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The personal blog of Peter Attia, M.D.

Why we’re not wired to think scientifically (and what can be done about it)

Why we’re not wired to think scientifically (and what can be done about it)
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Two years ago I was having dinner with a good friend, Rik Ganju. Rik is one of the smartest people I know. And one of the most talented, too—a brilliant engineer, a savant-like jazz musician, a comedic writer, and he makes the best coffee I’ve ever had (I may even share the recipe). As usual I was whining to him about something. This time it was my frustration with what I perceived to be a lack of scientific literacy among people from whom I “expected more.”  Why was it, I asked, that a reporter at a top-flight newspaper couldn’t understand the limitations of a study he was reporting on? Are they trying to deliberately mislead people, or do they really think this study which showed an association between such-and-such, somehow implies X?

Rik just looked at me, kind of smiled, and asked the question in another way. “Peter, give me one good reason why scientific process, rigorous logic, and rational thought should be innate to our species?” I didn’t have an answer. So as I proceeded to eat my curry, Rik expanded on this idea. He offered two theses. One, the human brain is oriented to pleasure ahead of logic and reason; two, the human brain is oriented to imitation ahead of logic and reason. What follows is my attempt to reiterate the ideas we discussed that night, focusing on the second of Rik’s postulates—namely, that our brains are oriented to imitate rather than to reason from first principles or think scientifically.

Two points before jumping in:

  1. I realize I said my next post would be about insulin resistance. I’m about 2,000 words into that post, and I don’t like it. It’s too technical and, frankly, it needs a lot of work, and I don’t have a lot of time. That post, along with Part X of the Straight Dope on Cholesterol, are still on my plate (what I call my “blog parking lot”), but they need more time. At my last counting there are only 168 hours in a week, and I’m somehow finding a way to be busy for all of them. My apologies for the delay.
  2. This post is not meant to be disparaging to those who don’t think scientifically. Rather, it’s meant to explain why. If for no other reason, it’s a way for me to capture an important lesson I need to remember in my own journey of life. I’m positive some will find a way to be offended by this, which is rarely my intention in writing, but nevertheless I think there is something to learn in telling this story.

The evolution of thinking

Two billion years ago, we were just cells acquiring a nucleus. Two million years ago, we left the trees for caves. Two hundred thousand years ago we became modern man. No one can say exactly when language arrived, because its arrival left no artifacts, but the best available science suggests it showed up about 50,000 years ago.

I wanted to plot the major milestones, below, on a graph. But even using a log scale, it’s almost unreadable. The information is easier to see in this table:

Milestones of human evolution

Formal logic arrived with Aristotle 2,500 years ago; the scientific method was pioneered by Francis Bacon 400 years ago. Shortly following the codification of the scientific method—which defined exactly what “good” science meant—the Royal Society of London for Improving Natural Knowledge was formed. So, not only did we know what “good” science was, but we had an organization that expanded the application, including peer review, and existed to continually ask the question, “Is this good science?”

While the Old Testament makes references to the earliest clinical trial—observing what happened to those who did or did not partake of the “King’s meat”—the process was codified further by 1025 AD in The Canon of Medicine, and formalized in the 18th century by James Lind, the Scottish physician who discovered, using randomization between groups, the curative properties of oranges and lemons—vitamin C, actually—in treating sailors with scurvy.

The concept of statistical significance is barely 100 years old, thanks to Ronald Fisher, the British statistician who popularized the use of the p-value and proposed the limits of chance versus significance.

What does this have to do with anything?

Well, consider that for 2 million years we have been evolving—making decisions, surviving, and interacting—but for only the last 2,500 years (0.125% of that time) have we had “access” to formal logic, and for only 400 years (0.02% of that time) have we had “access” to scientific reason and understanding of scientific methodologies.

Whatever a person was doing before modern science—however clever it may have been—it wasn’t actually science. And along the same vein, how many people were practicing logical thinking before logic itself was invented? Perhaps some were doing so prior to Aristotle, but certainly it was rare compared to the time following its codification.

Options for problem solving are limited to the tools available. The arrival of logic was a major tool. So, too, was the arrival of the scientific method, clinical trials, and statistical analyses. Yet for the first 99.98% of our existence on this planet as humans—literally—we had to rely on other options—other tools, if you will—for solving problems and making decisions.

So what were they?

If it’s 3,000 BC and your tribe mate Ugg never gets sick, all you can do to try to not get sick is hang out where he hangs out, wear similar colors, drink from the same well—replicate his every move. You are not going to figure out anything from first principles because that isn’t an option, any more than traveling by jet across the Pacific Ocean was an option. Nothing is an option until it has been invented.

So we’ve had millions of years to evolve and refine the practice of:

Step 1: Identify a positive trait (e.g., access to food, access to mates),

Step 2: Mimic the behaviors of those possessing the trait(s),

Step 3: Repeat.

Yet, we’ve only had a minute fraction of that time to learn how to apply formal logic and scientific reason to our decision making and problem solving. In other words, evolution has hardwired us to be followers, copycats if you will, so we must go very far out of our way to unlearn those inborn (and highly refined) instincts to think logically and scientifically.

Recently, neuroscientists (thanks to the advent of functional MRI, or fMRI) have been asking questions about the impact of independent thinking (something I think we would all agree is “healthy”) on brain activity. I think this body of research is still in its infancy, but the results are suggestive, if not somewhat provocative.

To quote the authors of this work, “if social conformity resulted from conscious decision-making, this would be associated with functional changes in prefrontal cortex, whereas if social conformity was more perceptually based, then activity changes would be seen in occipital and parietal regions.” Their study suggested that non-conformity produced an associated “pain of independence.” In the study subjects the amygdala became most active in times of non-conformity, suggesting that non-conformity—doing exactly what we didn’t evolve to do—produced emotional distress. From an evolutionary perspective, of course, this makes sense. I don’t know enough neuroscience to agree with their suggestion that this phenomenon be titled the “pain of independence,” but the “emotional discomfort” being different—i.e., not following or conforming—seems to be evolutionarily embedded in our brains.

Good solid thinking is really hard to do as you no doubt realize. How much easier is it to economize on all this and just “copy & paste” what seemingly successful people are doing? Furthermore, we may be wired to experience emotional distress when we don’t copy our neighbor! And while there may have been only 2 or 3 Ugg’s in our tribe 5,000 years ago, as our societies evolved, so too did the number of potential Ugg’s (those worth mimicking). This would be great (more potential good examples to mirror), if we were naturally good at thinking logically and scientifically, but we’ve already established that’s not the case. Amplifying this problem even further, the explosion of mass media has made it virtually, if not entirely, impossible to identify those truly worth mimicking versus those who are charlatans, or simply lucky.

So we have two problems:

  1. We are not genetically equipped to think logically or scientifically; such thinking is a very recent tool of our species that must be learned and, with great effort, “overwritten.” Furthermore, it’s likely that we are programmed to identify and replicate the behavior of others, rather than think independently, and independent thought may actually cause emotional distress.
  2. The signal (truly valuable behaviors worth mimicking)-to-noise (all unworthy behaviors) ratio is so low—virtually zero—today that the folks who have not been able to “overwrite” their genetic tendency for problem solving are doomed to confusion and likely poor decision making.

As I alluded to at the outset of this post, I find myself getting frustrated, often, at the lack of scientific literacy and independent, critical thought in the media and in the public arena more broadly (e.g., politics). But, is this any different than being upset that Monarch butterflies are black and orange rather than yellow and red? Marcus Aurelius reminds us that you must not be surprised by buffoonery from buffoons, “You might as well resent a fig tree for secreting juice.”

While I’m not at all suggesting people unable to think scientifically or logically are buffoons, I am suggesting that expecting this kind of thinking as the default behavior from people is tantamount to expecting rhinoceroses not to charge or dogs not to bark—sure it can be taught with great patience and pain, but it won’t be easy in short time.

(By the way, I am not suggesting at all that anyone who disagrees with my views or my interpretations of data frustrates me. I have countless interactions with folks whom I respect greatly but who interpret data differently from me. This is not the point I am making, and these are not the experiences that frustrate me. Healthy debate is a wonderful contributor to scientific advancement. Blogging probably isn’t. My point is that critical thought, logical analysis, and an understanding of the scientific method are completely foreign to us, and if we want to possess these skills, it requires deliberate action and time.)

How does this fit into nutrition?

I think I know the answer, but I’m not sure how to explain it simply. Today, most lean people are what I would call “genetically immune” with respect to obesity, or largely so. Sure, many of us are not—I certainly know my “natural” state, which is anything but lean—but those of us who have found a path to being lean and healthy despite our natural tendency are actually the exception. After all, less than 10 percent of people who lose more than 10 percent of their weight will maintain this weight loss for more than a year.

If you consider someone like my wife, who can eat whatever she wants, copying her doesn’t do much good. And I would argue that most habitually lean folks today—basically those who have demonstrated they have the genotype to produce a lean phenotype despite the default food environment we live in—can sort of do whatever they want. (Can you just hear Napoleon Dynamite saying, “Lucky…”)

Now, I’m making this up, because I have no way of knowing, but I’m assuming that of the “lean” folks, 75% are pretty much going to be lean no matter what they do/eat (i.e., my wife). The remaining 25% are folks like me (and maybe you) who have figured out what works for them, but it’s not default eating. Think of the signal-to-noise ratio in this system! It’s horrible.

The 75% are doing anything and everything, right? They can (certainly my wife can) eat junk food all day and still be lean. The 25%, conversely, can’t do that, but they have their own “special sauce”—for example, I can’t really eat carbohydrates that aren’t fruits or vegetables, while another guy in the 25% has a completely different diet. Some of these folks might be doing great on a vegan diet, while others do masterfully on the Atkins diet. And everything in between.

How does the overweight person copy that? Where do they even begin? Well, assume they decide to copy my wife. That’s probably not going to end up well. Next they decide to copy me. Well, that may work, but it may not. Even if it does, they are just as likely to see another person in the 25% group doing something completely orthogonal to what I’m doing. Because the pace of meaningful fat loss is long and slow (for a quick refresher on the pace, give this post a quick skim), it’s very easy to “jump ship” from one strategy (i.e., imitated behavior) to another. And so the vicious cycle continues.

What can we do about?

I’ve suggested that we aren’t wired to be good critical thinkers, and that this poses problems when it comes to our modern lives (of which nutrition is but one example). The just-follow-your-peers-or-the-media-or-whatever-seems-to-work approach simply isn’t good enough anymore.

But is there a way to overcome this?

I don’t have a “global” (i.e., how to fix the world) solution for this problem, but the “local” (i.e., individual) solution is quite simple provided one feature is in place: a desire to learn. I consider myself scientifically literate. Sure, I’ll never be one-tenth a Richard Feynman, but I “get it” when it comes to understanding the scientific method, logic, and reason. Why? I certainly wasn’t born this way. Nor did medical school do a particularly great job of teaching it. I was, however, very lucky to be mentored by a brilliant scientist, Steve Rosenberg, both in medical school and during my post-doc. Whatever I have learned about thinking scientifically I learned from him. (And that which I don’t yet know is because I wasn’t patient enough to learn.) In other words, I was mentored in this way of thinking just as every other person I know who thinks this way was also mentored. One of my favorite questions when I’m talking with (good) scientists is to ask them who mentored them in their evolution of critical thinking.

Two relevant asides:

  1. Take a few minutes to watch Feynman at his finest in this video—the entire video is remarkable, especially the point about “proof,” but the first minute is priceless.
  2. Dr. Rosenberg has been featured recently and very broadly in the news for a breakthrough—here’s a clip.

Back to my point: the good news is that while we aren’t born with this ability, we can learn it.

You may ask, is learning to think critically any different than learning to play an instrument? Learning a new language? Learning a physical skill like tennis? I don’t think so. Sure, some folks may be predisposed to be better than others, even with equal training, but virtually anyone can get “good enough” at a skill if they want to put the effort in. The reason I can’t play golf is because I don’t want to, not because I lack some ability to learn it.

If you’re reading this, and you’re saying to yourself that you want to increase your mastery of critical thinking, I promise you this much—you can do it if you’re willing to do the following:

  1. Start reading (see below).
  2. Whenever confronted with a piece of media claiming to report on a scientific finding, read both the actual study and the media, in that order. See if you can spot the mistakes in reporting.
  3. Find other like-minded folks to discuss scientific studies. I’m sure you’re rolling your eyes at the idea of a “journal club,” but it doesn’t need to be that formal at all (though years of formal journal club did teach me a lot). You just need a good group of peers who share your appetite for sharpening their critical thinking skills.

I look forward to seeing the comments on this post, as I suspect many of you will have excellent suggestions for reading materials for those of us who want to get better in our critical thinking and reasoning. I’ll start the list with a few of my favorites, in no particular order:

  1. Anything by Richard Feynman (In college and med school, I would not date a girl unless she agreed to read “Surely You’re Joking, Mr. Feynman”)
  2. “The Transformed Cell,” by Steve Rosenberg
  3. Anything by Karl Popper
  4. Anything by Frederic Bastiat
  5. “Bad Science,” by Gary Taubes
  6. “The Structure of Scientific Revolutions,” by Thomas Kuhn
  7. “Risk, Chance, and Causation,” by Michael Bracken
  8. “Mistakes Were Made (but not by me),” by Carol Tavris and Elliot Aronson
  9. “Thinking, Fast and Slow,” by Daniel Kahneman
  10. This paper, “The Method of Multiple Working Hypotheses,” by T.C. Chamberlin

I’m looking forward to other recommendations.

276


About the Author:

Peter Attia, M.D., is a physician in private practice in NYC and CA. His practice focuses on longevity and healthspan. His clinical interests are nutrition, lipidology, endocrinology, and a few other cool things.

Discussion

  1. Nicky  May 21, 2014

    Very interesting! Thanks for the list and links within the article – a lot of reading to do! And please post the coffee recipe 🙂

    (reply)
    • Peter Attia  May 21, 2014

      Here is the coffee recipe, courtesy Rik. I make this often and the typical response is, “Why are you not making this for a living?”

      • Look for Vietnamese cinnamon, also known as Saigon cinnamon; you need two big dashes if that.
      • You need real vanilla (be careful there is no added sugar). Best is dissolved in ethanol; if that doesn’t work for you get the dried stick and scrape the pods.
      • Then find a spice store and get chicory. Amazon also sells.
      • You’ll want to replace coffee beans with ~10% chicory on a dry weight basis.
      • Then cut you coffee with Trader Joes organic Bolivian. But do use at least 50% of your favorite coffee by dry weight. 50-40-10 (50% ether, 40% TJ Bolivian, 10% other ingredients [cinnamon, vanilla, amaretto for an evening coffee]) would be a good mix to start.
      • Let it sit in a French press for 6 min then drink straight or with cream, but very little–max is 1 tablespoon of cream.
      • Best base coffee is “Ether” from Philz

    • Nicky Beach  May 21, 2014

      Thanks Peter

    • Jean Buckner  May 21, 2014

      Does the list of resources contain a good practical book or paper on interpreting stats? Misinturpreting stats is a huge part of the problem. If not; might you recommend one? Grad school is a faint blur. Also, you can order Cafe Du Mond Coffee and Chicory blend online from the New Orleands Establishment by the same name. It works well in a Vietnamese coffee maker.

    • Peter Attia  May 21, 2014

      I don’t know which is best for the non-math person. I was a math major, so stats was part of my life, but I bet there is a great book out there for non-math folks, especially one that focuses on life sciences. You may find the brief summary I wrote here (pages 149 to 153) to be a quick start: http://www.med.unc.edu/surgery/education/files/articles/Hopkins%20Review.pdf

    • Robin McFee  May 25, 2014

      I will supplement with a suggestion that you look into home roasting for your beans. The quality is unbelievably good.

      I purchased a roaster for ~$200 a year ago and I haven’t drank coffee more than two days “stale” since. Most cities have a few coffee shops that sell green coffee beans. Greens are typically less than half the price per weight of roasted beans. Even with the 30% weight lost during roasting you’re still paying $7-$10 per pound for the end product. Roast in small batches so it’s always fresh. Roasting takes 10-14 minutes.

    • Peter Attia  May 26, 2014

      I’ve been noodling this for a while, also on the rec of friend. I may need to try it. One more thing to obsess over…great.

    • John  June 1, 2014

      A cheap way to try roasting coffee at home is with a hot air popcorn popper. Buy some green coffee online and throw it in there and roast to desired level. It is interesting because it does pop (first and second crack) which helps you figure out how roasted it is.

  2. Bob Kaplan  May 21, 2014

    A few that leap to mind:

    “The Art of Scientific Investigation,” by WIB Beveridge.

    “Introduction to the Study of Expirmental Medicine,” by Claude Bernard.

    “Do We Really Know What Makes Us Healthy?” by Gary Taubes in the New York Times Sunday Magazine.

    (reply)
    • Peter Attia  May 21, 2014

      Nice additions, Bob.

    • Jeff  May 21, 2014

      My guess for your top ten list would be “Mistakes Were Made (But Not by Me).” Great article. Thanks!

  3. Alexandra M  May 21, 2014

    Excellent piece! I’ve been thinking about this a lot, especially the part about how there’s nothing ABnormal about people who have not learned to think critically. I run into a lot of blather (from all sides of the nutrition wars) wondering how people can be so gullible, as though being a free-thinking iconoclast was the natural state. It isn’t.

    I’ve also run across a lot of this:

    “Smart people believe weird things because they are skilled at defending beliefs they arrived at for non-smart reasons.” ? Michael Shermer

    (reply)
  4. Bob Kaplan  May 21, 2014

    A few more:

    “Strong Inference,” an article by JR Platt.

    “Mistakes Were Made (But Not by Me),” by Elliot Aronson and Carol Tavris.

    “Fooled by Randomness,” “The Black Swan,” and “Antifragility,” by Nassim Nicholas Taleb.

    (reply)
    • Peter Attia  May 21, 2014

      Ditto last comment. One of these books is on my all-time “Top 10” list–can you guess which?

  5. Gerard Pinzone (@GerardPinzone)  May 21, 2014

    Another thing we need to realize about humans and science is that this idea that scientists do science by following the scientific method is a myth. Gary Taubes often quotes John Ziman when he said that in physics, textbook science may be about 90 percent right, whereas the primary literature is probably 90 percent wrong. I researched and wrote about how science gets done in the real world. http://gpinzone.blogspot.com/2014/05/the-myth-of-scientific-method.html

    (reply)
    • Peter Attia  May 21, 2014

      I agree that a lot of published science is incorrect–how much is up for debate–but I don’t think this fact implies the scientific method is broken. Rather, the current incentives for science are. Getting grants, peer review, publication, etc. is more like the problem, not the ideas conceived by Bacon and others.

  6. Anu  May 21, 2014

    For more on why it’s difficult to think in a scientific manner and why humans (even scientists) are terrible intuitive statisticians, I highly recommend Daniel Kahneman’s amazing book, Thinking, Fast and Slow. The fast and slow types of thinking he refers to are the intuitive leaps we tend to make vs. the slower more measured thinking we do when deliberately conducting an experiment (which we are generally loathe to do, being lazy).

    (reply)
    • Peter Attia  May 21, 2014

      I spent a day with Danny once. Wonderful experience. Brilliant guy.

    • Colin  May 21, 2014

      Beat me to it with “Thinking Fast and Slow”, but I’ll double the recommendation for you. I will admit to being a little impatient while reading that book at Kahneman’s consistent bias toward System 2 — both types of thinking are necessary; catching yourself using one of the two where the other would be more appropriate is a very real, and useful, skill of self-reflection. It’s also damned hard to do!

      Another comment about what passes for science much of the time — in Chapter 16 of “Brave New World” Aldous Huxley gives Mustapha Mond an almost throwaway line that is a real gem:

      “I was a pretty good physicist in my time. Too good–good enough to realize that all our science is just a cookery book, with an orthodox theory of cooking that nobody’s allowed to question, and a list of recipes that mustn’t be added to except by special permission from the head cook. I’m the head cook now. But I was an inquisitive young scullion once. I started doing a bit of cooking on my own. Unorthodox cooking, illicit cooking. A bit of real science, in fact.” He was silent.”

    • Peter Attia  May 21, 2014

      Colin–nice work! How did Huxley (Darwin’s “bulldog”) escape my list?

    • greensleeves  May 21, 2014

      I second Kahneman’s Thinking Fast & Slow. You can’t “educate” yourself out of your innate & predictable irrationalities, because System 1 (limbic system) is indeed more resilient and active than System 2 (lateral prefrontal cortex and posterior parietal cortex ), which is quite lazy and tires quickly. Everyone will, when faced with a tough System 2 problem, leap to what Kahneman calls “substitution” – that is, unconsciously switching the problem to something System 1 can handle – and all you can do is try to back yourself up to engage System 2.

