Seth’s blog

How much disease do genes cause? Sure, they cause some rare diseases that affect very few people but what about major health problems, such as depression, that affect everyone? The notion that genes make a big difference to human health — that some people are healthy and others sick because of genetic differences — was much of the rationale for funding the human genome sequencing project, which cost billions. The founders of the company 23andme (23 = 23 human chromosomes) often say genes matter, most recently in The New Yorker:

“It’s very useful if you know that you’re at increased risk for deep-vein thrombosis and you’re on a plane,” she continued. “You might want to stay vigilant about moving around.” Instead of finding out the hard way that their children are allergic to peanuts, parents may someday be able to test their DNA. Even small inherited traits, Avey added, can serve as health clues: “There is some correlation between your ability to metabolize caffeine and your risk for a heart attack.”

There is something breathtaking in the fact that someone who believes you can learn about allergies by studying DNA is taken seriously in The New Yorker.

Some rare non-hype on this issue has recently come from Dr. David Goldstein:

But David B. Goldstein of Duke University, a leading young population geneticist known partly for his research into the genetic roots of Jewish ancestry, says the effort to nail down the genetics of most common diseases is not working. “There is absolutely no question,” he said, “that for the whole hope of personalized medicine [where people with different genes are treated differently], the news has been just about as bleak as it could be.”

The researchers have been unable to find genes that make much difference.

If they had found such genes, I would have been stunned. My self-experimentation has led me to believe that our environments are far from ideal — in non-obvious ways. I believe that people don’t get sick because of their genes, or gene-by-environment interactions, they get sick because of their environments, which lack something essential or include something bad. Animal experiments have given us a decent understanding of nutrition; maybe we know half or more than half of the basic requirements. When it comes to subjects that don’t lend themselves to animal experiments, little is known — about what causes depression, for example. My self-experimentation took over where animal experiments left off; it provided a way to do experiments that generate ideas. (Which is crucial for knowledge advancement, as opposed to career advancement.) I have been able to find one big self-experimental effect after another (most recently, about omega-3s and sleep) related to common health problems only because (a) so little was known and (b) I accidentally picked up an effective tool (self-experimentation) that no one else had used this way (to find new experimental effects).

More More from the other side of the debate: 1. Elderly genetics. 2. Google co-founder has Parkinson’s gene. It is hard to find support for my side of the debate in print. It isn’t easy to notice when you don’t get sick (because of advances in the study of nutrition, for example) so it isn’t easy to notice how study of the environment has paid off in concrete ways. I’m in an unusual position: I can easily notice how my life has improved via self-experimentation.

Even more Dean Ornish agrees with me. Thanks to Carl Willat.

In late July, JemSparkles posted this to the SLD forums:

Ok so I have tried many diets. Here’s the list Jenny Craig (10 lbs lost but gained back), Atkins (3 months of phase 1 and nothing lost), Curves (1 year and 10 lbs lost), Herbal Magic, a multitude of diet pills, the Zone, and then simply working out non stop. The weight doesn’t want to come off. So here I am with the last attempt that sounds crazy enough to work! I bought the book and this is day two. I am going to start tracking my data and see if I get any results.

Here’s to hoping!!!

Ok so I weighed myself for the first time this morning and my starting weight will be 260lbs.

Two weeks later she posted this:

Ok so I haven’t seen the fast results that some have seen but I am seeing results which is what matters. And compared to any diet this has been super easy to keep up with.

Today she posted this:

254!!! Yes I am finally down a total of 6 pounds and starting to feel much better. I have been working really hard on this and am not giving up. This diet has been the most effective I have been on to date.

We now return to our regularly-scheduled blogging.

During Bill McKibben’s book tour for Maybe One (1998), an argument for having no more than one child, he gave a reading in Berkeley. I attended, and asked a question: Jane Jacobs says the problem isn’t too many people, the problem is the undone work. (Which I also said at the end of The Shangri-La Diet.) For example, air pollution. The solution won’t be fewer people, it will be cars that pollute less. I asked McKibben what he thought of this. He said he thought highly of Jacobs, but  the EV1 was a failure. Terrible answer, I thought.

Yesterday I spoke to the owner of an electric car. It is entirely powered by electricity from solar panels on the roof of her house. It can’t go on the highway but is perfectly good for taking her and her two children around town. She’s had it about a year; she bought it after seeing someone else drive one. Leaving aside the cost of the solar panels, driving costs her almost nothing, is very quiet, and produces no pollution. The car was made in Vancouver. In America, it’s small; it wouldn’t be small in Japan. Looks like the future, I thought.

Green Motors, a Berkeley store specializing in electric cars, started by the man she bought it from. Lovely website, his enthusiasm shines through. Car-maker difficulties.

A few days ago I blogged about how Tim Lundeen, via careful  and repeated measurement — let’s call it self-experimentation — uncovered a serious and previously-unreported side effect of a drug he was taking. Tim’s example illustrates an important use of self-experimentation: discovering unreported side effects, which I believe are common.

By coincidence today I came across a talk about the very subject of unmentioned side effects: Alison Bass speaking about her new book, Side Effects: A Prosecutor, a Whistleblower, and a Bestselling Antidepressant on Trial. Near the end, Bass said,

It’s not the just the antidepressants, it’s not just the antipsychotics. This is happening with a lot of other drugs. With Vioxx, with Vytorin, an anti-cholesterol drug, with Propries [?] and Marimet [?], anti-anemia drugs. Where again and again the drug companies know that there are more severe side effects and they’re not letting the public know about that. It just keeps happening, unfortunately.

Just as it would be foolish to think the problem is limited to mental-health drugs, it would be foolish to think the problem is limited to side effects, that drug company researchers do everything right except fail to report side effects. Tim’s example shows how hard it is to learn about unreported side effects — so it is only realistic to think that there are other big problems with drug company research we don’t know about. Bass mentioned one I didn’t know about. A company did a clinical trial of Paxil. The goal was to see if the drug helped with Measures of Depression A and B. Turns out it didn’t: no effect. So the company changed the measures! They shifted to reporting different measures that the drug did seem to improve. Creating the hypothesis to be tested after the data supposedly supporting that hypothesis had already been collected. Without making this clear. (Which I presciently mentioned here, in response to an interesting comment by Andrew Gelman.) And if you think that drug companies do research like this — in ways that seriously damage people’s lives — but everyone else, such as academia, is really good, that is as realistic as thinking the problem with drug company research is restricted to side effects. Self-experimentation has all sorts of limitations, yes, but (a) you know what they are and (b) it is cheap enough so that you can gather more data to deal with the problems. Drug company research and lots of other research is too expensive to fail — or even be honest about shortcomings.

This is an aspect of scientific method that scientists rarely discuss: the effect of cost on honesty. Is there an economic term (a Veblen good, perhaps?) for things whose quality goes down as their cost goes up?

In the last chapter of The Shangri-La Diet and this post, I said it was foolish for those who want to improve the world to denigrate those in industry. (”[Food] companies will put anything in their food if they think the extra marketing hype will help them sell more of it,” said Marian Nestle.) A recent article in the NY Times described in detail how a wash-your-hands campaign became more effective by studying industry tactics. The head of the campaign said pretty much what I’ve been saying:

“For a long time, the public health community was distrustful [not to mention scornful] of industry, because many felt these companies were trying to sell products that made people’s lives less healthy, by encouraging them to smoke, or to eat unhealthy foods, or by selling expensive products people didn’t really need,” Dr. Curtis said. “But those tactics also allow us to save lives. If we want to really help the world, we need every tool we can get.”

And every person.

Thanks to Marian Lizzi.