This is a terrific discussion about the evidence for barefoot running, and what the actual benefits may be. The audience is a bunch of doctors, so he's being quite specific and careful in his argument; it's fascinating.

Paleo Soccer Player?

Sounds like it:

"I am often asked how I still stay fit enough to play at the top level in my 40s and it is pretty simple. I changed my diet, I work more in the gym than I used to, and I still do the same training routine that I always have done through my career.

"I don’t eat bread, I don’t eat pasta, I don’t really eat carbohydrates, I eat meat for three meals a day and lots of vegetables so I get my carbs through the veg.

"I snack out on a lot of pistachio nuts, they are very addictive and part of the fun with them is peeling them out of their shell – it slows you down as well.

"All that has helped me and as a result it is a great honour to be the only overseas player to have made 500 Premier League appearances and I have enjoyed every single one of those games."

Via Mark Sisson

Local Barefoot Runners: David Adams

From Norwalk Hour Road Racing Notebook:

BARE FOOTING: New Haven's David Adams, 74, is a rare breed - a runner who actually runs barefoot. He says he started running sans shoes in the 1970s to alleviate knee problems.

"If you run barefoot, you don't have knee problems, " Adams said Saturday after participating in the Southport race. "Your foot plant is more stable."

Adams, a former United Nations employee who retired in 2001 from UNESCO where he was the director of the unit for the International Year for the Culture of Peace, blames shoe companies for the dearth of bare foot runners.

Perhaps the most famous runner to run barefoot was South African Zola Budd.

"I talk to the really star African runners after they run road races here and I say to them would you wear shoes in Africa and they say, 'No', but they're paid to wear shoes. It's big business."

Adams got a few curious looks Saturday as he ran toward the finish line in his bare feet. Running on pavement doesn't hurt his feet.

"To tell you the truth, today it cost me a little time because the streets we ran were very rocky," Adams said. "I don't run quite as fast when it's real rocky."

He claims that running barefoot actually leads to faster times.

"A shoe doubles the weight of your foot," he said. "(Running barefoot) prevents knee problems and hip problems because you run soft. The shoe is not stable. There's a little torque there and the knee has to compensate for it.

"If you think about tissues, if you injure a tendon or a ligament, it scars forever. If you injure muscle, it takes awhile to rebuild. If you injure skin, it just gets tougher. Skin is made to be beaten."

Adams says he is going to keeping running until he keels over.

"Death is always three steps behind me," he said.

Haven’t seen this guy around, and I’ve run in Southport for several races.  I’ll keep an eye out for him!

Thanks to Barefoot Gentile (another local barefoot runner) for this link.