      Except in Kahneman’s experiments even trained experts, statisticians, & logicians often failed to notice when they had “substituted.” It’s a very difficult problem, to go back and force yourself to engage System 2. You need to devise a really robust process to help you remember that you are likely substituting and then to go back to the decision and try to circumvent that.

      The truth of Kahneman’s experiments have been demonstrated experimentally many times, and fMRI has shown the situation in action! A very nice such demo with lovely pix can be found in the classic paper, “Separate Neural Systems Value Immediate and Delayed Monetary Rewards,” by McClure et al, in Science Oct. 15 2004, pp 503-7.

    • Brian Reinthaler  May 22, 2014

      Peter, Colin refers to a different Huxley. ‘Darwin’s Bulldog’ was Sir Thomas Huxley, not Aldous of “BNW” fame. Or perhaps I was misreading a bit of humor on your part?

    • Peter Attia  May 22, 2014

      No attempt at humor, alas, just my careless quick reply.

    • Henry  June 28, 2014

      Hi Anu,

      I highly second Thinking, Fast and Slow.

      By the way, are you from the east bay, CA?

      Henry
      Oakland

  7. Eric  May 21, 2014

    Hi Dr. Attia,

    Don’t know if anyone else pointed out this article in New York Times. Good stuff by Dr. Ludwig.

    http://www.nytimes.com/2014/05/18/opinion/sunday/always-hungry-heres-why.html?emc=eta1&_r=0

    Best,
    -Eric

    (reply)
    • Peter Attia  May 21, 2014

      Yes. Mark Friedman co-authored. He’s NuSI’s VP of Research (and Ludwig is a NuSI grantee).

  8. FrancisT  May 21, 2014

    https://dominiccummings.wordpress.com/the-odyssean-project-2/ seems somewhat relevant

    (reply)
  9. Larry Whitted  May 21, 2014

    On your list of major milestones you did not include the development of agriculture 10-12,000 years ago. You may want to reflect on why you did not include that.

    (reply)
    • Peter Attia  May 21, 2014

      I consider that a technical achievement more than a “thinking” achievement. Also, the real breakthrough in agriculture was 1940s to 1950s for reasons we can discuss another time.

  10. larry  May 21, 2014

    Peter when you speak of the small percentage of naturally lean people who can eat seemingly anything, are you aware of the growing problem referred to as TOFI ( thin outside fat inside) ? Dr Lustig has some data on this and the percentage ( which I don’t have in front of me) is really shocking! He says there isn’t currently a good understanding of how this happens that many folks display little subcutaneous fat accumulation but have very significant and unhealthy visceral fat nonetheless. As a fitness and nutrition trainer I don’t rely solely on visual or even caliper measurements any longer. I advise “clean” relatively low carb, low sugar eating for everyone over 40 ( and preferably even for younger)

    (reply)
    • Peter Attia  May 21, 2014

      Yes, and I was going to make this caveat, but figured it would only complicate an already cumbersome point! But I’m glad you brought it up, since it’s important for folks to know.

    • Ash Simmonds  May 22, 2014

      Saw this post a few days ago:

      “A lot of people are convinced that if they are naturally slim they are naturally healthy, unfortunately their fat is inside, in and around their organs.”

      Was drunk and in the mood for an online rant response:

      “More than that, insulin resistance affects other organs – especially the brain – but you won’t really notice it for decades.

      People who get fat are lucky, they have a vanity and outward facing health reason to tackle poor diet.

      Thin folk who eat junk tend to find their moods terrible, energy peak and trough, anger and depression, then as 40-50s approach rapidly declining health that requires medication and treatment that takes up huge amounts of time and financial resources.

      But hey, at least they’re thin.”

  11. Dan  May 21, 2014

    Bad Science is by the great Ben Goldacre; Taubes wrote Good Calories, Bad Calories. Feynman has written too much of great importance to rely recommend just one item!

    (reply)
    • Peter Attia  May 21, 2014

      Check again, Dan. The “Bad Science” I’m referring to was written by Taubes.

    • Jen  May 23, 2014

      Are you thinking of Bad Pharma by Goldacre? Great book!

    • Juha  May 23, 2014

      Ben Goldacre has written a book called Bad Pharma and had a blog called Bad Science. Taubes has written a book called “Bad Science: The Short Life and Weird Times of Cold Fusion”.

    • PJinLA  May 27, 2014

      Just to clear up the confusion, Gary Taubes and Ben Goldacre both wrote books called Bad Science (different sub-titles), and both are very much worth reading. Goldacre followed his book with Bad Pharma and he has a blog called Bad Science.

  12. Vicente  May 21, 2014

    Hi Peter,
    the problem I see is that, even if we wanted, very often we (ordinary people) lack the background to understand the implications of what we read. I don’t see myself as a moron (I have an engineer Ph.D) but I can’t have critical thinking if I don’t get what I read. Therefore, in nutrition, for me the most important readings are critical analysis (books, blogs, etc.) from people I trust.

    So my point is that in this field, at least for me, trust is an important factor (not quite scientific, I know, more like a hunch) and critical thinking is severely limited without experts that pre-digests information. And then because of those experts.

    (reply)
    • Peter Attia  May 21, 2014

      I don’t know Vicente, a PhD in EE isn’t very “ordinary” in my book! I think you can figure out any of this. But more importantly, for those without PhDs, it gets to the community thing. You read a paper. Your buddy reads a paper (not the blog to start, the actual paper). Start with the methods section. Then look at the figures. Then go back and read from end to end. After a while you’ll see there are a few things that pique your interest with respect to the rigor of the experiment.
      Once you do this, I think you’ll be less trusting of everyone (me included!), when you read their interpretation.

  13. Jack  May 21, 2014

    Great insights, Peter!

    However, even within the scientific community, where the scientific method and critical thinking are fundamental to its endeavors, there is still this general reluctance to embrace the findings that contradict established paradigms, even if it’s pretty conclusive. Furthermore, many subjects of research are excluded from the mainstream scientific community simply because it doesn’t fit with the accepted worldviews, and is dismissed as pseudoscience not because of the methodology, but because of its subject of study.

    My question is, does practicing critical thinking and the scientific method really allow us to break free from our conformist nature, or could there be other factors at play?

    PS, not about nutrition, but pretty convincing research that is an example of what I’m talking about: (https://www.youtube.com/watch?v=_u7RqklxNnA).

    (reply)
    • Peter Attia  May 21, 2014

      Agree with your concerns Jack. I think the problem you describe is really the “herd mentality” issue which I very loosely touch on with that fMRI study–the so-called “pain of independent thought.”

  14. Xavi Vives  May 21, 2014

    Great article, thanks.

    I second Daniel Kahneman’s book “Thinking, Fast and Slow” : https://www.goodreads.com/book/show/11468377-thinking-fast-and-slow

    I highly recomend Rolf Dobelli’s book “The Art of Thinking Clearly”, which is basically a guide for critical thinking and how to avoid cognitive biases:
    https://www.goodreads.com/book/show/16248196-the-art-of-thinking-clearly?from_search=true

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  15. Al  May 21, 2014

    I somehow get the impression that medical sciences are riddled with people who think that their world view is more important than evidence. Nutritionists seem to enjoy telling people what to do and so many times I as an educated layman cannot believe what some of these people are trying to tell me on TV shows for example (law of thermodynamics, physical activity, lipid hypothesis etc.).
    I think we should all try to think more like children, with a will to honest inquiry and a sense of curiosity (I think you have this).
    We should be concerned not about what the truth is, but that it is the truth.

    I recommend this article in The Atlantic about bad medical science:
    http://www.theatlantic.com/magazine/archive/2010/11/lies-damned-lies-and-medical-science/308269/

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    • Peter Attia  May 21, 2014

      Good points, Al. I’d add one more quality we should aspire to (which is really hard sometimes): Saying “I don’t know” when we don’t.

  16. Roy Barzilai  May 21, 2014

    http://www.amazon.com/dp/B00IX279SI

    The Objective Bible: WESTERN CIVILIZATION’S STRUGGLE for PHILOSOPHIC LIBERATION from a Herd-Mentality and Pagan Mysticism

    The Objective Bible investigates the entire sweep of Western philosophy to display the pattern of mystical dualism that has lured man throughout the ages into a trance of group-think. This research examines the evolution of Western civilization by integrating different aspects of the humanities: social psychology, philosophy, and history. The result is a comprehensive illumination of the disparity between the unconscious, herding instinct that regulates social mood and the individual’s cognitive mind. Unveiling the role of these forces in the cultural evolution of the West sheds important light on the worst atrocities of the twentieth-century.
    Even more significantly, comprehending the operative forces of the communal dynamics of destruction equips readers to critically assess what is currently besetting societies in order to not repeat history.
    In ancient polytheistic religions, numerous chaotic, supernatural forces were believed to manipulate the otherwise stagnant physical world. Defying this primeval mysticism, the monotheistic revolution of Abraham launched the radical cosmology of a natural, orderly, and lawful universe guided by a benevolent Creator. The belief in one, transcendent God affirms the fundamental uniformity of the natural laws that govern the universe. Through these laws, the Creator directs the evolution and progress of creation, generating meaning and purpose—ultimately through the emergence of the ethical man. God created man in his image and likeness, so that his conscious mind would bring a moral meaning to nature.
    The liberty and objectivity inherent in monotheistic ethics is under assault—as much now as it has been throughout the ages. In Western philosophy, this biblical worldview has been gradually neglected, denigrated, and even abandoned since the Enlightenment. The results of this are evident in countless universities, where postmodernists today systematically attack the rational and ethical foundations of the West with moral relativism and social subjectivism, fueling a herd mentality and the irrational worship of outright nihilism.
    By shattering the idols of pagan mysticism, the Bible’s objective ethics emancipate man from tribal collectivism and empower individuals to pursue liberty and prosperity.

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  17. Isaac  May 21, 2014

    Dear Peter,

    Interesting post… so many things I would like to add but I am at another city, 3 hours away to give a seminar -on mathematical methods to estimate reaction rates on metabolic networks and slides are not finished just yet- So let me send you the following link:

    http://www.motherjones.com/politics/2014/04/inquiring-minds-john-hibbing-physiology-ideology

    Notice also the section “IF YOU LIKED THIS, YOU MIGHT ALSO LIKE…” with other interesting links and book recommendations.

    By the way there is another book called “Bad science” by Ben Goldacre that I would also recommend. On the same vein, and to understand why we get poor media coverage -generally- you have the book of “flat earth news” by Nick Davies.

    Take care,

    I.

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    • Peter Attia  May 21, 2014

      Thanks so much, Isaac. Look forward to checking out.

  18. Sharon Villines  May 21, 2014

    A great impediment to thinking more scientifically and being more critical of research studies is the vocabulary. To someone who has many other interests and occupations, learning all those technical terms is onerous. Anyone who didn’t have a good scientific education in school and doesn’t use this vocabulary in daily life, can’t comprehend the material much less read critically. I read the findings of reports on brain studies, diabetes research, and social issues, but it’s hard. The statistics look like computer programming language. I’m largely dependent on second sources and they don’t always interpret the data correctly. When I click through to the original study to read more details, I’m often lost in gibberish.

    The legal profession is gradually learning to write in Plain English and the sciences need to do the same. I can’t expect everyone to understand how to think critically as a writer or an artist. Why should scientists expect everyone to be able to think critically like a scientist?

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    • Vicente  May 22, 2014

      The first step should be that scientifics should act as scientifics. Assuming that they do is a mistake. Have you read Denise Minger’s reviews of the China Study book? (It is a must)

      I agree with your point about “vocabulary”: may be not-MDs can understand the scientific method but when articles include words like hormone, thyroid, oxidation, hemoglobin, ferritin, etc. things get complicated. Statistics are also out of reach for many.

  19. James Roman  May 21, 2014

    Nice article (as always). I see Taleb already made the list. His Incerto series (FBR, TBS, AF) is a must. Also, be sure to check out his technical companion, Silent Risk, if you can stomach the math… http://www.fooledbyrandomness.com/FatTails.html

    One other recommendation would be the below essay by David Bentley Hart. Dr. Hart is a philosopher & theologian of all things but he hits the nail on the head. “…only when a method is conscious of what it cannot explain can it maintain a clear distinction between the knowledge it secures and the ideology it obeys.”
    http://www.firstthings.com/web-exclusives/2011/09/lupinity-felinity-and-the-limits-of-method

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  20. Sharon Villines  May 21, 2014

    On the development of agriculture not being a major milestone in thinking. The idea of staying in one place and creating food instead of foraging when no other animal was doing this, I would consider as important as the development of the printing press, which was a technical invention. It may have led to a leap in literacy and knowledge, but so did agriculture. It produced towns and cities. Concentrated intelligence and specialization. None of this would be possible in a foraging or nomadic culture.

    The next great leap may be in developing more collaborative societies and governments. And less war and competition. Greater transparency. Awareness that society is composed of individuals that must be regarded as equivalent in order to build a strong and nourishing society developed with scientific thinking.

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  21. Anna  May 21, 2014

    Ah, this is such an excellent post, relevant to so much more than just nutrition.

    Obviously this quote comes to mind: “Science is a way of thinking much more than it is a body of knowledge.” -Carl Sagan.

    All this reminds me of an online course I recently took, called Food for Thought. It’s taught by three McGill profs and is offered through edX (http://www.mooc-list.com/course/chem181x-food-thought-edx). It covers the basics of nutrition, spanning from micronutrients, to macronutrients, food additives, agriculture, weight control and everything in between. It’s very comprehensive but presents the information in a way that’s accessible to the general learned public. One of the things I really appreciated was learning about scientific publications- their history, how they work and how to interpret them. For every study that says “white”, there is another equally reputable saying “black”. One must also be aware of some important factors that put the findings in context, notably dosage and exposure. That is, chemical “A” may be dangerous at high doses when administered to rats, but do humans have nearly the same amount of exposure, and if they do, will it have an affect on them? (After all, humans are not rats.)

    So, lots of great stuff in this course. Perhaps there are some questionable assertions in some parts (mostly regarding agricultural methods), but at least the course teaches you to think critically and so not to take anything at face value.

    Once again, great job on this post. Thank you and keep it up! I look forward to reading more from you.

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    • Peter Attia  May 21, 2014

      Great quote by Sagan! Thanks for sharing. I think it addresses concerns put forth by others.

  22. Yossi Mandel  May 21, 2014

    Think of it from another perspective: We are all hard-wired to imitate. When we are offered mentors to imitate who are critical thinkers, we become critical thinkers. Most people are not offered such mentors, not at home, not in school, and not in college. When elementary school barely teaches science (in schools of poor children science is often cut in favor of the three ‘r’s) and what it does teach is only that which is already agreed to be absolute, then children are not exposed to the give and take of science exploration, that a large portion of hypotheses turn out to be imprecise or false. The public’s view of science is that created in school, that science knows everything absolutely. Then the press etc. present the vagaries of real science, and the public just shrugs shoulders and gives up or takes sides.

    Another example: If you would have also been offered mentors who taught a mystical approach to life, you might have imitated them and thought mystically in addition to scientifically. Steve Jobs imitated rebels and critical thinkers and created his brilliant products and designs, and he imitated quackery health presenters and died young of delayed treatment of his cancer. Not that combining disciplines has to lead to this.

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    • Peter Attia  May 21, 2014

      Yup, certainly puts into perspective the role of luck. Feynman would be the first to acknowledge the role his father played in developing curiosity in him.

    • Yossi Mandel  May 21, 2014

      And Neil DeGrasse Tyson’s mother just spoke about the role she played in raising him: https://www.wnyc.org/radio/#/ondemand/369021

  23. Nicole  May 21, 2014

    For not being a neuroscientist, you do a great job of consolidating a lot of key points here! I especially like your focus on learning and practice as a way of overcoming our more basic cognitive tendencies (like imitation). I have no evidence of this, but I suspect that our current culture exacerbates the problem of science literacy by training our brains in the exact opposite way we’d want them trained if we were going to focus on critical thinking. This starts early on in schools, which now focus on (and reward) teaching kids to excel on standardized tests rather than thinking critically. It continues well into adulthood given so many aspects of our modern life focus on relatively immediate rather than long-term rewards (video games, TV, email, finding information at any time of day online, etc.). Our opportunities for practicing critical thinking skills (weighing the benefits of short vs. long term rewards, seeing both sides of an issue, anticipating outcomes, etc.) are becoming few and far between, unless we are the lucky few who are born with an abundance of curiosity (and/or have our curiosity encouraged from an early age). I also suspect our growing dependence on sugar has a role in this process by weakening our prefrontal cortex and its ability to regulate our more basic reward system (in a similar way that alcohol and drug addicts’ reward systems take over their ability to think critically). And that’s not even taking into account the damage high levels of dietary sugar likely does to the brain in general! I’m more than a little concerned we won’t see many improvements in get in teaching more people to think scientifically without some major policy changes in education, health, and nutrition.

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  24. Juha  May 21, 2014

    50000 Development of language

    2500 arrival of ancient philosophy and formal logic

    You forgot *writing*! People could much more easily transform information from generation to generation. Maybe 5500 or so years ago in Mesopotamia and Egypt. Surely it helped those Greek philosophers in the end, and helped in this boom of culture, etc. 🙂

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    • Peter Attia  May 21, 2014

      Fair point. Doesn’t change my thesis, though.

  25. Tim C  May 21, 2014

    As a computer programmer, I’ve always felt that logic is the solution to any problem. But as I get older, I realize that solving the problem of how to get people thinking for themselves is much more difficult than it seems at face value. Half the time, people don’t understand the difference between good and bad data, and the other half of the time, people are contrarian for the sake of contrarianism. It hits on a quote you mentioned in another post by Bastiat:

    “We must admit that our opponents in this argument have a marked advantage over us. They need only a few words to set forth a half-truth; whereas, in order to show that it is a half-truth, we have to resort to long and arid dissertations”

    The trouble is that most topics are so enormously complicated, that people might extract a small component of it, ignore crucial details, and make faulty conclusions (ie Butter has fat in it, body fat is bad, therefore don’t eat butter). The more complicated components, the more likely people are to build faulty logic. It’s hard to understand why hormones have an impact on fat storage, just like it’s hard to understand why measles immunization is not going to stimulate inflammation in your gut and give you autism.

    Simultaneously, any topic that takes more than 45 seconds to explain is ignored by mainstream media, which amplifies public ignorance about most topics.

    Also, in order to be open minded about anything, one has to navigate through the world with a presupposition they might be wrong. As it turns out, people are not particularly good at doing this, especially when new information is coming from a person who they do not know or respect. Even if a person gets good information, it’s likely to fall on the floor.

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    • Peter Attia  May 21, 2014

      All very depressing, but likely correct.

  26. Michel  May 21, 2014

    We all have the answer within us….. Historically we did not have a TV, radio or light after dark. I believe that many people turned to meditation and intuition to gain the knowledge of proper eating. For my healing jerney I used intuition and questioned all the food and the science and each time I got the correct answer. A clear yes or no to every study and every morsel of food to enter my body.

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  27. Birgit  May 21, 2014

    I’m very excited about this blog. I got a reading list for at least this summer. 🙂
    As a non-scientist I only have the little bit to offer I learned in my college philosphy classes. The biggest gem to me: Plato’s cave story. If you don’t see the truth you can’t reach for it.
    In the meantime I’m eagerly waiting on the blog post on insulin- resistance. Going low-carb (to the point of measuring blood sugar after every food) has helped with insulin-resistance of my muscles (I’m increasing muscle mass and losing body fat), but seemingly not insulin-resistance of the liver, which still dumps too much glucose into my blood in the morning when cortisol goes up. Will I always have to exercise hard when this happens or is there hope that my liver will get more insulin-sensitive?
    Thanks for all your wonderful blogs that help me get through the science I missed in college.
    Birgit

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    • Peter Attia  May 21, 2014

      I’m working on it…

    • Tim C  May 21, 2014

      Birgit,

      Have you considered the effect of gluconeogenesis on your blood glucose level as you sleep? I think it’s a fairly common phenomenon among humans that blood glucose is high in the morning.

    • greensleeves  May 22, 2014

      Birgit,

      “Dawn phenomenon” is often caused by eating too much protein in the evening. Try reducing your dinner protein portion and eating more protein at lunch instead. 😉 This has worked for many women.

  28. Vic  May 21, 2014

    I have a couple of thoughts on this interesting post:

    1. I believe science has been around a lot longer than 400 years or so. If you take into consideration the practice of herbs and other natural remedies you would find that shamans/medicine men, etc. who used these remedies did so based on predictability, repeatable results and standard dosages. Isn’t this science?

    2. In the late 1960s Candace Pert, PhD, presented the idea that the “mind” isn’t located only in the head/brain, but rather throughout the body. Over the decades this has led to some fascinating leaps in scientific (not the mainstream) thinking. People like her as well as many others (Robbie Richardson, PhD, Jon Kabat-Zinn, PhD, Carl Simington, MD, et al) have discovered that the this interplay between mind and the physical self is closer to the Eastern paradigm than the Western one that is modeled on the Cartesian philosophy. Thus, we see the interplay between emotions and physical health (visa vis neurotransmitters) as well as between mental states and emotions. For example, certain ways of thinking lead to stress which may lead to emotional and/or physical problems (depression, ulcers, inflammation, cardiac illness, etc). A good number of neuroscientists and biologists have discovered the value of meditative practice in reducing not only stress but also increasing grey matter. Logic, therefore, tends to be a bit overrated in the overall picture because it is a conscious activity and so much of what is creating and affecting states of health is actually subconscious. And if you read Sam Harris’s latest work on free will, then it seems that more important than conscious thought is what’s going on beneath the surface.

    In the interest of brevity, and I’ve already taken up enough space here, by branching out into the study of contemplative practices it becomes apparent that one of the biggest stumbling blocks is the misunderstanding of what “mind” actually is. Our study of the mind in the West is very limited, while the study of how the mind works, reacts and changes is much better understood by, say, the Buddhists who have been at it for 2500 years or so.

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    • Rik Ganju  May 22, 2014

      Observation has been around forever. Sharing has been around forever. But with modern science you have a high standard – to write and publish a methods and materials section that is absolutely transparent about what’s being done. This is a requirement which I believe the shaman did not have to live up to (btw- i have respect for these people, and I’m not suggesting they avoided transparency about methods). And the results must be reproducible by your peers or anyone with access to the materials, not just by one blessed shaman. There was a turn towards radical transparency in the 1660s that was needed before one paper could build open another in a solid way. I have respect for those older traditions and not enough knowledge about how they dealt with transparency and reproducibility in their ecologies – just pointing out some distinctions that first come to mind.

    • Nicky H  May 30, 2014

      I’m trying not to be rude but you need to look up the scientific method and critical thinking e.g. The study of herbs and their benefits was essentially irrelevant before the scientific method. Even after that actually – if you can’t test a persons blood, what scientific results could you really provide. Sure you might give horny goat weed to 10 people and have them all increase their libido and assume by extension testosterone but what if horny goat weed only grew in summer when lots of people naturally have higher testosterone or maybe it decreased estrogen?

      I strongly recommend looking up the differce between correlation and causation. You have to be able to specifically identify that something was the cause for whatever the results were. If you can’t than it’s simply a correlation. Correlation is fine it’s the basis for most scientific peer reviewed research but you have to understand it’s evidence not proof of something.

      Otherwise mistakes are made. Aka fat must make you fat because fat people have lots of fat or a vegetarian diet is healthy but perhaps the benefits are because a vegetarian is more likely to take better care of themselves in other areas of their life?

  29. Tom Kirkendall  May 21, 2014

    Peter, I enjoyed your and your commenters’ recommendations. Here are a couple of recent books that I enjoyed, not specifically on the scientific method, but relating to other subjects raised in your post:

    “A Troublesome Inheritance: Genes, Race and Human History” by Nicolas Wade.

    http://www.amazon.com/Troublesome-Inheritance-Genes-Human-History/dp/1594204462/ref=sr_1_1_bnp_1_har?s=books&ie=UTF8&qid=1400691472&sr=1-1&keywords=a+troublesome+inheritance

    “Incognito: The Secret Lives of the Brain” by David Eagleman.

    http://www.amazon.com/Incognito-The-Secret-Lives-Brain/dp/0307377334/ref=tmm_hrd_title_0?ie=UTF8&qid=1400691745&sr=1-1

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  30. Naomi  May 21, 2014

    A few random thoughts in response to your post:

    Portions of Michael Shermer’s “The Believing Brain” are interesting. He posits the evolutionary advantage of pattern recognition and causation assumption, even when erroneous, e.g., walking the Savanna and hearing a rustle in the grass: assume it’s a dangerous predator and survive vs. stop and analyze whether it’s a lion or merely the wind and be removed from the gene pool.

    I don’t know that it will improve critical thinking or reasoning, but for sheer beauty, almost anything by Bertrand Russell is a joy to read.

    Congratulations on the Ludwig/Friedman piece. I was reading it and thinking “these guys are channeling Peter Attia,” so I wasn’t surprised at the end to see Friedman’s NuScI association. And that made me think, yet again, how much I hope that NuScI is devoting resources to planning how best to communicate effectively the results of the research it is supporting. I have encountered a few obstacles in my recent efforts to educate friends about nutrition science. First, as you note, because people have little ability to discern whether lay press accounts of recent studies — or the studies themselves — have any validity, they assume that none of it can be trusted and the science will change, i.e., that today’s vilified carbs will be resurrected in a decade or so. So new results must be conveyed along with explanations about how and why prior understandings were incorrect. (You’ve done a fabulous job of this, but as you point out, explaining why things are wrong takes a lot more time than making incorrect assertions). And try as I might, I can’t get everyone to read your “How did we come to believe . . .” or to watch “Sixty Years of Ambiguity,” or to read Denise Minger’s book, or Gary’s, or Volek and Phinney’s explanation of the story. So that’s first: how to get normal people to pay attention to this news and not assume that it’s just another chapter in the ongoing and to-be-ignored saga. The second obstacle is the power of authorities. I have friends with cancer who will not read your “metabolic quirk” piece, or any of the other work on possible benefits of a ketogenic diet when battling cancer, because their oncologists said there isn’t anything they shouldn’t eat! I have another friend just diagnosed with autoimmune hepatitis who won’t explore all the work being done with food sensitivities and autoimmune disease processes because her doctor said there isn’t anything she shouldn’t eat (other than a few obvious things relevant to a compromised liver). This is all extremely frustrating and painful, and I’ve been doing a lot of fig tree resenting. So I think it will be essential for NuScI to focus on physicians and medical training, because we defer to doctors, and we will not see the massive change we need until the doctors are on board.

    Finally, I met Kirk Parsley at Paleo f(x); his talk on sleep was fascinating. And thanks for turning me onto Tim Ferriss, who is also fascinating — and just taught me how to swim! How cool is that?

    Thank you, thank you for all you do.

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    • Peter Attia  May 21, 2014

      Great to hear. Kirk is my man. Glad you got to hear him speak.

  31. Brett  May 21, 2014

    Great blog. I can’t think of a more important topic. I have often thought about this issue and have come to the conclusion, similar to yours I think, that humans are just not very good at science. Your reasons why are very persuausive. I think we are creatures that understand nature by telling myths and stories and we are constantly trying (often without realizing it) to fit “facts” into a story that makes sense to us. Because we may be hard wired this way it will be very difficult to change. I also think that having one of our stories challenged can be threatening and makes us defensive. It also requires effort, the ability to sit with the discomfort that we may be wrong, and to accept the possibility that we may have to learn a new approach. Unfortunately, these are attributes that are often lacking. All of these problems are present in the current debate about nutrition which can be very frustating. (Today in the New York Times there was a short article on how Polar Bears appear to have a gene that allows them to eat “artery clogging fat” without getting heart disease). Please keep up your excellent work. You have many fans and supporters pulling for you.

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    • Peter Attia  May 21, 2014

      I saw that article…so painful to read this drivel.

    • Lew  May 22, 2014

      Brett, they must have been French Polar Bears!!
      I love this fat phobia issue, in particular horrifying my family and freinds by eating a diet that 2/3 fat!

  32. raphael711  May 21, 2014

    Christopher Hitchens was an incredible thinker, debater/orator and bastion of intellectual integrity. He wasn’t a “scientist” but remains an example of how to gracefully navigate the limits of ones own scientific literacy. His many YouTube debates and conversations with fellow scientists are always worth hearing.

    This http://www.gnolls.org/3637/what-is-metabolic-flexibility-and-why-is-it-important-j-stantons-ahs-2013-presentation-including-slides/ piece on metabolic flexibility is a rare and welcome example of good concise scientific reasoning IMO.

    Other scientists with very interesting and high-quality papers worth reading are Dr.Stephanie Seneff (MIT) http://people.csail.mit.edu/seneff/ & Dr.Dominic D’Agostino (USF Health, Florida) http://health.usf.edu/medicine/mpp/profile.html?person_id=24854 .

    Gary Taubes is one of the best ‘scientific mentors’ that one could wish for. June 11th 2012 ago he granted me a Skype interview about nutrition – amazing – I couldn’t believe it and can’t thank him enough. Here’s the link: https://www.dropbox.com/s/3ltnly97gew40oq/gary%20taubes%20on%202012-06-11%20at%2018.26.mov
    (Nota bene: my views on pre/probiotics & on the gut microbiome/microbiota have changed since then)

    Interesting post Peter!

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    • Peter Attia  May 21, 2014

      I’ll make sure to pass along your kind words to Gary.

  33. Polly  May 21, 2014

    This is an important topic that we tackled recently in a philosophy discussion group I belong to precisely to sharpen my critical thinking skills. I do not think of this in an all or nothing way. How could logic be invented without the ability to think logically already present? I agree there are strong incentives to make quick decisions about most things using limited information and observations of how those around us behave. And maybe that becomes a habit or the dominant thinking pattern because it sure is a lot of mental overhead to think critically about or apply the scientific method to every new thing we encounter. The pressures of daily life discourage us from taking the time to use our critical thinking muscles and over time they atrophy. When you combine that with all of the sources of information we are exposed to now, each of which should be examined critically before being accepted, one is often forced to rely on the opinions of others. So my approach is to always question and to make the effort to research and think critically about the issues that are most important to me while recognizing that those issues will not be a priority for everyone.

    I look forward to checking out the great bibliography here.

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    • Peter Attia  May 21, 2014

      Agree, it’s less that logic was “invented” per se. It’s more the codification that enabled “mass” adoption.

  34. Ken Adkins  May 21, 2014

    Hey Peter,

    Thanks for mentioning the importance of being mentored in thinking logically. It’s a critically important skill and certainly not one that comes easily to a large portion of people.

    I myself learned to think logically by playing chess, and my chess coach was instrumental in that regard.

    I would highly recommend that you add the serious study of a game like chess to your list of things that are good for learning logical thinking.

    Thanks for the piece, it is great as usual. Though there appear to be some typos…

    Ken

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    • Peter Attia  May 22, 2014

      Mentorship maybe the only vehicle for most of us. Please recommend a book about chess if you know one.

    • Ken Adkins  May 26, 2014

      Logical Chess, Move by Move by Irving Chernev.

      Yasser Seirawan is a good writer who wrote some great books for beginners, but they are mostly very specific (openings, endgames, analysis).

      I learned a lot of what I know (about chess) from a book entitled “Chess tactics for students” by John Bain. It is, unfortunately, not a chess book for non-players of the game, and is a text for study of the game.

      I think the best way to get people interested in chess is to show them the art of the game. For this, you would want a book of analysis of games of some of the best attacking players: Mikhail Tal, Bobby Fischer, and the legendary Paul Morphy. There’s one called “The King Hunt” by W H Cozens that details plenty of the most beautiful games of those three specifically.

  35. Patrick Snook  May 21, 2014

    Peter,

    Please forgive the pedantry, in the interest of correcting a tiny error above.

    Aldous Huxley was the author of fiction. His grandfather, Thomas Henry Huxley was Darwin’s bulldog.

    Thanks for another great meaty read, and for more to read as follow up. Can’t wait to sink in my teeth!

    A recent book on the topic, science and critical thinking: “Ignorance” by Stuart Firestein.

    Patrick

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    • Peter Attia  May 22, 2014

      Patrick, you’re absolutely correct and I “spoke” too soon…I need to slow down.

  36. OldTech  May 21, 2014

    Hi Peter,

    Good post. However, as a statistician, I that it is even worse. At times I think that we are very little better off than in antiquity when oracles were used. For example, you said that you are working on a post on insulin resistance. Yet when I did a search for ‘insulin resistance’ in Google scholar I got 1,690,000 hits. Just limiting the search to 2014 resulted 38,200 hits. These are huge numbers and are way beyond reading and analysis by any one individual. And that is before knowing that on a statistical basis a significant number are likely wrong or misleading.

    Note that I am not disparaging your work. In fact I am looking forward to your article. I am just pointing out that you are working in a toxic minefield. The oracle had it easier, since if he was good, he would just provide the expected answer. Otherwise he might just loose his head.

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    • Peter Attia  May 22, 2014

      You’ve reiterated my point! With 1.7 million “hit” what do you figure the signal-to-noise ratio is?

  37. Read  May 21, 2014

    Thanks for a very interesting post.

    I think anyone who regards man as a fundamentally rational animal is historically unconscious. The triumphs of reason are rare and minds like Feynman’s rarer still. Fighting your way through the tendencies you noted, and the social pressures, and the misinformation of the information age, to find some truth is a significant accomplishment. It requires the critical thinking skills you noted. All we need is 1/1000th of Feynman.

    I think with diet we can put it to the test and experiment on our bodies to find what works for the individual. A little applied science can be very illuminating.

    As to what might be done about the lack of thinking skills, I have seen some programs for high school students like Critical Thinking in Science (UNC) or Teaching Critical Thinking Skills (Dayton) that if I were king would be mandatory. However, it may be that only a few will ever really become better at thinking no matter what we do. We tend to run with the herd.

    Thanks again. I enjoyed this piece.

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    • Peter Attia  May 22, 2014

      Read, you may never be king of the world, but don’t give up on try to make this happen with high school kids.

  38. Jeremy Reynolds  May 21, 2014

    This is a very interesting post. Framing logical thought and critical thinking skills in the context of millions of years of evolution is an insightful way of thinking about just how many biases need to be overcome in order to accomplish it.

    If you need or want data regarding how difficult it is to learn (or teach others) to think critically, then there’s a pretty large literature. A pretty old (but still solid) review of the cognitive work is:

    Halpern, D. F. (2001). Assessing the Effectiveness of Critical Thinking Instruction, The Journal of Education, 50(4), 270-286.

    One of the huge challenges of this field is knowing how well such instruction and interventions generalize to novel contexts — It is hard to get people to think about anything critically. It is even harder to get people to develop a more general skill that can be applied across many domains. For example, it is not particularly fruitful to teach people how to critically approach a multiple choice, standardized test if that same critical approach can’t be applied to other situations in which they are consuming information (e.g. reading a popular press article about some scientific report). This idea of training and transfer has been around an extremely long time, but has recently witnessed a resurgence, largely because of a burgeoning sub-field in the cognitive neuroscience literature that you brought up. Results have been pretty mixed, so far, with more recent articles raising more questions about the effectiveness of recent techniques:

    Redick, T. S., Shipstead, Z., Harrison, T. L., Hicks, K. L., Fried, D. E., Hambrick, D. Z., et al. (2013). No evidence of intelligence improvement after working memory training: A randomized, placebo-controlled study. Journal of Experimental Psychology: General, 142(2), 359.

    Overall, this is to say that the problem of training critical thinking is probably even harder than we’re giving it credit for!

    Best, and keep up the great work!
    -Jeremy

    (reply)
    • Peter Attia  May 22, 2014

      Is there any hope?

    • Rik Ganju  May 22, 2014

      Excellent point about training and greater ecology.

    • greensleeves  May 22, 2014

      @Attia

      “Is there any hope?”

      Depends on what you think “hope” means, Peter. If Kahneman is correct – and he is piling up strong evidence, no doubt even despite the limitations of social/psychological science – then the answer is “no.” There’s no hope, because we all have monkey brains that have evolved only a limited rational capability and with a built-in irrational system that cannot be overcome, just compensated for. We’d need more evolution to “fix” the balance between Systems 1 & 2.

      On the other hand, it can also be argued that we have a lot of hope, because some rationality is better than none, there is a range of rational capability that perhaps can be slightly improved through expert training, and we can work together to create better techniques, systems, and processes that will help us compensate for many of the predictable errors of System 1.

      And on the third hand, we don’t need any hope, because as tribe- & family-based primates, we’ve evolved to be pro-social: to love our families, to be altruistic, to help not only our own children, but other people’s children as well, to show concern and care for others, to be happy & experience joy. These are irrational behaviors & capabilities but ones that make life beautiful and which we ought not be eager to trade away. 😀

    • Peter Attia  May 22, 2014

      Nice point of view.

  39. Debbie  May 21, 2014

    Never thought about it this way. Very interesting. Following a leader is related to our human need to not be isolated; we need to belong to a group and have an identity. Historically those talented in persuasion and appealing – not necessarily wise or humane – have risen to lead tribes, states, religious groups. To think independently does seem to go against our very basic needs. So why are some of us skeptics and questioners (like me)?

    I’ve been shocked to learn that often science is bad science, that doctors and researchers are like everyone else, reluctant to keep an open mind, unlikely to question what they learned in medical school and information received by their organizations. I assumed science reporters of all people would be the most eager to ferret out facts and lies.

    I feel if you’re an honest person – with yourself – you eventually face the truth: that no one has the absolute truth and absolute answers about anything – certainly not health and nutrition. And I’m NOT a science person. But, I have a body, a brain and a history, and have always been pretty honest (got that from my mother).

    Over the years I realized the experts failed me in my quest to lose weight, cure my eczema and carpel tunnel, not to mention my depression and overall emotional problems. I had to be scrupulously honest – which means I never know exactly what’s going on with me – and try to learn stuff on my own through reading, trial and error, thinking hard, and most of all sitting with that discomfort you talk about, the discomfort of disagreeing with everyone in the room and also of not having real answers, of sitting with a lot of contradictions. We don’t like that, we like the answers our leader provides. (As in our currently political climate of red and blue.)

    So, here’s to the discomfort of being a critical thinker! Thanks for this great post.

    (reply)
    • Peter Attia  May 22, 2014

      Debbie, make sure you pick up Mistakes Were Made (but not by me). Definitely addresses your points.

  40. Hap  May 21, 2014

    Two thoughts on imitation:

    1. Like animals, children and babies seem hard-wired to do it. Kids make great mimics. Which is why, I think, we have younger and younger kids putting on amazing performances of one sort or another, thanks to YouTube videos facilitation of finer and finer mimicry. (Though I do wonder how a nine-year old singer’s gestures and apparent emotion can be authentically rooted in experience.)

    2. One of my favorite books is Julian Jaynes’, “The Origin of Consciousness in the Breakdown of the Bicameral Mind.” Jaynes believed that before around 1,500 B.C. pretty much everyone hallucinated voices (of parents or other authority figures), that there was no ego as we know it, i.e. no subjectivity, no mediating “I” or “me,” no interiority or self-talk. This is a state nearly impossible for us to imagine. But Jaynes shows how conceptualization, thinking, learning, etc. still happened unconsciously, thus enabling civilization to grow. (With no interior “I” to complain, I wonder, how else might things like the pyramids have been constructed?) Jaynes’ theory is, of course, controversial. But it is stimulating and, as a writer and thinker, he makes great company.

    The scientific method requires interiority, thus a capacity to weigh and judge. Before the development of consciousness (roughly paralleling the development of writing, according to Jaynes), men were, he claimed, automatons, responding to hallucinated voices much in the manner of modern day schizophrenics. (These last, unfortunately, suffer the pain of ‘knowing what they’re doing; they are conscious.)

    Without the prior development of consciousness/subjectivity, then, the scientific method would have been impossible. So it makes sense that since consciousness (“there being someone home”) introduces what I would call a kind of ‘friction’ in mentation, then the default response would be the easier one, i.e. imitation. For some, doubt can be frightening.

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  41. Ash Simmonds  May 21, 2014

    This topic came up at dinner last night, I had a brief moment where something bugged me and I just had disdain for the modern world we live in, the girlfriend asked “do you think we’re evolving too quickly?”, I said “no, I just think technology and society is a few dozen thousand years ahead of where it should be.”

    As to mimicry, in the end we’re just overwhelmed with options for a “healthy” lifestyle, and in the last 5 or so years especially so as everyone is now not just exposed to, but often barraged with constantly as many “sciencey” reasons for following a given health and nutrition path. Being constantly connected has it’s downsides. At some stage we just have to commit to something, pick a thought leader who expounds a system that seems tenable and fits in with our desired lifestyle, then tweak as necessary – but not every damn day.

    It’s a telling sign that your most popular posts are about what YOU actually eat and do.

    And also just yesterday I stumbled on an obscure magazine article from 1950 (which I believe was mentioned in GCBC or WWGF) all about how to have an “eat all you want reducing diet” – driven by Dr A W Pennington, which is effectively what we now know as somewhere between keto and PHD. Reproduced here:

    –> http://highsteaks.com/an-eat-all-you-want-reducing-diet-elizabeth-moody-1950/

    (There’s a ton of great quotes in there)

    The point being I’ve read and have notes written down on science studies numbering in the thousands, yet as I read the article and got taken back into some quaint notions and ideologies, I found myself just thinking that this article was so simple yet prescriptional with *just enough* science that it’s a diet and lifestyle I could really follow (plus it’s also not much different from my own), and I don’t need to read another 20 RCTs a day seeking to confirm my bias, or be bombarded by “The Others” who want me to read their own confirmation biases.

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  42. Rik Ganju  May 22, 2014

    Hello Friends. Thanks to Peter on another stimulating post and to all of you for adding color and nuance here in the comments. If you have gained from this (or the coffee recipe), I wonder if you would support the following: I released a song last week called “Stars Fell on Daniel” for a friend who passed away recently. I’d like to donate the profits from download sales to research in mental health illness, and to suicide prevention hotlines – at least my local hotline. I released the music under the name Ganfunkel, the album is called Fighting Music with Music, and the song is Stars Fell on Daniel. Personnel joining me on this piece have recently recorded and/or toured with the Kronos String Quartet, Terry Riley and John McLaughlin. If those names mean anything to you, and you have 99 cents to spare, please consider a purchase at itunes, amzn, or anywhere downloads are sold. The song is instrumental blending tabla, guitar, and woodwinds and unfolds into a lyrical somewhat meditative lament for this lost friend.

    Please accept my thanks in advance for those willing to offer support. – Rik

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  43. JJ Bell  May 22, 2014

    Peter, thanks again for a brilliant post.

    I sometimes wonder if I am the only one who thinks the way I do (which some might describe as obsessive when it comes to learning and understanding) but thank God for the web. You are part of the peer group I refer to, thank you for keeping me sane (or insane depending on your viewpoint).

    I can 100% relate to your points on 75%/25%. In a nutshell, my family are fat (thank God they don’t read this but if they did perhaps they wouldn’t be or at least as much) but I am not. I used to be (lost about 70 pounds and maintained for 10 years, now BMI around 18, looking to eliminate last bits of ‘skinny fat’) but similar to yourself it was a tough learning curve to really understand how my body works. It is amazing that I almost now feel like I am one of these naturally lean people as remaining in this state for so long I find it hard (in a good way) to shift my weight either upwards or downwards – this last element of control was learned from the knowledge I acquired after following your site and reading wider.

    Anyway to the point, resources. There is nothing which sums up and explains this phenomenon better in my opinion in an accessible to the lay population than Daniel Kahneman’s ‘Thinking Fast and Slow’. This is a must read. He shows how we often default to a kind of natural pattern recognition survival mode which defies logic. It takes so much more effort to pause, take a breath and really apply our critical minds. Kahneman developed a whole new language for describing our natural tendency towards this and teaches us how to recognise some of the situations where our ‘system 1’ (the non-logical) thought process can prevent us from making rational decisions. A good example of this was where students were offered either a mug or a sum of money say $6, most chose the $6. However, where students were given the mug first as a gift then offered $6 to part with it most refused to sell.

    We like stories and we are hard-wired to recognise patterns therefore we tend to attribute meaning even where the evidence (or scientific experiment) proves these theories to be wrong. For example, the simplistic view of calories in, calories out (where calories are ‘perceived calories’, calories in are via bomb calorimetry and calories out are via some arbitrary value the popular media agree upon e.g. it takes x calories to climb the stairs). This is a powerfully simple story that many are unwilling to question.

    I disagree on one small point you make about blogging probably not contributing to scientific advancement. I think that in general this is true, but in the case of your blog, you bridge the gap between the scientific and lay population creating an irresistible force (for some) pulling them closer towards the science. You are contributing big time!

    One other resource which might be of interest is Nate Silverman’s ‘The Signal and the Noise’ which shows how we often apply meaning to data even where there is more noise than signal.

    Finally, thanks for the props to Fehnman and the reference to Napoleon Dynamite 🙂

    (reply)
    • Peter Attia  May 22, 2014

      JJ, thanks for sharing all of this. I can’t believe I forgot to add Danny’s book (which I’ve read). Need to fix that! I’m going to send this post to Danny, also, given how many folks, like you, have brought it back to his work. This is what happens when I rush blog posts…sloppy work!
      I hope you’re right about blogging…I guess time will tell. Lastly, glad at least one person could “hear” Napoleon Dynamite saying, “Lucky…!”

  44. Lauren Romeo, MD  May 22, 2014

    Another great post and many very sharp commenters! I’ve been wondering about this subject for some time. Example: I prescribe dietary changes to assist my patients with blood glucose control and they ignore my advice, telling me, “fat is bad for you!” I provide them with reliable sources some of which are noted above, and they continue to eat in the way that has damaged their metabolism and body habitus.
    I was assuming it was “sugar brain” a phrase i’ve used to explain to my staff that they are having cognitive difficulties as a result of high BG. But, even with better control they don’t believe me and rely on some TV doc and his/her infomercial-like presentation. Sigh.
    A great quote : ” Don’t believe anything you hear and only half of what you see.” I don’t know who to attribute this one to….it fits a lot of thinking patterns.
    Thanks for the great reading list.

    (reply)
    • Peter Attia  May 22, 2014

      Lauren, I hear your frustration. Maybe such patients will be swayed by Dr. Oz changing his tune?

  45. Mark  May 22, 2014

    Great post, Peter! I would just add that not only does one need to read the media carefully, but one also needs to read those original papers carefully and not take the authors at their word about what their research implies. I would suggest that a surprisingly large proportion of health researchers don’t interpret their studies correctly, and the media often just repeats what they say in their papers or what the university press release says. When reading the scientific literature, my strong suggestion is to avoid reading the Discussion or the authors’ conclusions in the Abstract. Read the Methods and the Results first, and make your own interpretation.

    (reply)
    • Peter Attia  May 22, 2014

      Absolutely. The last time I looked into it (about 10 years ago), one of most surprising facts I found was that some 70-75% of peer-reviewed published research was never cited again–in other words about 3/4 of all published research is pure junk. Others have estimated that as much as 90+% is likely outright wrong.

    • Ash Simmonds  May 22, 2014

      Ioannidis, J.P.A., 2005.
      Why Most Published Research Findings Are False.
      PLoS Medicine, 2(8).
      Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1182327/

      ————————————————

      I will likely be citing this and others like it in my own publications.

    • Peter Attia  May 22, 2014

      Epic paper.

  46. Jeremy Tyler  May 22, 2014

    Peter,

    Great post as usual. I just finished “Surely you’re joking Mr. Feynman” after you suggested it. A great book. A example of imitation in his book is his teaching in Brazil. He remarks how the students there had no conceptual ideas of physics but instead was just learning the equations (without knowing what they mean) and did not ask questions because they thought they needed to imitate other countries by having a big science dept. I can personally say that the more advanced the math got for me in school (I quit at calculus) the less they bothered telling me what the equations meant to the point where I no longer could understand or remember the equations because they had no meaning behind them.

    As already recommended “Thinking, Fast and Slow” by Daniel Kahneman is a great book on the subject. One test he talks about is how people resort to “non-thinking” as their glucose levels got lower. Made me wonder if us in ketosis use “thinking” more than non-keto because of a steady supply of brain energy? Something to look into from a nutritional side for sure.

    Love Frederic Bastiat. Another economist I would recommend is Friedrich Hayek. His book “The Fatal Conceit” gets very much into how people imitate more than thinking logically and how that applies to economics and the type of words we even use. Thanks again.

    (reply)
  47. Jan James  May 22, 2014

    My high school education occurred in the 1960s. The science teaching staff was very skilled and even midgrade students were offered challenging fare. I am not mathematically inclined at all (I tend to be “arty”) but my science education was amazing and the effects of it have carried throughout my life. Now high school science has been dumbed down and the equivalent to the classes I took can be found at universities or sometimes at community colleges. But you have to complete many mathematics classes before you can take them. My son, who is mathematically impaired as I am, was eager to take science classes, but it was not allowed even though he wa a 4.0 student. My point is, decent science classes are only offered to a narrow population, and we’re suffering as a society because of it. I think everyone needs to be educated in chemistry, biology, and physiology.

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  48. steve  May 22, 2014

    Did your wife read” Surely your Joking”? And had she not, have you thought about what that loss might have meant to you?
    You mention at times in the post ” the signal from the noise”, but wondered why Nate Silver book not on the list.
    I think if most just read this book, they would be on the path to improved critical thinking and might not have to delve in to more complex thinkers such as Popper.

    Taleb’s Fooled by Randomness said it all for me, and his other two I found to be derivatives, variations of the thinking discussed in the first book.
    Lack of critical thinking is a major shortcoming of the educational system. To go through HS and college and not have a modicum of critical thinking skills is a tragedy!. Of course schooling in our politically correct culture, has become watered down. All should be required to study statistics/probability which would go a long way in achieving a level of critical thinking skills..
    Great post!

    (reply)
    • Peter Attia  May 22, 2014

      1. Of course she did! We would not have got to date #5 if she had not. And she “had” to read The Transformed Cell (also on my list). In retrospect, I’m lucky she didn’t tell me to screw myself, as I would have lost out on the opportunity to marry her (by my calculation, there are only 7 women on this earth could happily live with me).
      2. I haven’t read Silver’s book, but I’ve just ordered it.
      3. I loved FBR (better than BS, actually). Probably should be on the list, also.

    • steve  May 22, 2014

      7 women! I won’t ask what the margin of error in that calculation might be!
      Anyway, your wife is apparently a flexible and accepting soul. Many would have flipped you the bird!
      Silver book is relatively elementary; good discussion of Bayes theorem

      thanks for the post

    • Peter Attia  May 22, 2014

      I think it’s +/- 1. But she is a very unique person.

  49. JJ Bell  May 22, 2014

    (Brief note to say thanks x 1M for reply, am amazed & impressed you are on first name terms with one of my heroes, more evidence for the theory that you possibly are a legend!)

    (reply)
    • Peter Attia  May 22, 2014

      Ha ha. I’m no legend, but I’m lucky to be friends with a few.

  50. Mike Miller  May 22, 2014

    I also highly recommend Daniel Kahneman’s Thinking, Fast and Slow. Daniel Kahneman won a nobel prize for his research into cognitive biases which is exactly the subject of this blog. He includes lots of different categories of cognitive biases and he also has solutions for over coming the biases.

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  51. Joseph  May 22, 2014

    I think the following 2 books by Ben Goldacre are worth looking at:

    Bad Science (2008)
    Bad Pharma (2012)

    He also has a couple of TED videos which I like as well:
    http://www.ted.com/talks/ben_goldacre_battling_bad_science#t-614314

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

    (reply)
  52. LeoniusP  May 23, 2014

    Blimey, an intelligent and erudite blog. My friend Alan might even like it http://goodlondoncopywriter.co.uk/ I mention him because he’s been a friend for nearly two decades and rarely agrees with anything I say, he certainly doesn’t take anything on face value. A true friend indeed.

    I have two comments to make, both of which are going to be quite long and so, I’ll split them up into separate comments. The first comment is about the pain of not imitating everyone else. As far as I’m concerned, that pain is real but, if you do it often enough, like anything else, your brain normalises it.

    In the early nineties, I was given the task of designing a system so complex that everyone except my mentor and my employer said that it was impossible. My employer was one of the largest law firms on the planet and they hoped that since I was “untrammelled by a formal education”, that I could do it – they realised that I didn’t have to “think outside of the box” because I just don’t have a “box”. My mentor, one of the most senior consultants for one of the “big three” management consultancies, somehow knew that I could do it and spent seven years supporting me in my research before I designed the thing.

    I won’t bore you with what the system was but instead, I can contribute the lessons that I learned in my journey of designing it.

    First, I think it was the physicist Murray Gell-Mann, who really jumped up and down with rage when something wasn’t simple and elegant, on the basis that it must be wrong. As far as I’m concerned, he was right: if something is complicated, you’re thinking about it in the wrong way. By “wrong”, I mean in a way that doesn’t actually help you in thinking through the problem – and if you go too far down that road, the problem will bury your brain. I believe that’s called “Analysis Paralysis”.

    Second, memory is key – you need to have a wide fact base to draw on, so that you can apply your concepts to it and test things out in the simulator that is your brain. On my journey, I researched the telegraph system, the railways and healthcare (since I was designing a national infrastructure that was much more complex than any of those). I learned about how these things evolved, how they were financed and the politics of the time that affected them.

    So, thirdly, we come to the fact that the brain is a simulator and if you put enough information into it, it will simulate veridically i.e. the simulation it runs will match reality. This is a key point because, once you have confidence in your ability to simulate, then you can accurately simulate something that’s never been done before. This situation gave me the most pain, as you can imagine, but I also got into a “god-like” (with a small “g”) scenario, where I could just create at will.

    Fourth is the understanding the dynamics of your own learning curve. Know that you’re as dumb as anything when you start something but also know how you learn effectively – and then apply those techniques to everything you learn that’s beyond trivial.

    Fifth, understand the structure of the creation that you’re creating inside of – it’s self similar i.e. you will see the same patterns repeating themselves at any level you look at. A good one is a tree. You will see a dendritic pattern (tree-like) on a microscopic level in the soil, on a human scale in lungs, on planetary scale in river deltas. Learn these patterns and life will be simpler – your thinking will be simpler but much more powerful

    Sixth, understand what far from equilibrium dissipative systems are – those are the ones that are born, grow and then die (like a business, or on a smaller scale, a business transaction), not the ones that are manufactured on a production line. The reason for knowing this is so that you know what needs to be controlled and you don’t bother with trying to manage chaos that can never be controlled – you just corralle that stuff e.g. stick it in a database in such a way that you can get at it later.

    Seventh, Kahneman, along with Tversky won the nobel prize for doing the research that changed Howard Raiffa’s received wisdom on negotiation – rational people do not respond rationally throughout the risk curve – rational people are more willing to spend their way out of a risk, than they are to buy a benefit. This gets you into the (in my opinion) rather dodgy ground of neuro-linguistic programming, so that you frame your wares in terms of helping a buyer to ameliorate a risk, rather than to gain a benefit.

    The reason I think that neuro-linguistic programming is dodgy ground is because I see that using it on someone who’s unaware of it is the same as spiking someone’s drink at a party. It’s just unfair and that’s not done in a humane society.

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  53. LeoniusP  May 23, 2014

    Okay, now for my second comment and this one is on diet. Another decade – long friend of mind is a leading psychotherapist in the UK http://www.klearminds.com/ and, many years ago, we had a conversation about diet and blood groups.

    I spent five years in a vegetarian boarding school, which only served organic food. I got sick, I got cold, I was miserable. “How can this be?” You ask. Well, I found it really interesting that once a day kid found out that I could shoot and he invited me to his dad’s farm for “bunny blasting” and to help myself to pheasants, I got a lot better, faster and stronger. I’m an O positive blood group and over the years, I’ve developed a high protein, low carbohydrate, full fat, organic diet, without the weird fats that are new to us, like rapeseed oil and sunflower oil and I never get ill.

    My psychotherapist friend did get very ill and, eventually, it was pinned down to her diet. Not having been taught to cook, she was very distressed when she eventually received her diet sheet and had no clue of what to make of it. I spent several weeks with her, making meals out of the ingredients from the diet sheet and then she suddenly said to me “but this is your diet, it’s what you eat”. “We’re the same blood group”, I replied and my friend is now fully functioning and cooks lovely meals.

    My partner and my son are both B+ and if they imitate me and eat my diet, they get ill. They lack energy, they get constipation, wild flatulence and they’re just generally miserable. Their diet is beans, not beef, duck, not chicken, loads of fruit (which I like but I’m really not bothered about) and about the same level of carbohydrate as me. That said, they can handle beef if it’s minced and served with a load of beans. So chile con carne is a meal that suits us all, whereas steak and chips is not.

    I know that two cases are not statistically significant but I don’t meet B+ people very often, because they’re rare in the population. However, we recently had our second child delivered, and whilst my partner was in the throes of labour, the hospital staff realised that they didn’t have her blood group noted down. I told the mid-wife that my partner was B+ and that the hospital would probably have to go hunting in the basement for some replacement blood, since it’s so rare. “Oh, the same as me”, the midwife said. So, then I put it to her that her diet is beans, not beef, duck, not chicken, loads of fruit and not much carbohydrate. I did this point by point and she agreed with each point.

    Okay, now you get the point, I’m going to get really left field on you. I have no idea about men but I’ve encountered a lot of “fat” women, who are not actually fat – if you prod their “fat”, it wobbles like water. It is water and I can tell you why but I have to mention the word “orgasm” and if you’re not comfortable with that, then stop reading now.

    As a very lean and muscular guy, spending five years in a mixed boarding school, watching the females around me agonise about their figures as they developed through puberty, I discovered two things. First, all women have an intrinsic beauty that’s unique to each of them, second, they’re being conned into thinking they’re fat by an industry that knows women will hop from diet to diet, when “diet” is not the solution.

    The “solution”, should that be desired (and I’m a great fan of allowing a woman to be who she is, naturally, because as a man, I then get the benefit of a happy, contented woman who is authentic to herself) is to come in pints when she orgasms.

    This is really simple to achieve and you’ll see the difference in 10 days, if not sooner. So here’s how it goes. There’s a point inside a woman’s vagina called the Anterior Fornix (that’s “front arch”, to you and me) it’s the point where the top of her cervix joins her vagina. If you stimulate that, as you would a G-spot, she’ll feel the need to pee. This is what’s called a “shadow sensation” by the physiology crowd because you’re just stimulating the nerve that sends a signal to the brain that tells a woman she needs to pee. So she should pee beforehand, just so that she’s sure everything is fine.

    If she pushes, during this type of orgasm, as she would push to push a pee or a poo out, then, after a bit of practice, her orgasm will be accompanied by pints of liquid coming out and with some force (so be kind to your mattress and protect it). I’ve done this so many times with so many women, with so many body types, I’ve satisfied myself that this is a truth. Women who use this type of orgasm as part of their sexual repertoire are, in my experience, more settled in themselves, more loved and more self-determined (handy, if you’re a bloke) and, in their forties, they look and feel in themselves to be “ten years younger”.

    The key to achieving this, for a man, is to get off “transmit” and get on to “receive” what a woman’s body is telling you to do, then you’ll find out why you have such physical strength and stamina. You’ll need it, as she “rides the tiger’s tail” as the far eastern sexual martial artists say.

    I’d be really interested if anyone has an equivalent solution for men, not because I need one but because I find biochemistry and physiology really rather fascinating.

    (reply)
    • Nicky H  June 14, 2014

      So sometimes fat isn’t fat but just ‘water’ that needs to be flushed out by orgasm. Is that truly what you were saying? So somehow the water comes from the fat cells in the body and shoots out through the uretha instantly? How does it get there? What about children? What about old people?

      Also there is as far as I can tell no proof to the blood type diet. While I don’t deny the possibility but I think you are jumping to conclusions. That type of mentality is exactly what caused the diet issues plaguing most of the western world.

  54. M Bertler  May 23, 2014

    Hi Peter-
    I’ve been a long time reader- I’ve been on a ketogenic diet (check glucose and ketones periodically) for 6 months. I’m not diabetic, not overweight (5’9″, 148 lbs), not a smoker, exercise pretty regularly (walking, hiking), no immediate family history of issues, and feel better than ever! I was leaning metabolic syndrome, I’ve lost 17 lbs from abdomen in 6 months, but now weight stable. My lipid profile 5 years ago (last time I had it checked) was identical to yours pre-diet change. After my last 6 months, I just did an NMR LipoProfile to make sure the train didn’t come off the tracks and the results are astronomically, horrifically bad. I have read of this phenomenon rarely, and you have spoken of it on some video’s. Can you advise on a low carb doctor that can interpret and advise me, look into Thyroid, or tell me to leave it alone, etc? I’m in unchartered waters given the current medical community! If you need a case study for NuSi, give me a shout out!! hehe – thx for any help? No need to post in the comments-

    LDL-P: >3500 (OMG walking dead)
    LDL-C: 323 (*&$% walking dead)
    HDL-C: 43 (ok)
    HDL-P: 24.0 (low)
    Tri: 148 (on damn near 0 carb)
    Small LDL-P: 1848 (Jesus $%#$)
    LDL Size class: 21.1 (Pattern A)
    LP-IR Score: 43

    Lost in Northern CA……….

    (reply)
    • Peter Attia  May 23, 2014

      I have an idea what’s wrong, but I would need to see a few other labs and it would take 3 months at least to tweak. I wish I knew a good doc to help with this. Tom Dayspring, who is in VA, is the other other person I know taking the same approach to mine in situations like this. I’ll try to address in part X of the cholesterol piece.

    • M Bertler  May 23, 2014

      Thx for the response Peter-
      Hard for me to even conceptualize what is happening- anything you can do to shed light would be amazing- In the interim I plan to check my CRP, Thyroid panel, and Lp-PLA2 to try and see if anything looks amiss, while adding back some low GI carbs- I’ve watched many of Mr. Dayspring’s video’s, have not seen him address this.

    • Jeff Johnson  May 23, 2014

      Some People

      I have wondered about this sort of thing –

      My thoughts being that for some reason food combustion (oxidation) – the last step in the ATP cycle( I think) –

      is not complete – resulting in un-oxidized food remaining in the bloodstream – the low-carb diet making this substance risistant to being stored as fat –

      in other words – the only path the un-oxidized food can take is too float around in the bloodstream carried by excess amount of LDL-P (particles)

    • JJ Bell  May 23, 2014

      Sorry if this is a distraction from the main piece but is related to the concept of non-mainstream thinking.

      Have you had any experience of a system called Arx Fit (don’t worry I don’t work for them, I’m in the UK where you can’t even access the machines)?

      Its basically a weight exercise machine that adapts to individuals so that a super weak (aka moi) or incredible hulk could use it and both feel like a house is coming down on them as it matches your ‘force output’ at each part of the ‘strength curve’ i.e. it makes any movement or lift damn hard at each part of the lift.

      The part I like is that it works equally well for any level of fitness (or weakness) and because it is so efficient, apparently you can complete a meaningful workout in say 30 mins. I heard Dr Rocky Patel comment that this could be good for diabetics as would put more force on eccentric movements (e.g. when you lower the weight) allowing muscles to ‘soak up’ more blood sugar.

      See, even body builders use science … kinda ….. 🙂

    • Andre  May 24, 2014

      I would not be too concerned right now, we do not know to well what all these things really mean. My cholesterol skyrocketed on full-keto initially. The last time I researched I found that the most trustable ratio for general health is Triglyceride to HDL. Yours is actually 3.5, just between cutoff for between A and B pattern. We dont even know if that stuff is meaningful, but according to what I remember th TG to HDL is better than any other mainstream ratio, like total colesterol, ldl etc.
      I have one APO e4 Gene for example, according to some studies this mandates a low-carb (Dr Dayspring might disagree re high-fat on APO e4, but I am not sure he has justified this anyhow) , high activity lifestyle (=5 times a week moderate exercise), with that I appear to have excellent health, endurance and even blood labs, even the ones we dont know a lot about.

      You could try exercising 5 times a week and just not force any more weight loss, which is probably not on your list. You are already ketogenic, you could soften that introducing much more leafy green stuff and in turn add in a fast day here and there. Actually I did a multiple day fast and got my blood labs to see how my fat metabolism works while using only stored fats. We are all very different with our genes and things we did to our body, you will have to experiment.

      oxLDL and CRP is a good idea, maybe much more important than the other stuff.

    • M Bertler  August 8, 2014

      Hi Peter-
      Updating my original post, the case study you referenced was an amazing read. For lack of direction, I followed the general intent outlined in the write-up: reduced SAT (eliminated coconut oil) , increased MUFA, increased carbs to just out of ketosis, and lots of leafy greens- Voila, an amazing reversal in lipid profile! Gene expression is normally some vague, amorphous thing, but seeing raw data tied directly to diet is truly amazing- It’s strange though, I felt my absolute best with my lipids off the charts bad…With my “better” lipids, my energy and mental clarity are good but not quite the same- at least I’m in a known (good) medical state… Thx again for the continued enlightenment!

  55. Jeff Johnson  May 23, 2014

    P Value Insanity

    I never knew what a P Value was – when looking at studies – i assummed it was some kind of stasticical pro or con –

    I’m sorry I looked up it’s meaning on Wiki – people who get this involoved in this usless crap in manipulating numbers are in sorry need of help or medication or both –

    I’m afraid to look up the exact meaning of – The Scientific Method – for fear of further disappointment –

    My Critical Thinking has taken a hit just reading about some of this mindless crap –

    I suppose my critcal thinking ? is just too stupid too appreciate the fact – that people actully get paid to indulge themseivles in these sorts of activities –

    It seems their time would better spent cleaning toilets for the next 20 years until they repented –

    (reply)
    • Peter Attia  May 23, 2014

      Jeff, you’re throwing the baby out with the bathwater. Don’t dismiss statistics because most people misuse or abuse them.

  56. Steve  May 23, 2014

    saw the best bumper sticker ever the other day, ” If evolution is outlawed, only outlaws will evolve”

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  57. Steve  May 23, 2014

    hope this is not off topic, but I think this is one of the best examples critical thinking I’m come across. The argument exercise vs. recreation is elaborated on here- http://www.renaissanceexercise.com/wp-content/uploads/2010/11/Exercise-vs-Recreation.pdf

    if anyone can refute any of this I would like to hear it

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  58. Steve  May 23, 2014

    and thanks for the excellent post, as usual

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  59. majkinetor  May 23, 2014

    This is totally inline with recent DNA similarity study 🙂

    In short, recent study showed that people are attracted to those with similar DNA. If it is true that we copy external behavior, internals can’t be much different for obvious reasons.

    https://plus.google.com/+MiodragMili%C4%87/posts/5WMdbtsWEev

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  60. William Johnston  May 23, 2014

    I suggest you take a look at two works of Richards J. Heuer, Jr. They are, respectively, The Psychology of Intelligence Analysis, and Analysis of Competing Hypotheses. The former is an excellent treatise on how an intelligence analyst should form and test hypotheses. The latter is a procedural program (done with the Palo Alto Research Center – PARC) that allows some automation of the process.

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  61. William Johnston  May 23, 2014

    This is wildly off the subject, but what is the function of the almond milk in your ice cream recipe?

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  62. grinch  May 23, 2014

    I learned a lot about how deluded us humans are by reading the book “You Are Not So Smart” by David McRaney

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  63. Andre  May 24, 2014

    I loved the post and all the comments, discovered some excellent video about Feynman and his book is just awesome. Actually I loved the post, because me and me wife have been struggling with this a lot recently.
    People will just replicate mainstream ideas regardless of whether they are true, politics, rumors about politicans, nutrition etc and on all fronts we do stuff differently (really no bread? really? your dog eats raw meat AND bones? etc)
    You can even bring a package of solutions for their problems, if those have surfaced already (overweight, bad skin, smelly dog), with all the science behind it and they will just go on with what they are doing already. It is so incredibly hard to convince people using the scientific way, they just dont lead the literature and it just confuses them.
    Enough of the complaining….

    One important thing I need to mention, the pain of independence is definitely experienced by my wife, this seem to be a phenomenon and I know some others who are impacted. It does not impact me that much, I have always been a free thinker and I have the warrior gene (which may reduce all kinds of fears and maybe that type of pain as well). It would be very interesting to have those people genotyped.

    Just as in nutrition, in thinking and decision making there could be huge genetic impact how people act on information.

    Finally, this may well be coupled with the http://en.wikipedia.org/wiki/Dunning%E2%80%93Kruger_effect that you overestimate what you know if you are inept and a bunch of other biases (like the availability bias).

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  64. Bo Vine  May 24, 2014

    I subscribed to and read Scientific American for several years. Lots of great stuff in there, and a wide range of topics. And while maybe not strictly scientific, I really love all of Douglas Hofstadter’s books.

    It’s hard to grasp the numbers in your table. And while my numbers may be off a little, have a look at this picture. Here you can see the difference between 1000 years, 10,000 years, and 2.5 million years.
    http://captaincheeto.com/2.5.html

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  65. John U  May 25, 2014

    I started down this path of the study of nutrition after reading GCBC by Taubes. The book was recommended to me by my son (we were both educated as engineers) about 5 years after it was first printed. I was stunned by what I read, and I actually read it all again to make sure I absorbed as much as possible.

    So looking back, a well educated person like me, skilled in science and R&D, was just eating the standard American diet, trying to consume good portions of veggies and fruits and whole grains. Why not, after all, my doctor told me to eat well and to avoid saturated fats, and the media just confirmed all this and added the stuff about avoiding salt and too much red meat, eggs, etc. Why would I believe that my doc and the media were wrong? I was not an expert in the science of nutrition, and professional nutritionists kept repeating the conventional wisdom. Why question it? I could have, I was smart enough, but why? Where does the spark come from to question scientific advice? If I had been unhealthy, obese, diabetic, on drugs that made be feel bad, maybe I would have been more motivated to question, but I was none of these.

    In my case I was fortunate that my son lent me his copy of GT’s book. It opened my eyes to the likely deception, and started me on a mission of self-education and diet change. It was not a lack of ability or even curiosity which inhibited me from questioning. It was the total and naive belief in the medical profession. I never questioned the advice I received because it came from what I believed to be reputable and credible sources, and that is the real problem. Our personal medical practitioners are not well educated on the subject of nutrition so they just naively regurgitate the conventional wisdom. The media is in the business of selling information. Why should they be concerned about the validity of what they are reporting, especially since it comes from bona fide research reports and helps sales? As you mentioned in your blog, there are forces at work which tend to influence the kind of research that is done and the way the results are reported. Money and politics have been influencing our existence and welfare for a long time. A big lie has been perpetrated on us and continues to be, and the vast majority of the population are not skilled enough to realize it. Even those who are skilled will likely not question it. Also, the young and still healthy cohort has no incentive to question. It has almost nothing to do with emotional stress, our evolution, or our genes. Most people just naturally believe what the (medical) authority figures are telling them. Only when the odd (very likely scientifically educated) person with a reason to be curious starts to question the wisdom does the situation change.

    Yes, we all learn to copy our neighbours when we observe a possible benefit to us, because in the absence of any valid and good reason to do otherwise, that is our best course of action. However, when it comes to complicated issues such as nutrition, who will you copy? Your neighbour? Or will you just follow the advice of your medical professional who is, after all, an expert? My experience tells me that it will be the latter for most of us.

    Probably everyone who reads this blog is an outlier and has learned to reason and question in the search for truth. What is it that we all have in common? Maybe the answer lies there.

    Peter, great blog in general (not just this specific issue) and one of my top two.

    (reply)
    • Peter Attia  May 25, 2014

      Yes, that’s probably true of this blog. Pure outlier substrate.

  66. Joe Davis  May 25, 2014

    I suggest The Fatal Conceit by F.A. Hayek as a counterpoint to logic and reason leading to the best conclusions.

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  67. Rob Lyons  May 26, 2014

    Hi Peter,

    Been catching up with your work via Gary Taubes. All very interesting and useful.

    You’re right to say ‘We’re not wired for science’. In fact, we’re pretty much not wired for anything that makes us distinctly human. What we have is the benefit of history and society to overcome these failings of individual thought. History, because we can stand on the shoulders of giants, as Newton put it, through science and the scientific method. Society, because we have a shared desire to try to come to the truth – or at least, the best version of the truth we can come by given our material and intellectual development. But there are some important social changes happening which tend to undermine those two foundations of scientific development.

    One such change is relativism or post-modernism or whatever you call it, which says that multiple points of view can be in some sense ‘right’ and that ‘overarching metanarratives’ are somehow oppressive. This might have been kind of interesting for a while in saying that what currently goes for how we live or how we organise society might not be the best way of doing things, that we should be tolerant, live and let live. But it bleeds into every kind of intellectual discourse and it’s very unhelpful, with researchers both within and between spheres of research operating in ‘silos’ and engaging in ‘group think’, with little desire to reach beyond them.

    Another is the rise of scientism. We forego the scepticism of science in favour of the expertise of scientists. This is crucial at a time when other sources of authority have been discredited. Politicians rarely seem to say a thing now without claiming it is ‘evidence based’, and pull out a scientific expert to justify their views. Even worse is the way that scientists have cottoned on to this, and have become activists. The world of obesity research is among the worst for this kind of thing. ‘We need to ban X’ or ‘We need to change the guidelines to Y’, rather than really grappling with causes for problems and resolving them. As Taubes effectively points out, Ancel Keys was the godfather of activist science, and it has had a baleful influence on actual research in many respects.

    Rob

    (reply)
    • Peter Attia  May 27, 2014

      Really good insights Rob.

    • Kelley  June 11, 2014

      Rob: two obvious examples that leap to mind when you discuss “relatvism” are the anti-vaccination advocates (who believe their “data” are just as valid as that of the establishment scientists) and the climate change deniers.

    • Kelley  June 11, 2014

      Somehow, both groups believe that the scientific consensus is “oppressive” to their views.

  68. Marijke  May 26, 2014

    I have been trying to find out what you mean by ‘the scientific method’. I cannot find a definition but it seems that is has to do with interpreting statistics in the right manner. For me the scientific method is something else:

    The scientific method is a way to ask and answer scientific questions by making observations and doing experiments.
    The steps of the scientific method are to:
    Ask a Question
    Do Background Research
    Construct a Hypothesis
    Test Your Hypothesis by Doing an Experiment
    Analyze Your Data and Draw a Conclusion
    Communicate Your Results
    It is important for your experiment to be a fair test. A “fair test” occurs when you change only one factor (variable) and keep all other conditions the same.

    from http://www.sciencebuddies.org/science-fair-projects/project_scientific_method.shtml

    (reply)
    • Peter Attia  May 26, 2014

      Missing a key step. After analyzing data, must compare to hypothesis. Be sure to watch the Feynman video I linked to.

    • Rik Ganju  May 31, 2014

      Marijke, you can change more than one variable at a time. The art of doing this is called DOE (Design of Experiments) if you want to search on this. The important thing is to change variables in a way that does not cause confounding when you want to compute effects. The test or tests will still be fair. I teach beginner to advanced courses on this, and you are welcome to send your email if you have questions.

    • Brian Swartz  July 20, 2014

      Hi, Peter et al.,

      There are many great thoughts, posts, and comments here, but for the sake of doing justice to science (especially when communicating it to the public), it is perhaps wise to make sure that we do not just focus on test by *experimentation. Experiments can be great, and I think we can all agree that if done appropriately, they are effective ways to test hypotheses. However, regarding “the scientific method” mentioned above, we often test hypotheses without doing experiments. The geologist cannot make a mountain just as the astrophysicist cannot make a star; but this does not mean that we cannot test hypotheses about historical events. When we relegate science to a process that “does experiments” then we automatically push any question about *history to the edge of where non-science begins. In this way, it is perhaps better to emphasise that science is a systematic method of empirically-based hypothesis testing, without the explicit emphasis (or requirement?) that we necessarily perform experiments. Also, you are likely familiar with this, but here is a good ref to illustrate that science is not the linear process that it is often made out to be: http://undsci.berkeley.edu/article/scienceflowchart. No surprise, each element here has its own history, too; they have all come together to make science (today) all of what we know and love.

      Cheers,
      Brian

  69. Chuck W  May 26, 2014

    Surely hunter-gatherers and early agrarians had some cognitive abilities beyond just “mimicking” their successful neighbors. What about following signs and tracks on a hunt? Inventing and refining tool usage? Navigation across land or water? Studying the behavior of other people or animals, inferring motivations, and predicting future behavior? They may not have conceived of it in formal, logical terms, but it all seems more complex than just mimicry.

    (reply)
    • Peter Attia  May 26, 2014

      Sure, but I guess the question is what proportion of those in said societies were doing the problem solving and what what proportion were following? I don’t know the answer, of course, but I’d guess the vast minority were leading and the majority were going along for the ride.

    • Rik Ganju  May 30, 2014

      Chuck, the claim is that the brain was and still is oriented towards imitation over establishing facts from first principles. “Oriented towards” is much different than “destined to” or “limited to”. That claim does not say people did not have observation skills, creative potential, or could not make cause-and-effect links.

      I still stand by this: the world spent $503 billion dollars on advertising last year – how many of those ads featured logical arguments? How many featured celebrity endorsements (a subtle invitation to imitate)? If logic were a powerful, primary force why not appeal to it?

      Secondly ‘refining’ and imitation are not that much different. Adding jalapenos to hummus and calling it jalapeno hummus is refining – yes – one can focus on the creative twist, or one can also see the imitation at the root of it.

      There is a lot going in imitation or getting in sync with each other that is not conscious: why do British speakers of English speak with a British accent, Americans with their American accent, Australians with their accent? No one has to.

  70. Tim C  May 26, 2014

    I found a talk Leonard Susskind did on Richard Feynman – https://www.youtube.com/watch?v=hpjwotips7E. He concludes his talk by saying: “how should we honor Richard Feynman? By getting as much bologna out of our sandwiches as we can.” Even though the low carb community might argue that we should get as much sandwich out of our bologna as we can, I thought it was a decent metaphor, and some interesting anecdotes

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  71. Jeff Johnson  May 27, 2014

    Hunting 101

    I’m quite the hunter and being quite the hunter – I plan my hunt’s -I plan like a madman – crazied – sniffing the air for the slightest tinge of prey –

    But first I look at all the ad’s in the paper -( all the stores I go to send me their weekly specials) – this is how a real hunter does it

    Then I saddle up my 88 Chevy Celebrity and I ride like wind – ya – I ride like the wind knowing that – that Penzoil Ultra Platinum will keep my pony going –

    By the time I stroll to the store door I’m in a killing frenzy -nothing can stop my pure bloodlust – so I stealhfully enter and head to lettuce isle where I bag 6 heads of lettuce at 2 for dollar –

    It was a good hunt – I head home and feast on my lettuce dipped in Valentino’s hot sauce or mustard or most likely – both

    I live for these hunt’s – riding like wind in my 88 Chey Celebrity with the Penzoil Ultra Platinum and my High quaility Chevron gas keeping me going –

    Being a hunter – No – being thee Hunter I know bad gas and bad oil are for lesser mortals –

    Pretty soon the urge to hunt again will come and while I’m at it – I’ll stop at the Taning Booth : not only am I a great hunter – No– thee Hunter – I’m also taned up – and head on down to Winco and get my Baker’s Chocolate and Grapefruit Diet Pop – and then ride like wind – ya – I ride like the wind in my 88 Chey Celebrity with Penzoil Ultra Platinum and Chevron gas in it – till home – where the Gas furnace with the cover door is off and I can stare at camp fire (the pilot light) –

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  72. Joe Justice  May 28, 2014

    Peter,
    I understand that each person is individual, so declarations of specific amounts of carbs, proteins and fats is not to be taken as universal law, but is there a ratio of fat to protein to carbs that should be followed to reach and maintain ketosis? In one of your posts I read that more than 150 grams of protein was too much and 50 grams of carbs was too much, but I have not been able to find a breakdown of intake that includes fat intake. Could you also talk about sources for fat that should be used as well as those that need to be avoided (I think the plant based are out of bounds–but I have not found a list that says where olive oil should be in a diet.)

    Thanks

    JJustice

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  73. Kate Koefoed  May 29, 2014

    Dear Peter,
    My scientific curiosity has been sparked by a new lecture on You Tube by Dr Douglas C Wallace called “A Mitochondrial Etiology of Metabolic and Degenerative Diseases, Cancer and Aging”. (Sorry, don’t know how to put in a link!)
    There is lots of engaging observational scientific information which I think could be very relevant for fans of your approach to nutrition. Most intriguing of all is a quick reference Dr Wallace makes to ketogenic diet during the Q & A.
    I only stumbled on the lecture because my interest in metabolic problems is personal; I am delighted this blog gives me a chance to recommend such an incredibly academic lecture with big-picture thinking to like minded people.

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  74. Patrick  May 29, 2014

    Good post.
    My recommendation: building on Bastiat, I highly recommend Human Action by Ludwig Von Mises.

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  75. Caitlin  May 29, 2014

    Hi Peter, Great post as usual. While we are on the topic of critical thinking, there’s a fundamental premise in this discussion on health that I haven’t found much evidence behind. I wonder if you have stopped to ponder the science behind the “healthy” weight. There are people with heart disease, diabetes, cancer etc. who are a “healthy” or “normal” medically defined weight. Further cause for pause is the 2013 study in JAMA that suggests being slightly overweight actually reduces your mortality risk. Perhaps a certain amount of fat storage is a good thing when it comes to health? Or perhaps consuming fat, even when not in ketosis, has some healthy benefits? The body certainly resists losing those final 10-15 pounds much more than the initial 10-15 pounds in a obese/overweight individual.
    p.s. My dad got me reading Feynman growing up, his way of thinking outside the box has always stuck with me.

    (reply)
    • Peter Attia  May 29, 2014

      Too many nuances to respond with any fidelity. My talk at TEDMed sort of addresses this, but only indirectly.

    • Vicente  May 30, 2014

      Hi Caitlin,
      are a few of us healthier because of being overweight, or are a few of us leaner because of illness?

      This is a letter (by Walter C. Willett, MD et al) to the editor of the JAMA article:

      To the Editor: In their meta-analysis of BMI and mortality “to inform decision making in the clinical setting,” Dr Flegal and colleagues1 found that mortality was not increased up to a BMI of less than 35.

      We believe their study is flawed. Their comparison group (BMI of 18.5-<25) contains persons who are lean and active, heavy smokers, frail and elderly, and seriously ill with weight loss due to their disease, as well as Asian populations historically undernourished and burdened by infectious diseases.

      In my opinion, if the flaw is true that study shouldn't have been published.

    • Peter Attia  May 30, 2014

      Be careful how you interpret this letter. Flegal was probably right.

    • Vicente  May 30, 2014

      Hi Peter,
      the authors say that “overweight was associated with significantly lower all-cause mortality” (association) but Caitlin wrote that “being slightly overweight actually reduces your mortality risk” (causality).

      May be I am wrong about that, but the authors may be right about association but causality has not been proven (may be people with an increased mortality risk tend to have a lower weight and not the other way). The letter to the editor I quoted may be interpreted in that way: if the authors of the JAMA article included in the low BMI group people “seriously ill with weight loss due to their disease, as well as Asian populations historically undernourished and burdened by infectious diseases”, what you would see is not that being overweight is protective but instead that ill people tend to weight less than healthy people.

      Moreover, ill people contribute to the “being lean is bad” account, bodybuilders (high BMI and may be healthier than the standard guys) contribute to the “being overweight” is good. A lot of confusion that doesn’t lead me to believe that been overweight is good (causality), not even when we talk about a slight overweight. Does the study really tell us anything?

      (please excuse my english as my mother tongue is spanish and not english)

    • Caitlin  May 30, 2014

      Vicente, Thank you for the additional info on the JAMA study. My point was not that there was causation but that we use this biomarker too heavily. Thinking outside the finer points of the study, it doesn’t change the fact that a slender non-smoking marathon runner in his early 40s can have a heart attack or Dwight Howard, not only a person of “healthy” weight but a pro athlete, can be prediabetic (http://sports.yahoo.com/blogs/nba-ball-dont-lie/prior-doctor-intervention-dwight-howard-eating-equivalent-24-215009519–nba.html). We tend to think in terms of “if some is good, than more is better” especially when it comes to losing weight. Where did this concept of a “healthy” “normal” weight come from? It strikes me as interesting that someone like Howard could be viewed as healthier (super athlete!) than someone who was slightly overweight, but with no other biomarkers of disease. My main thought is that sometimes our public discussion on health focuses too much on weight loss and not enough on what is actually beneficial for the body.

    • Vicente  May 30, 2014

      Hi Caitlin,
      from reading “Wheat belly” I got the idea that visceral fat tissue was a real danger to our health. May be there is not a specific section in the book related to visceral fat, but I think the message was here and there.

      I have the feeling a lot of people assume being fat is not that bad because they think it is impossible to change their weight: they do the officially-right thing and they gain weight. When you see that your goal is impossible, you change your goal: “I can’t lose weight, therefore being fat is not that bad”.

      But, as I see the world, nobody really wants to be fat. Am I wrong? When I see fat people I don’t think it’s their choice, I think they are told to eat the wrong way.

      For me it is OK to tell people: “try to be lean because it is good for your health. There is a real chance for you: forget about carbs (except vegetables) and processed foods. But if eating right doesn’t work for you, then sure, you should try to be happy with what you have”.

    • Caitlin  June 2, 2014

      I think that’s the interesting thing about the ketogenic diet. It’s not the traditional “eating right” diet. You do cut out a lot of obviously ‘bad’ food, but you also eat a LOT of fat. Personally, I did lose weight, but I also felt better all around: higher energy levels, better sleep, clearer thoughts. I did not do the ketogenic diet strictly to lose weight, but to curb a B12 deficiency that was severely impacting my memory and mood. Previously, I ate “healthy” by mainstream standards (low-fat, lots of fruits and veggies) but I was really struggling from a true “health” perspective. Sometimes, I think the overweight are the lucky ones because they have a glaring reason to search for answers. Should someone who’s overweight reach for a cigarette to control their appetite? Is being a “healthy” weight desirable at all costs? I think not… and in the case of ketosis, we still don’t know a lot about it. Is it best to be as skinny as possible by being in ketosis continuously? Maybe. Maybe not. My point is, weight is only one biomarker. We don’t know for sure what the long-term cause-and-effect is of merely being slender, but we do know that fat, as a macronutrient, is great for the body and the brain. I think about the people without weight as a biomarker and see how they struggle with health… what if ketosis solves a lot of more health problems than just obesity?

  76. Steven Jon Kaplan  May 29, 2014

    This is an especially thoughtful essay which has some fascinating overlap with classic contrarian philosophy. Thank you for your insights!

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  77. Alex Mennen  May 30, 2014

    Nitpick: the chart likely misplaces the appearance of language. You say that the best evidence suggests that language first arose “about 50,000 years ago”, but the source you linked to says that fully developed language was in place by “at least 50,000 years ago”, and possibly much earlier. The time of the first thing that the article describes as a possible sign of language use was 2.4 million years ago.

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    • Nona  July 24, 2014

      Alex, I agree with you. I remember something from physical anthropology that the anatomy of homo sapiens shows adaptation for speech. 50,000 years even for “fully developed language” sounds way off, not even an educated guess.

  78. Nicky H  May 30, 2014

    I was actually just wondering about this issue. Since about about the age of 14 I’ve noticed I seemed to approach things much different to others. I think genetically I am predisposed to be a critical thinker but a point
    I would like to raise is reading. I’ve heard that the human brain in the process of reading a story will actually associate itself with what is happening – basically, in a way your mind is shaped just as though the story happened to you. Not sure if there is any scientific research to back that up.

    While in itself not relevant, what happens when you step into the shoes of a critical thinker through story? Coincendatally at the age of 14 is when I really got into reading, specifically books that usually had a very observant but neutrally bias major character. Books like stranger in a strange land (an incredibly interesting book), vertical run, Robison Crusoe etc.

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  79. Jeff Johnson  May 31, 2014

    Relative Risk(mathematical puke)
    There are a couple things about this post that bother me –

    I do not care for the idea that I evolved from a monkey – I don’t like monkeys – their ugly – their stupid – they have tiny penis’s and for some unfathomable reason scientists like to study them

    on the other the hand I’m okay with evolving from a horse – I’m okay with being hung like a horse – but hey – that’s just me and for that matter every other male on the planet who’s fine being a male –

    Aside from these distractions – something else is on my mind –

    and it’s Relative Risk or Mathematical Crap – because that is what it is – it has zero useful function – zero reason for exixting –

    and yet it is used in almost or every scientific study done – why – why – Why for Godsake – Why ?

    Because apparently scientists who do studies are really Idiots –

    So if smart people can not Think Critically – where does that leave the rest of us ?

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    • Nona  July 24, 2014

      we did not evolve from monkeys! they are a completely separate branch in the primate family tree!!! Argh.

  80. Yasmin  May 31, 2014

    Since we’re all not wired to think logically, allow me to point out a huge bias in your article:

    Eastern philosophies existed before Greek philosophy, yet Westerners always jump towards Plato and Socrates and others of their ilk.

    It’s even more disturbing that you’re writing about eating a curry whilst absolutely ignoring non-Western milestones in evolution beyond vague, “humans first acquired language”.

    I really like your work but if I start seeing more outdated anthropological approaches to explaining humanity (such as the caucasoid/mongoloid/negroid pseudo scientific classifications of humans), I will stop coming here.

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    • Peter Attia  May 31, 2014

      Get in the arena, my friend. https://www.youtube.com/watch?v=8-JXOnFOXQk&feature=youtu.be
      If you can’t make time to watch the full 22 min, be SURE to watch from 7:00 to 9:00, ok?
      When you’re in the arena, alongside me and not up in the cheap seats, let’s discuss your feedback. Otherwise, I have no time for your criticism.

    • Yossi Mandel  June 2, 2014

      That last paragraph is a classic straw man. Well done.

      To the point, let’s say that Eastern philosophy was successful in teaching people how to relax and handle what is, Western philosophy was successful in teaching people how to challenge who they are and what they know and become more than what they are. Eastern produced inner peace and stopped there, Western philosophy evolved to science and the scientific method. I’m Jewish, and I don’t mind Peter describing evolution that way without including Jewish philosophy that predates both Eastern and Western, because Jewish philosophy didn’t evolve into anything else either (or if you will, Jewish philosophy is about the person evolving themselves into something more than what they are, nevertheless not what he is talking about). Take his arguments on their merit, they don’t have to involve our personal lives.

    • Nina  June 3, 2014

      Yasmin,

      Such a silly & ungrateful comment.

    • Rana  June 7, 2014

      Amen to this comment.

    • Nicky H  June 14, 2014

      There are differences between the races though…

      The easiest and most blatantly obvious is color. In reality it would be better if we could break it down even further to more specific groups of people. That way a doctor could put you into for example Caucasian Class C based on some type of test. People during the majority of our evolution experienced infrequent contact with other groups and logically would share many of the same genetic traits with people of the same group.

      A doctor could than recommend a diet/lifestyle that minimizes potential risks based on studies of people with the same genetic markers. Societies that first begun drinking milk can digest lactose is a good example where this would be handy.

  81. Kelley  June 2, 2014

    For us layfolks, here’s a good article on how to read and understand a scientific paper. (I enjoyed your essay, Peter, and posted a link to it on my FB page, where it prompted a spirited discussion.)

    http://violentmetaphors.com/2013/08/25/how-to-read-and-understand-a-scientific-paper-2/

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  82. Betty Jo Brenemen  June 2, 2014

    Very intriguing article and comments! I will definitely read it several more times. Perhaps it will entice me to stop and think the next time I experience “pain of independence,” perhaps the same phenomenon psychologists refer to as cognitive dissonance which is, indeed, an emotionally painful experience.

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  83. Richard Greenberg  June 2, 2014

    For some thought-provoking and humorous graphical examples of coincidental “spurious correlations”, see http://www.tylervigen.com/ . (I am not affiliated with that website in any way.) There’s a nice 3-minute video at the bottom of the page, discussing correlation vs. causality.

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  84. Jonathan Christie  June 2, 2014

    Splendid blog, thank you! But It’s left me with a nagging concern …

    I’m a 30-year insulin-dependent diabetic, 68 years old, with an HbA1c of 5% on Dr Bernstein’s lowcarb diet. My doc insisted that I statin my high LDL-P. I counter-insisted on an EBCT which showed my coronary artery calcium score is zero, same as it was 6 years ago by CAT scan. No calcium, no plaque, and since this is an enduring result, probably no fast-growing popcorn plaque either.

    If I’ve understood your cholesterol series correctly, LDL-P is a risk factor and whether it’s a cause or correlation has yet to be established. Why does my doc recommend a hazardous treatment for my risk factor without first testing for atherosclerosis? It’s grossly unscientific.

    Why do I, an extremely high-risk non-patient, have no plaque?

    You said early in the cholesterol series that little attention has been paid to fostering endothelial health. I’ve made every effort to foster my enothelial health. I take a gram of vitamin C every day – Linus Pauling pointed out that saturating the body with vitamin C completely cross-links collagen, leaving no open bonds to attach to and trap LDL beneath the endothelium – “Long-term ascorbic acid administration reverses endothelial vasomotor dysfunction in patients with coronary artery disease” Vita 1999. I take Epsom salts baths – “High magnesium intake is associated with lower concentrations of certain markers of systemic inflammation and endothelial dysfunction” Liu 2009. I take fish oil supplements: “Supplementation of omega-3 fatty acids significantly improves the endothelial function” Gu 2012. And so forth. Maybe, just maybe, post hoc ergo propter hoc –

    25% of Americans take in no detectable w-3 Dolecek 1991, Hampl 2004 found one in three Americans to be depleted of vitamin C, and “68% [of Americans] consumed less than the recommended daily allowance (RDA) of magnesium” Woolson 2005. So it’s plausible that the fellow traveler of Keys’s wanky cholesterol numbers are nutrient deficiencies which actually cause atherosclerosis. Lowcarb avoids empty calories and lowers insulin which could help – but what if the underlying defect is nutrient deficiencies?

    I urge you to make discovering the determinants of endothelial health a priority for NuSi – the alternative of optimizing risk factors is like rearranging the deck chairs on the Titanic, as though Francis Bacon never lived.

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    • Kelley  June 2, 2014

      Richard: Have you had your thyroid hormone tested? I put together the following document (text lifted entirely from other sources, both cited, one of which is Doc Bernstein) for my husband’s doctor. Hubby is a type-1 diabetic, diagnosed at age 4 (he’s now 51). He’s in great health, but just recently had his LDL-P tested for the first time. It was very high. All other blood markers are good. In the next round of blood tests, he will have thyroid tested.

      “Sometimes, months to years after a patient has experienced normal or near-normal blood sugars and improvements in the cardiac risk profile, we will see deterioration in the results of such tests as those for LDL, HDL, homocysteine, and fibrinogen. All too often, the patient or his physician will blame diet. Inevitably, however, we find upon further testing that his thyroid activity has declined. Hypothyroidism is an autoimmune disorder, like type 1 diabetes, and is frequently inherited by diabetics and their close relatives. It can appear years before or after the development of diabetes and is not caused by high blood sugars. In fact, hypothyroidism can cause a greater likelihood of abnormalities of the cardiac risk profile than can blood sugar elevation. The treatment of a low thyroid condition is oral replacement of the deficient hormone(s)—usually one pill daily. The best screening test is free T3, tested by tracer dialysis. If this is low, then a full thyroid risk profile should be performed. Correction of the thyroid deficiency inevitably? corrects the abnormalities of cardiac risk factors that it caused.”

      Source: Dr. Richard Bernstein’s website, article “Recent Developments Regarding Risk Factors for Heart Disease, Part 2”

      ==========================================

      “Poor thyroid function is another potential cause of elevated [LDL] particle number. Thyroid hormone has multiple effects on the regulation of lipid production, absorption, and metabolism. It stimulates the expression of HMG-CoA reductase, which is an enzyme in the liver involved in the production of cholesterol. (As a side note, one way that statins work is by inhibiting the HMG-CoA reductase enzyme.) Thyroid hormone also increases the expression of LDL receptors on the surface of cells in the liver and in other tissues. In hypothyroidism, the number of receptors for LDL on cells will be decreased. This leads to reduced clearance of LDL from the blood and thus higher LDL levels. Hypothyroidism may also lead to higher cholesterol by acting on Niemann-Pick C1-like 1 protein, which plays a critical role in the intestinal absorption of cholesterol.
      “Studies show that LDL particle number is higher even in subclinical hypothyroidism (high TSH with normal T4 and T3), and that LDL particle number will decrease after treatment with thyroid hormone.”

      Source: Chris Kresser.com, “What Causes Elevated LDL Particle Number?”

    • Jonathan Christie  June 3, 2014

      I should add that “In most hypercholesterolemic persons with a low vitamin C status, the administration of ascorbic acid in doses 500-1000 mg per day lowers total cholesterol concentration” (Ginter 1982), and that low magnesium intake raises cholesterol in animal studies, and giving 395 mg of magnesium for six weeks “was apparently effective in reducing blood total cholesterol and LDL-C, and also in decreasing lipid peroxidation in [42 human] hypercholesterolemic subjects” (Fu 2012). It’s common knowledge that fish oil supplements reduce triglyceride levels but perhaps less well known that increasing sugar from 5% to 18% of calories for six weeks elevated cholesterol by 20% in men, and in the group fed 33% of their calories as sugar, cholesterol increased by 31% (Reiser 1980).

      Cholesterol responds to dietary improvement

  85. Kelley  June 2, 2014

    Correction: I meant “Jonathan, have you had your thyroid tested?”

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  86. Jonathan Christie  June 3, 2014

    Wow Kelley that’s interesting!

    I’ve been hypothyroid since I got diabetes, I take 3 grains of Westhroid per day. This year’s test showed:
    TSH = 0.81
    T4, free = 1.2
    T3, free = 6.5 (H)

    But I’m not sure it’s been established that high LDL-P is a risk factor in low-carbers …

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  87. Ralph Doncaster  June 4, 2014

    Great blog!
    Just yesterday I was feeling a similar frustration about people not seeing the logical fallacies in their ‘beliefs’ even when I point them out and explain the fallacy. Straw man, argument to authority, and added hominem attacks are soo common.
    I also found it interesting how you learned logic and critical thinking – i was lucky I guess to be born with it, much to the chagrin of my devout catholic mother. 🙂
    Nice reading list. I too am a impressed with Feynman, especially his enthusiasm with educating people who will probably never understand the concept of a position being an electron traveling backwards in time.
    I’m also a fan of Malcolm Gladwell. Although Khaneman seems dismissive of Blink, it explained how we think in two ways well before he finished writing ‘Thinking, Fast and Slow’

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    • Jason  June 10, 2014

      People often employ the classic fallacies as rhetorical flourishes(and have for like…. forever). If you consistently disregard or criticize peoples points because they use the vernacular they grew up with, you come off as nit nit-picky. Right or wrong If you encounter a skilled communicator in a competitively environment they can use that need to correct against you.

  88. Andis  June 6, 2014

    Thanks, Peter!
    Just red “You Are Not So Smart” by David McRaney and started “You Are Now Less Dumb”. Good read about functioning of human mind.
    Interesting book is Robert O Becker “The Body Electric”. Besides descriptions of his research, Becker gives insight how mainstream science is shaped by personal intrigues, commercial and military interests.
    On a lighter note I’d suggest Terry Pratchett “The Truth”, very cool allegory on mass media.

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  89. Rana  June 7, 2014

    I haven’t taken the time to read all of the commentary, so this may have been posed already. Dr. Attia … I find quite a number of holes in your logic and reasoning. Your position is one of an elitist. Wow. You suggest that mankind didn’t discover how to think with logic and reason until the sciences of logic, reason (the Scientific Method) were established? Really? You believe that mankind evolved by mimicking? You’ve suggested that very few human organisms had the ability to directly adapt to the environment (by making cause and effect observations) and the rest of us have evolved by mimicking the chosen few. I suggest that evolution would have come to a screeching halt if that were the case. … OH! but it nearly has! The mimicking that your friend suggests that we are hardwired for is happening now. The majority have become hardwired for mimicking because of our current state of devolution. I’d suggest we (all) look at the role of the brain’s Pineal Gland. Could it be that this gland is the physical structure that every human has that serves the purpose of converging intuition with logical thinking and reasoning. I suggest that the loss of the use of the Pineal Gland among the masses has led our brains to rewire to imitate. I suggest we are hardwired by evolution to think logically when making observations and to adapt accordingly … but we’ve succumbed to the forces which serve to render the Pineal gland, minimally operable. Furthermore, the myriad of forces all fall under man’s adaptation to man’s inventions and away from a dynamic adaptability with the Earth. (Perfect example is our current position of trying to adapt to the food industry environment and yet wondering why degenerative and autoimmune disease is on the rise.) Lastly, I suggest that the ‘invention’ of the scientific method is simply an evolutionary measure of the time that our species reached the realization that in order to share observed findings with each other (among subgroups), with the purpose to push humanity’s evolution, we needed to agree on a standardized method of obtaining “truth” so as to share across language and thought barriers. The advent of the scientific method, in NO WAY, renders truth finding by all humans as inferior. Again, it is merely the way that we measure and share what really seems to be working (at least for the time at hand).

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    • Jonathan Christie  June 8, 2014

      Rana, I couldn’t agree less!

    • Rik Ganju  June 8, 2014

      Rana, I’m afraid your post is not finished. There is a great deal of study that’s been done (and still being done) on Stone Age peoples, for example – one doesn’t need to speculate about them. So go ahead and tell us if their most cherished truths are derived from logic, reason and primary observation as opposed to imitation, habit and tradition. And this does not have to be logic or reason in its modern formulations. Tell us what you know about greater activity in their pineal glands for those who’ve left their tribes and made their way to fMRI or MRI machines. If not the Stone Age, where and when specifically was this golden age of the pineal gland, and what initiated the degeneration?

      The claim is that the brain is oriented towards imitation. ‘Oriented towards’ does not mean ‘limited to’. I’m happy to be wrong about this, but you’ll have to do a little more work to establish your point.

    • Jonathan Christie  June 10, 2014

      Peter’s post is about Rana’s thinking

  90. Razwell  June 7, 2014

    Hi Dr. Attia

    You are right. We evolved to avoid lions etc. on the plains of Africa, not to understand the universe. We have to work at science.

    A lot of the time, what the universe is telling us does not appeal to our common sense notions. Sometimes, in science, common sense goes out the window. It is what the universe is telling us that matters. In science, we have to make our views conform to the evidence from reality.

    For instance, the universe appears to be governed by quantum mechanics. We are not wired to understand this. Nonetheless, it is what reality is telling us. Replicated A1A quality experiments confirm it.

    The gift of science is that it makes us uncomfortable. This makes us challenge our beliefs and leads to learning.

    Having said all of that, science also has limits, We may forever be limited in the questions we can ask or what we can know about the universe and nature because there may have been extremely ,important observables 5 billion years ago that we missed that we essential to see. Billions to trillions of years in the future, beings around at that time will look out into the universe and see what we saw pre 1925, never knowing what we know now- as the galaxies will have disappeared expanding faster than the speed of light away from us- all evidence of the Big Bang gone. We live at a very special time in the universe- the only time we can observationally verify that we live ata special time. 🙂

    Take care,
    Razwell

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  91. Chris  June 11, 2014

    it’s no reason why the mirror neurons in our pre-motor cortex and our powerful ability to emphasize…powerful article Doc, thanks for the references!

    and to contribute:
    Daniel Lieberman – The Story of the Human Body

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  92. Rana  June 12, 2014

    Rik,

    I concur that my post is not finished. I am but a novice.. and not in academia. It would be interesting to have the folks over at Univ. of New Mexico’s Evolutionary Psychology department weigh in on the matter. Seems to me that imitation has served the proliferation of our species. However, differentiation (aka evolution) does not happen by imitation. We’ve come a long way, baby. Could it be that the “pain of independence” was wired in as a survival mechanism at a time in our evolutionary history when torture and death was a predominant means for power and control (not that it still isn’t). In “free” society … numerous mechanisms are theorized to calcify the Pineal Gland. These include both measurable and non measurable variables. Examples are fluoride, sugar (and all inflammatory foods), 24/7 artificial light, EMF as well as fear (dogma, religion, etc.). For me … fascinating questions.

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    • Jeff Johnson  June 13, 2014

      I’ve been warned about alluding to the sorts of things I’m about to explain – regardless –

      The qualities of the soul – are hidden – they are sacred – they are the heart of God – they are revealed naturally too but a few –

      That said – anyone is free to pursue whatever they can find – by any sane or reasonable means – but ascetic practices in search of such knoweledge is a dangerous path at best –

      The Chakra’s – the energy centers of the soul – are or have a covering over the top of thema veil – this veil must be rendered to see what’s inside the Chakra’s – if one can do so – then they have seen a part of god or his hidden creation –

      It’s not that your seeing God – but whatever you do see or hear is Sacred – thats the deal of it – plain as anyone will evr tell you –

      Many people who experience the rising of the Kundalina energies from the widened base of the lower pelvis – are afraid of a little noise (this can be loud) or the blinding white light seen as kundalina passes thru the eye Chakra and out the top of the head –

      Strange that people would fear something so profound ?

      Natural Seer’s are often born with Mars conjunct the Sun -( these energies of Mars combined with respiration(the Sun) produce just the right type and amount of energy needed to help render the veil – the veil can split or part – the veil can spin about a billions miles per hour and therefore open and most probably the veil can open in many ways – or visually(assuming your lucid enough to see it or it can open with yourself being mostly unawares it even happened –

      The anology in the Bible – the verse about circumcision – is actually speaking about these veils covering the Chakra’s – the anology in this regard being the skin(veil if you will) covering the end of the penis being removed and the veil covering the Chakra being rendered so as see the hidden realm of God –

      That verse – has nothing to do with recommending actual circumcision – but is simply an anology as already explained –

      The author of the verse knew full well what the anology meant (I assume) – and apparently also had a wicked sense of humor( a desire that blood be spilled for reasons that perhaps I best not explain except to say that some few beings use this blood to stay earthbound – if they do not remain earthbound then they are swept into a final hell of no return – it’s either finding a way to remain earthbound or a certian and final extinction

      Needless to say this is just the opposite of what ordinary people desire –

      This is not the same thing as eating meat (at least there’s a difference)

      So the Jews – and not being at fault really – have believed for thousands of years something completlty false (actual circumcision) – when the truth of the matter ( an analoly in bible verse) – is something simple but very different

      The development of the Qualities of the soul – (this being something very difficult at best) – is about enregy – the type of energy – the control of this energy and various ways these processes may be improved

      The Yogi spends eight hours a day working on just this thing – and does it for sixty years and rest assured that
      even with this amount of effort – results are not a given

      It’s a job for most people – it’s not a whim – it’s not a dream –

      Most do not have the time for this sort of thing – but know this – the Chakra’s and Soul Qualities express themselves from time too time – you don’t have to see or hear them but it happens anyway

      When the Jesus of the bible was taliking about Talents – he meant the Chakra’s – and these Talents express themselves in all ways – you don’t have to be a Seer to search for the truth – just a searcher in whatever field you desire and there are many fields and many many crops to harvest

      A few words about the Schizophrenic – do not assume what they see or hear as hallucinations –

      there are many beings in the hidden realms who like nothing better than hurting those they can and most people are not bothered by these beings or thankfully they can’t see or hear them

      The truth is a curious thing – there are people who know and apparently people who don’t – as for me – I am under no constraints of most kinds – yes – even I have to follow a couple of rules –

      But I haven’t related anything that a thinking person could not figure out on there own – just talking a little shop as it were

      I was trying to leave the reader with a perspective perhaps they did not have before – about how certain things work –

      And give the Jewish people some information they should or might give heed too – because no one else will

      Anyway – while walking to the mailbox – I pass my Anemones growing along the path – there just something else –

    • Rik Ganju  June 15, 2014

      Thanks

  93. Darren  June 13, 2014

    Great blog post, Dr. Attia. I’d recommend “The Glycation Factor” by Dr. Greg Ellis.

    It contains a very good outlay of how the current medical establishment got the power it has today and has marginalized other types of medical understanding. It also explains why we are so backwards about fat and carbs. It has a very nice explanation of how so much of our research reporting is screwed up because of Relative Risk Analysis.

    Dr Ellis is pretty unique and can come across pretty strong in the book but it is because he was (and is) a researcher for over 40 years who was held back from knowing the truth for a long time by all this confusion. He makes a good point that doctors are not generally going to be the ones who know things, researchers are. The book is also a bit repetitive at times, but it is still invaluable to my understanding of all the things you just blogged about.

    Keep up the good work, sir.

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  94. Jon D. Gilmore  June 15, 2014

    No slam intended towards the author, but I found it quite funny to see this article’s first comment included a desire to “mimic” a coffee recipe. That’s all…

    …interesting article, thanks!

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  95. mary scriver  June 16, 2014

    I appreciate this discussion very much. I live in a little village on the edge of the Blackfeet Reservation in Montana. The people of the village (Valier) were brought here from Belgium as a coherent transplant of most of a village, escorted by their priest. They are wheat farmers dependent on an irrigation project which was the reason for bringing them. They suffer from morbid obesity and diabetes.

    The people of the reservation (whom I have known for fifty years, some of that time as their English teacher urging them to think) also suffer from morbid obesity and diabetes. Their genetics are nothing like Belgians’. Their favorite foods are boiled meat (historical) and fry bread (a-historical). But they love sweets.

    The Belgians on this side of the line also love sweets but are more likely to bake fancy cakes and pies and also include potatoes.

    I was diagnosed with diabetes II about five years ago and immediately eliminated sugar from my diet, plus most carbs. Fifty pounds dropped off me almost in a matter of months and over the years my face and neck have thinned and tightened. I was super-conscientious because I am a writer and need my eyes, but I neglect exercise because I sit here and write all day. My blood glucose figures are okay. I’m 75.

    I’ve been interested in two factors about thinking. One is that the copycat effect is VERY strong on this Belgian side and I have to be careful not to be demonized by my differences. (I am a U of Chicago Div School grad, do a lot of thinking about post-theist patterns, and don’t much care what I look like.) These are dry land farmers who succeed because if one does well (Ugg) they all do what he did. Get fancy and you’re likely to be in trouble. Lots of cautionary tales.

    The Indian situation is quite different. They are splintered into political subgroups and right now unable to form a consensus. Outsiders take advantage — everyone has a special little deal that will make them rich. But the successful ones closely watch “white people” and do what they think they do, but don’t get the same results. They dress like white people (except the kids prefer black ghetto people) and go to college like white people, where everyone treats Indians like some kind of noble separate species, and it never turns out right. Many die young — like in their sixties. I go to the funerals of students were who NOT drunks, NOT reckless, not even fat.

    I think a lot about the stages of maturation of brains: the post-birth blossoming, the long adrenarche, adolescents and THEN the prefrontal cortex development of the early twenties — AFTER college and military service. That is, what the prefrontal cortex is good at is not timed right.

    There’s another factor. A white man asked me why the Indians here didn’t bury their dead. Clearly he is thinking of some kind of arcane theological principle. The plain fact is that this is glacial till, mostly, and without a metal shovel and a spud bar, it’s pretty tough to dig a hole. Also, the altitude is in the mid-thousands which means that ultraviolet light is strong enough to eliminate most germs. You can have all the theories you want — if you don’t come here and LOOK, it won’t be a valid experiment.

    I do SEE that pain in the amygdala from being different. (I don’t feel it much because I have friends like me.) But the failure to think is a big pain in the butt.

    Mary Scriver

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  96. mary scriver  June 17, 2014

    Two additional thoughts. One is about statistics which was taught in two halves when I took it. I took the first half three times before I got it and could pass an exam, but then the one prof who could explain it retired. I never took the second half. But that first half was VERY helpful. I wish that these studies and media reports would always include raw numbers instead of merely percentages. 1% of 500,000 is quite different from 1% of 100. So many of the more sensationalist reports are based on small actual numbers.

    The other thing is for your reading list. My original training was in theatre/acting, where we were taught to inhabit a mind and personality. When I read a scientist or theologian, I start with a biography.

    When the seminary profs complained about many of us not knowing how to do evidence and precedent rational thinking, I went over to the bookstore and in the “history of science” section found the work of Stephen Toulmin. Rounding up all his books, I spent a week marching through them. I also took his class for a few weeks but had to withdraw because he was too difficult to absorb by listening. Here’s a diagrammatic skeleton I wish I’d had then. http://www-rohan.sdsu.edu/~digger/305/toulmin_model.htm

    Mary Scriver

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  97. TJ Denehy  June 18, 2014

    Sir I just wanted to let you know that I stopped 4 times to put my phone down in excitement about my discovery of your blog. I would like to say thank you so much for what you do.

    “Healthy debate is a wonderful contributor to scientific advancement. Blogging probably isn’t.” I disagree with this your blogging has helped me understand so much about the discovery of new information, scientific thought, brain changes, copy catting, etc!!!

    I want to know if you think that your discovery of the brilliant person you are today is not in line with your understanding of evolutionary copy catting your mentors versus you just being a intellect hungry pain enduring superstar.

    I’m not the greatest writer so don’t take anything I wrote wrong. Also I’m currently at work, but I just wanted to drop in and tell you you are amazing thanks for doing what you do.

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  98. Mark  June 22, 2014

    In your table, you forgot: Year 5, Facebook

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  99. jennifer  June 22, 2014

    For the past 6 mos, I have done whatever possible to stay within 50g of carbs. I must say, after having a lot of blood work done, that my tryglicerides are down to 35 and my doctor was alarmed. I have also experienced a few episodes of dizziness and what felt like potential feiting spells, which also through me into a panic. could you offer any adivise? Should I go back to eating more carbs? I am a bit at a loss.

    thanks you kindly,

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  100. Cindy  June 23, 2014

    Steps I’ve taken since reading this post:

    1) Downloaded ‘Thinking Fast and Slow’. I’m on Chapter 6. Awesome. Sharing my enthusiasm about it with friends who are generally scientific thinkers but need to bolster their evangelism.
    2) When a friend ranted about how misinformation spreads so quickly on the internet I pasted your reading list in the comments. He loved that. Again this action was “preaching to the choir”. But maybe it’ll be a better choir now.
    3) Very proud of this one: I read the underline study from a health-related headline that two friends had shared on Facebook. That made me realize that both were likely endorsing the headline because it confirmed their preconceived notions about fasting. If you can believe it, one sells fasting related nutritional products! Neat trick. I found a nice way to encourage them to read the underlying study.

    The study itself looked like good science to me (I need to work on this) but if a person wanted to act on it there was very important information in the procedures that would be important to consider. It was in mice! And the fasting period was >48 hours to intentionally induce ketosis. Follow up questions I have now (not for you – just to prove that taking the step of reading the study is so key when reading health news) – could ketosis without a fast get the similar results? Would intermittent fasting get similar results? How does it transfer to humans?

    Again. Thanks, Peter.

    (reply)
    • Peter Attia  June 28, 2014

      Nice work, Cindy. Keep this up and you’ll be able to spot the cream from the crap from miles away. It’s fun, huh?

  101. Chauzie Nguyen  June 25, 2014

    Hello Dr Attia,
    I find you to be an interesting person, a major part of it is because you’re also a cyclist and endurance addict, and a weightlifter (in the context of an endurance athlete). I myself is also a cyclist. I have a few comments/questions:

    1. If i’m already thin, 5’7″ 120 lbs currently (I have dipped into the 115-116 in the past but I would get tired after a hard workout), and all my yearly health stats check out good (all of them), then would a ketogenic diet do me any good or harm? I think currently my diet composition of carbs/fats/proteins is about 40/40/20 (I’m guesstimating). The carbs I eat are mostly from rice, veggies, and fruits. I don’t eat processed simple sugar food. I also try to time my carb consumption so that I eat most of it right after a hard workout, when the glycogen stores are low. Would a keto diet make me any better in performace? I have noticed that my top end power and the ability to do repeated short bursts of zone 5 (anaerobic) suffer a bit when I severely limit my carbs and replace it with fats. My recovery time also seem to be slower with the higher carb restriction too. I wonder if a naturally skiny person like myself would be a poor candicate for a keto diet and still be able to perform well on the bike?

    2. What are the potential pitfalls for consuming a huge amount of fats? I would think if a system is overloaded with something, be it fats, proteins, or sugars,.. this will tax the system, and somewhere down the chain, something must give. Or does fat inflict no harm on our metabolism system? My fear is that 30-40 years from now, science will also say eating too much fats will be bad, just like it is showing what sugar had done. But the lag time is 30-40 years. A side concern of fats is that perhaps not all fats are equal, specifically fats from pasteur-raised versus fats from caged animals. For example, the fats from wild animals have a higher omega3/omega6 ratio than the fats from caged animals. And then there is the issue of caged animals with hormones and antibiotic, and possible processed using too much chemicals/disinfecting agents. I’m concerned that the side-effects of eating products from caged animals won’t be known in an epidemiological scale until 30-40 years later. I’m curious about your thoughts on the sources of fats. Myself, I prefer fats from plants such as coconut fats, olive oil, avocado fats, over animal fats.

    3. Lastly, humans have existed long before the introduction of logics, and then scientific method. We as a species survived quite well without those tools. Perhaps the reason we are not hardwired to not think scientifically is because whatever thinking process our ancestors had, it enabled them to pass on progenies to this day. Interestingly, some of the brightest mind in quantum physics and neuroscience today are turning to Buddhism to reflect the similarities between Buddhist thinking and science, and yet, Buddhism is not something one would associate with logics nor scientific.

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    • Peter Attia  June 28, 2014

      Interesting point, Chauzie. But I would not assume that Buddhism is somehow the opposite of critical thinking. To say we survived without critical thinking is like saying we survived without electricity or antibiotics or pasteurization. Sure we did, but it was a hell of a lot rougher than it is today.
      So critical thinking is a very important part of our evolution. In fact, without it, we’d still be in caves. Could we “survive?” Sure? Would we be talking about bikes and glycogen? Unlikely.

  102. Carol  June 26, 2014

    I am a late career scientist–a biologist. I have lived with and around PhD scientists most of my life. I can tell you that even people who have been trained in and practice the scientific method and critical thinking skills apply these only to their work. The moment they need to make a non-professional assessment or judgement they revert to their primal patterns of thinking. And worse, as we all become increasingly busy, our time stolen by the overly competitive workplace, our sleep stolen by increasing quantity of personal responsibility, our leisure time diminished by the need for do-it-yourself tasking as we prepare for the retirement we have not saved for, and as our brain fog mounts due to the glucose roller coaster that inevitably accompanies the officially prescribed high-carb diet, we succumb to the easier, more natural, patterns of reasoning to which we have evolved.

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  103. Vicente  June 27, 2014

    Hi Peter,
    I found the following video funny and enlightening:
    “Science For Smart People” by Tom Naughton
    https://www.youtube.com/watch?v=y1RXvBveht0

    I suppose you know about that speech, but may be a few of your readers don’t.

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  104. Maximilian  July 2, 2014

    Dear Peter,
    how do you think scientifically when there is no good data? Let me make an example, which affects myself. Would you treat someone with an elevated TSH (~4 mU/l) if he has no symptoms?

    – There is data which shows that high TSH is associated with metabolic syndrom.
    (http://www.ncbi.nlm.nih.gov/pubmed/20447068)

    -There is data that high-normal TSH is associated with associated with a higher CV-mortality and Endothelial dysfunction (decreased flow-mediated dilation).
    http://www.ncbi.nlm.nih.gov/pubmed/19010795

    – But, there is no prospective randomized data (!!!) on the questin of whether or not you should treat non-clinical hypothyroidism.

    Now, high TSH might cause a higher CV-mortality. Or a high TSH might be assoc. with a high CV-mortality without causality. What do you think about the TSH issue? Thanks alot!

    PS: Wearing shirts with the size ‘S’ is assoc. with a low CV-mortality, but in turn buying slim shirts won’t make me healthier.

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  105. Kelley  July 2, 2014

    Adding another book to the suggested reading list: Naked Statistics, by Charles Wheelan. Bascially statistics for the layperson. I came across it while browsing at Barnes and Noble for some of the other books on your list. I’m in the middle of reading it, and enjoying it very much. It’s informative and also manages to be funny. Although I have a bit of a grasp of basic statistics, and a good math brain, somehow I earned a bachelor’s of science degree (30 years ago) without ever having to take a statistics course. Now they’re teaching statistics in better high schools.

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  106. jennifer  July 19, 2014

    Hello Dr. Attia,

    I have just been made aware of the importance of alkalinity and our blood PH being in balance. My question would be, not much about scientific method but more of deductive reasoning, wouldnt following a ketogenic diet also throw your ph into highly acidic levels and thus be detrimental for your health?

    thanks,

    Jennifer

    (reply)
    • Peter Attia  July 19, 2014

      I’ve addressed this a few times in various comment threads.

  107. IamWoman  July 19, 2014

    I think there are some people who are more ‘wired’ to think scientifically than others. We are in the minority, but we exist. We are those who, even as children, and despite our surroundings, still naturally question things, don’t believe what we hear without investigation, explore the hows and whys of things, and who, most importantly, from an early age, eschew the religious and superstitious and traditional-thinking bombardment that starts from birth. Some people are able later to overcome negative nurture with training through education. But the majority of people are wired to be (and remain) sheep and to accept things that ‘feel’ best even if they don’t add up.

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    • Jere Krischel  August 5, 2014

      I think you can break it down by neophobes, and neophiles.

      Neophobes are the “imitators” – they are imprinted at an early age, and simply aren’t willing to consider any other options besides the ones they were indoctrinated into. This can be a militant left-wing guy against guns, or a right-wing bigot against gay marriage, but the key to understanding them is that they simply fear change.

      Neophiles, on the other hand, are open to being wrong about their ideas – a critical feature for scientific thinking. Wherever they might start, however they may have been indoctrinated, they’re willing to imagine being wrong.

      Now, a stable, progressing society probably needs a certain ratio of neophobes to neophiles…after all, it’s the neophile who will head to the river with the crocodile and get eaten, just to see it for themselves, and the neophobe who will listen to the wisdom of the elders and carry on in the face of adversity with staunch faith in their convictions. Similarly, it’s the neophile who will discover the new technology that jumps efficiency forward, while the neophobe stagnates in place.

  108. Jennifer  July 19, 2014

    Thank you Dr Attia,

    I will go back and look for it. My concern came after i had been following a ketogenic way of eating for about 7 mos and tested my PH after a Tony Robbins seminar and was at 5.75. 3 weeks after going off, doing a cleanse and started to eat mainly alkaline foods and no meat flesh or caffeine, I am at 7.25 and feel pretty good.

    I will search through your blog for the thread, nonetheless

    Best

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    • wukang  August 2, 2014

      Jennifer,

      The PH data you got, are they from urine test ? fasting or after the meal ?

      Thanks!

      kang

  109. jennifer  August 6, 2014

    Wukang,
    they were from urine tests with PH strips done at the same our in the evening for 5 consecutive days. After I did the juice detox cleanse and only ate salmon, fish, no dairy products or animal flesh,veggies and fruits for 2 weeks, I went to 7-7.25 and it has pretty much stayed in that level.

    Best,

    Jennifer

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    • wukang  August 6, 2014

      Thanks Jennifer.

      So it is measured 2-3 hours after the dinner I suppose. I’am constantly getting to 7 as well during that period.

      My morning fasting values are not good, 5.5 to 6 regardless of what I eat.

      kang

  110. jennifer  August 6, 2014

    so for the typo…at the same hour..

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  111. jennifer  August 13, 2014

    You are welcome Kang, if I may ask, what are your ketosis levels? and I will take my ph upon waking to see the variation. What I am having a hard time with is maintaining balance in my PH levels and ketosis above 1 ;((

    Best,

    Jennifer

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    • wukang  August 15, 2014

      Jennifer,

      My keto levels are below 1 most of the times. When it gets too high (like 1.5 to 2), I have heart palpitation.

      I found it very hard to increase the morning PH, let me know your morning levels.

      kang

  112. Solo Solus  August 14, 2014

    We are generally taught what to think; not how to think.

    Personally I’ve found the work of the philosopher Ayn Rand to be helpful in developing a rational method of thinking.

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  113. Dave Stafford  September 11, 2014

    I find it very ironic that people who are overweight are considered lazy for being so when their is such and overwhelming metabolic force pushing them in that direction and yet the very people who make that assertion refuse to even attempt the task of acquiring the ability to reason. Becoming more intelligent, increasing ones ability to question everything to resolve problems to constantly seek a greater truth really is a choice, sure its not effortless but it really is just a choice and I argue that the pain of going against the norm is pale in comparison to the pain of restraining ones self from a second helping of carbs.

    As for learning reason, anyone who has a massive amount of time and just needs the direction, the great books series curated by Mortimer J. Adler will get you almost everything you need particularly if you have a person or two willing to read along with you and have “what did Aristotle mean by that and how would that apply today” discussions. I had the very good fortune of having several logic mentors in my schooling but none was more helpful than my own nagging questioning of every piece of ‘conventional wisdom’

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  114. Matthew Duhamel  September 14, 2014

    This is something I’ve been thinking about a lot recently, especially in regard to stratifying risk rationally. I’ve been to the ER serveral times recently for chest pain only to be told after multiple tests (3 week holter, stress test, heart echo, numerous troponin and cholesterol tests) that they are entirely convinced it is some kind of combination of muscle pain from hunching at a computer a and anxiety. That being said, I’ve done just enough reading about the tests to know they’re not 100%, but not enough reading to really understand what that means for me. The result being that I am extremely anxious about any sort of physical activity to the point of panic attacks and for the last two weeks I’ve been confining myself to my apartment.

    Apart from getting a therapist – which I’m working on doing (just lost my minimum-wage job so I have very little money – can you shed any light on how I can reshape my thinking in regards to percentages of risk? I need to figure out how to look at this data and perceive it so that I feel safe taking a walk or doing some pushups.

    I also have a general question about reversing risk factors. I’ve been Class II-III obese for most of my life (Probably 7 until now at 28), is it possible for me to get to a point of athleticism where my essentially I can undo the risk percentage increase caused by my childhood and teenage obesity, or am I like a smoker quitting at 30 where the damage is done and the lives lost have already been taken from me?

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  115. Jon  October 12, 2014

    Had your dinner with Rik occurred earlier in time, this could’ve been your first entry on the website. As is often the case, well written.

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  116. Denise B.  November 6, 2014

    Having just stumbled across your TEDMed talk on insulin resistance and obesity and from there your website, I’m not contributing to this discussion per se but rather saying “thank you.”

    As a beginning nursing student (mid-life career change), your comments about compassion toward patients truly hit home and will be on my mind as I work with patients in the future.

    As the mom of a six year old homeschooler, this particular article will (when the time is right) contribute greatly to his development of critical/scientific thinking skills. And it will add to my own skills now.

    Looking forward to exploring more on your blog but just wanted to take a moment now to let you know you are still creating ripples in the pond. Take care.

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  117. Jared Lynch  November 25, 2014

    Peter,
    You might be interested in Rene Girard and his work. Specifically, his philosophical idea on Mimetic Desire. Long story short…he argues that we obtain our desires from witnessing the desires/objects of others. We know a certain pair of shoe exists only when we see them worn on someone else. Hence, our desire is derived essentially someones else.

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  118. Brent  December 12, 2014

    Thanks for your informative blog! This one touches on a subject I have been interested in for a few years, spurred by a similar situation you described at the beginning of your piece. Some would argue that logical/clear/critical thinking is how the human brain normally functions. It is only when the process of learning, stemming from natual curiosity, is interrupted in some fasihion that throws peoples thinking off, later in life.

    I know I am a late comer to this blog, and maybe someone else has brought the following ideas to your attention. If your interested in the above possibility, I would recommend a series of interviews concerning the trivium. http://www.triviumeducation.com/interviews/start-here-gene-odening-interview-part-1-the-trivium-method-049-video/

    Thank you again!

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  119. BG  December 24, 2014

    “Who Is Rational?” by Stanovich

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  120. Jack S  December 26, 2014

    The quickest starter kit to critical thinking is “Your Deceptive Mind” – a course by Steven Novella. Steve is a fantastic teacher and a carrier of the scientific method torch of our generation. Also a neurologist.

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  121. Allen  January 5, 2015

    Thanks Peter. I’ve just discovered your blog and I’m already hooked. As a health/fitness enthusiast, I enjoy reading research papers that investigate the health claims of various supplements however it can be very time-consuming. If you haven’t already discovered http://www.examine.com, check it out. It essentially unlocks all the research behind (virtually) every supplement on the market and delivers the scientific evidence in an unbiased and (importantly) easy to read format. It also has direct links to all published research that it references if you want to do further investigating. Cheers!

    (reply)
    • Peter Attia  January 6, 2015

      Yes, it’s a pretty good site!

  122. Kurt E. Walberg  January 6, 2015

    Check out “The Art of Tracking: The Origin of Science” by Louis Liebenberg, free download available at
    http://cybertracker.org/tracking/tracking-books/276-the-art-of-tracking-the-origin-of-science. Also Brain Rule 12 of John Medina’s “Brain Rules.”

    Both of these books seem to refute the idea that scientific process, rigorous logic, and rational thought are not innate to our species.

    Liebenberg posits that the scientific method originated on the savanna in Africa while our ancestors were learning how to survive by tracking and killing wild game. Of course, they would not have called it the scientific method, but it appears that the process has developed over a much longer period of time than we have had the words with which to describe it. Same for Medina’s brain rule number 12: “We are all powerful and natural explorers.” He describes his two-year-old son’s process of learning as paralleling the scientific method.
    My view is that our forebears experientially embodied the scientific method: forming a hypothesis, testing it, observing whether it worked, and then revising the hypothesis to fit the new information. Naturally, people copied the things that worked and didn’t copy the stuff that didn’t work.

    That we have only recently named, systematized, and formalized the process does not mean that it did not exist until we named it.

    I happily and enthusiastically agree that our brains did not develop by reasoning from first principles, whatever those are. First principles, and the like, are a gloss or overlay on experience, so we necessarily have to get burned a few times before developing the first principle that “hot things burn us.”

    (reply)
    • Peter Attia  January 8, 2015

      Thanks for recommendation.

    • Louis Liebenberg  May 28, 2015

      You can download a free eBook of an updated version of my theory on “The Origin of Science” at http://www.cybertracker.org/science/books
      best regards, Louis Liebenberg

  123. lchf by the sea  February 4, 2015

    hello to you all;

    on a first note i would like to start by saying that to much ketosis produce this kind of articles ( way ahead of the worries one as on is mind on a daily basis) where one can expect a broad discussion going on from this topic; and on a second note to go in nutritional ketosis will deliver as a result to no longer mimic and start your own production of reasoning!

    sure…that’s what i expect and foresee for myself.

    finally , i have this doubt: learn by doing, taking the real experiment, is that mimic or the start of a scientific reasoning?

    congrats for the blog

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  124. G  April 8, 2015

    Thanks for your excellent posts Dr.Attia. Reading this one brought to mind a book I recently read that seems to strengthen your argument. It’s “The Rational Animal” – Douglas T. Kenrick & Vladas Griskevicius (http://www.amazon.com/The-Rational-Animal-Evolution-Smarter/dp/0465032427). The authors make a claim that although many human behaviors do not seem rational, they very well may be if you look at them through the lens of evolutionary physiology. In particular there’s a chapter which makes a case for why statistics are ‘difficult’ for our brains to understand but if the situation is phrased differently it can make perfect sense (and why an illiterate Peruvian amazonian tribe was better at a stats quiz than Harvard students). 🙂 Cheers. !!G

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  125. Jeff Johnson  April 17, 2015

    O Canada!
    Our home and native land!
    True patriot love in all thy sons command –

    3:00AM I sit hear looking at my bare right foot – my already too high top of my instep has a lump or bone spur on it – humm ——— no wonder it’s so freaking hard to get my ski boots on –

    Hard lump 2 1/2″ above and right of my groin – doctor say’s hernia – I ask him what causes the hard lump – he just stares at me like a deer in the headlights –

    I figure since it occurs at the end of my small intestine – my large intestine may be to full preventing food leaving my small intestine and causing my small intestine to bulge (and therefore the hard lump –

    My doctor concurs and say’s – yes – ” I really do think your full of shxt ” –

    You betcha and dontchaknow – this hernia hard lump thing can last as long as four hours – your too sick or tired to move – too sick to get in your car and drive to the emergency room – so you just sit there or lay there and wonder if your dying or passing a kidney stone or your appendix is having an erection (the hard lump) – then during this time you throw-up twice and have two bowel movements –

    This happens like one time a month – I don’t wont the operation because I would have to stop exercizing for month –

    It:s now 3:24AM – dontchaknow

    So – If ? I catch it (hard lump) – early enough – I can usually massage it away –

    and – If I pop three Advil – three Tizanidine and three Hydrocodone – the hard lump just goes away –

    Which leads me to think that some sort of muscular bindment or contraction is happening to my small intestine –

    Since no one seems to know what causes a hernia – I’m left thinking up reasons or the cause on my own –

    O Canada, we stand on guard for thee.
    God keep our land glorious and free!
    O Canada, we stand on guard for thee.
    O Canada, we stand on guard for thee –

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  126. Trent Yeo  June 25, 2015

    Great article. Very succinct discussion on what is a complex thing.

    I am interested in the gap analysis of what you describe. A: It would be great for people to think more scientifically. B: Many intelligent people seem to take a running leap over what seems to some to be logical discussion and do not have an opinion that reflects non-scientific, possibly sensationalist, maybe ‘popular’ view

    You should do a TEDx talk on this subject.

    Just discovered your blog through this article so interested in back tracking your articles.

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  127. Connor  July 11, 2015

    Peter, I’d like to call your attention here. Don’t overlook Taleb. His last book has wide application across many fields, and there are some simple and powerful tools you could use in your work both for insight and for practical matters.

    I happened to come across this quote. It’s a reflection of the math of antifragility as applied to your favorite subject:

    Art de Vany and Jensen’s inequality: “Tissue gains are increasing but convex with nutrient intake (the curve is rising, but at a diminishing rate). This has to be the case for the point of origin to be a steady state solution. This implies that weight gain, including fat, is higher at the average intake than it is on a varying intake of the same calories and nutrients. Muscle and fat compete for substrate, so a fatter person will shift nutrient partitioning toward muscle because body fat induces insulin resistance in muscle. Insulin operates in a pulsate release and is far more effective with that pattern than with the chronic elevation induced by six meals a day. On the downside, where fat and muscle are lost, the curve is negatively sloped but declines at a diminishing rate (concave). This means you lose more fat feeding intermittently than continuously. The loss at the average intake (six per day keeps the variation of the average small) is less than the loss at the same intake but one that varies between a small intake and a large one.”

    His BS detector is high.

    Don’t overlook him.

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  128. Dan Barrett  August 3, 2015

    Best article I have read in a long, long time. & I regularly search out articles like this. THANK you for writing it.

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  129. Connor Moriarty  August 6, 2015

    Very interesting article. It’s an approach I had not considered.

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  130. Mike Santos  August 7, 2015

    I always come to read your articles, but this is the best one so far. Thank you to share, Dr.

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  131. Todd I. Stark  August 9, 2015

    From my perspective, the most important problem is not figuring out what to eat, a more important part is figuring out how to alter our lives so that we actually do what we know we should do. That’s where all of the dietary strategies fail for most people, their low adherence.

    Our current focus is too much on diets and not enough on actually implementing a healthy diet even when we think we know what that means. So rather than generic critical thinking books, I think more useful for thinking about nutrition would be books that offer long term change strategies such as by introducing the cognitive behavioral science of nutrition, which studies the reasons why we eat what we eat. Knowing the factors that go into preferences and eating choices lets us restructure our local environment to actually promote the better eating we know we should be doing.

    There is not a lot yet for popular reading but some early examples in this genre would be Brian Wansink’s “Mindless Eating,” and Tracy Mann’s “Secrets from the Eating Lab.”

    When we deal in critical thinking, the problem is that critical thinking is partly domain specific, so just like the case with learning about biases and heuristics in general, general books about critical thinking often tend to just help people confirm their existing biases while pretending to be thinking more critically. The need to actually engage the thinking in the subject at hand to also learn to think critically about a specific topic.

    I think Jamie Hale’s text “Knowledge and Nonsense” is a good example of critical thinking specific to nutrition and fitness.

    kind regards,

    Todd

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    • Todd I. Stark  August 9, 2015

      Also if you haven’t seen it, Tom Stafford has a very thoughtful and well researched article that addresses the intimately related question of whether we can persuade each other through rational argument.

      Conclusion

      “Are we a rational animal, or as Robert Heinlein said, merely a rationalizing one? Sure, there’s no shortage of evidence that our intuitions, emotions, prejudices and motivations can push reason around. Good luck to you if you want to use only argument to persuade – unless you’ve got people who already like you or trust you (ideally both) you’re going to have a hard time, but amidst the storm and shouting of psychological factors, reason has a quiet power. People do change each other’s minds, and if you can demonstrate the truth of your point of view, or help someone come to realize the short-comings of theirs, maybe you can shift them along. But beware Singer’s warning – logic has its own dynamic. If you open yourself to sincerely engage in argument then it is as likely that your interlocutor will persuade you as the other way around, after all, none of us has sole claim on what it means to be rational.”

      https://www.contributoria.com/issue/2014-05/5319c4add63a707e780000cd

  132. Safiya  October 10, 2015

    This was especially helpful, I started the Keto diet taking advice from my dad who reads your work extensively along with other more non conventional health professionals, and for the longest time I was unable to clearly explain the science behind eating “healthier” and cure through food. the only evidence I had was a huge smile on my face everyday because of the way I felt and my story of losing 20lbs in 3 months! Also bragging that I haven had a migraine not once since I switched to Keto. I was exactly like you, a little overweight but I exercised and my husband is a Doctor so we kept all “bad foods” out of the house. Then I got diagnosed with metabolic syndrome, my friends were shocked and the first thing they said was “But you are not fat?” it was refreshing hearing your story, I was 33 yrs old when diagnosed and weight 140lbs, never in a thousand years did I think I would be well on my way to Diabetes!!

    Im following your blog and trying to map out your research to make it easier for others to understand, Im not a scientist, but I think I get the bulk of it. Unfortunately not everyone is patient enough to comb through all the details. thanks for all of your help and actually going against the grain! You Rock!!!

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  133. Ted Spickler  October 16, 2015

    Adding to a list of great books about thinking and developing a scientific mind set I would include “Personal Knowledge” by Michael Polanyi. He influenced Kuhn!

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  134. Dwight Jessup, MPH  December 27, 2015

    Your Blog rocks.

    This addition to your blog is particularly stimulating.

    The Chimp Paradox by Dr. Steve Peters has some more suggestions on why we do not naturally “think critically”.

    You post also reminded me of something I had recently read by Dr. David Katz: Money, Time, and the Science that Suits Us
    https://twitter.com/drdavidkatz/status/664503288960827392

    If you have trouble pulling up the article send me your email and I will send along a PDF.

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  135. Carlo  April 11, 2016

    Peter,

    I feel a giant is missing from your list, that man being Friedrich Nietzsche.

    While often concerned with Art and the human soul (and how could one question that choice? a long discussion for another time), his incessant fight against Dogma and The Idols, the long musings about confusion/inversion of Cause and Effect and the all too human reasons for such fallacy constitute in my view the pillars of modern thinking.

    Then of course only he could get away with opening Beyond Good and Evil in such a graceful while unscientific way:

    ‘Suppose that truth is a woman – and why not? Aren’t there reasons for suspecting that all philosophers, to the extent that they have been dogmatists, have not really understood women? That the grotesque seriousness of their approach towards the truth and the clumsy advances they have made so far are unsuitable ways of pressing their suit with a woman? What is certain is that she has spurned them – leaving dogmatism of all types standing sad and discouraged. If it is even left standing!’

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  136. Peter Dove  June 16, 2016

    Good thoughts, do you think the fact that we are not wired to think logically has something to do with why there are so many sick people around these days (we are more stuck in our heads, overly analytical and logical, and disconnected from our more primitive senses) ?

    Very interesting debate anyway! I just came across this site, glad I found it!

    Peter

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  137. Michael  June 20, 2016

    Hey Dr A –

    Ever come across ” THe Story of the Human Body” by Daniel E Lieberman? A very broad review of human evolution and its bearing on disease. Might be worth a perusal for you.
    Good luck with your book project . Most of us are not wired to write entire books either!

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  138. Robert Young  July 19, 2016

    Dear Peter Attia, MD

    I watched you on Ted Talks this morning talking about “Insulin Resistance” Fat people may be the victims.” How you had to make the decision to amputate the ladies leg, very sad. My Wife & I both struggle with weight issues. Read a few of your Bloggs this one started “How people do not think Scientifically!” I only started thinking Scientifically as I started having bad reactions to chemicals I had worked with on my Job. After discussing my saga of Headaches, Strange sparkles in my vision, chemical sensitivity, and skin rashes, weight gain! Recently I started using Sodium Fluoride Free Toothpaste. The sparkles in my vision stopped, I am exercising stronger than ever before. Started to detox my body of Fluorides with Iodine. It is so liberating to think Scientifically and find some Junk Science like Fluoridating our water and brushing our teeth with Rat Posion Sodium Fluoride and the heavy metal SnF Tin Fluoride in Toothpaste so the Sodium Fluoride does not poision us, unless You floss with your Toothpaste as I was. Not one MD ever mentioned these could be reactions to your Toothpaste! Back to the fat cells not working correctly in Obese people; could this be due to Sodium Fluoride low grade poisioning since the 1950’s? Can we really trust Chemist working for Corporate America?

    Thank You.

    Robert Young

    (reply)
  139. Dwight  January 31, 2017

    In response to the Coffee Recipe , “Look for Vietnamese cinnamon, also known as Saigon cinnamon; you need two big dashes if that.”

    All varietals of cinnamon are not equal. The vaiable is Coumarin, a substance that can cause liver damage or complete failure. Only Ceylon Cinnamon has low levels of Coumarin, while all other varieties of Cinnamon have high levels of Coumarin. If you are just using cinnamon for coffee this may not be an issue but if you are also ingesting cinnamon to reduce insulin resistance, anti-inflammatory effects or to help lower blood sugar levels there may be risk.

    More complete info here:
    https://www.cinnamonvogue.com/Types_of_Cinnamon_1.html

    And here:
    http://www.askdocweb.com/cinnamon.html

    Warning 4 – Hepatotoxic drugs: Medications that can harm the liver interact with cinnamon. Taking large amounts of cinnamon along with medications that might also harm the liver might increase the risk of liver damage. Do not take large amounts of cinnamon if you are taking a medication that can harm the liver. These include:
    acetaminophen (Tylenol and others)
    amiodarone (Cordarone)
    carbamazepine (Tegretol)
    isoniazid (INH)
    methotrexate (Rheumatrex)
    methyldopa (Aldomet)
    fluconazole (Diflucan)
    itraconazole (Sporanox)
    erythromycin (Erythrocin, Ilosone, others)
    phenytoin (Dilantin)
    lovastatin (Mevacor)
    pravastatin (Pravachol)
    simvastatin (Zocor)
    An article in Clinical Toxicology, “Essential Oil Poisoning” (Issue Volume 37, Number 6/1999) voiced concerns about the risks of very high quantities of cinnamon. An ingredient in some cinnamon products, coumarin, may be toxic, particularly in people with liver problems.

    (reply)
  140. DT  July 11, 2017

    You might get something out of

    Why Do Humans Reason? Arguments for an Argumentative Theory

    published in Behavioral and Brain Sciences, 2011.

    (reply)

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