Feeling the Future: Room For Improvement

My Frontiers of Psychology class read Daryl Bem’s new paper Feeling the Future that reports nine experiments that show an effect of the future on the present. I have a different take than anything I’ve read: I think there are several good reasons to take it seriously. But in this post let’s start with how it could have been better:

1. Lack of background. There have been lots of experiments along these lines. What did they show? This question is not clearly answered. The prior probability of these claims is enormously important. As I told my students, if seeing the future was common and easy for even a small fraction of people, we wouldn’t have businesses, such as casinos, making money on gambling. But the existence of such businesses doesn’t rule out weak effects.

2. Lack of exact repetition. An obvious criticism is that Bem slanted the data analysis to favor the results he wanted. In any data analysis of unfamiliar data, you must choose — how to transform the data, what test to use, and so on. You must also choose how many subjects to run and how many trials to give them. There are rules for these choices (Bem doesn’t seem to know how to choose a transformation) but nevertheless they allow favoritism to creep in. Drug trials have big problems along these lines — severe slanting of the analysis to make the results more favorable — which is why when you register a clinical trial you must specify the endpoints. The answer to the criticism that your data-analysis choices made your favored result more likely is to do a data analysis with no choices at all. This cannot be done from scratch. You need to do the experiment once, make all the necessary choices, and then do the same experiment again (same everything as much as possible) and analyze the data exactly the way you analyzed the data from the first experiment. Bem never does this. Instead each experiment is different from all the rest. This is what experimental psychologists traditionally do but here it is a bad idea. Better to have taken the two simplest and clearest effects (priming and word learning) and repeated them several times exactly.

3. Were experiments left out? Let’s say you observe a weakly-significant result, p = 0.03. Now you do the same experiment eight more times. How likely is it that each of the eight replications will also find a significant difference? Quite low. Yet Bem finds a weakly significant difference in each of his nine experiments. This is highly unlikely. Bem appears unaware of the problem. Mendel had the same problem (data too good to be true). Ultimately Mendel was proved right. But again it stresses that Bem should do exact repetitions and report the results no matter what if he wants to be more persuasive.

Examples of MS Liberation Therapy

This story from the Globe and Mail describes what happened to ten Canadians who left the country to get liberation therapy for their multiple sclerosis (MS). The therapy consists of widening veins that drain blood from the brain. The therapy does not always work, but it usually does. The improvement is so fast and large — comparable to giving someone with scurvy Vitamin C — that the thing being changed must be the source of the problem.

Mainstream MS researchers missed this completely. The mainstream view is that MS is an auto-immune disease (e.g., according to Mayo Clinic staff). This view would never lead you to the liberation surgery. Doctors not only have the wrong idea, they are unwilling to defend it. A woman in the Globe and Mail story tried to get the anti-liberation argument from neurologists. She couldn’t:

Unfortunately the neurologists are all hysterical. You can’t talk to them.

Remember this the next time someone tells you that ulcers are not caused by stress but are actually caused by bacteria — as several contributors to this EDGE symposium claim.

The vast improvement in understanding of MS came about because someone with the necessary expertise (a professor of surgery) cared more than most MS researchers because his wife had MS. I think this is why my self-experimentation found such different solutions than mainstream science: because (a) I cared more than the professional researchers who studied the subject (e.g., sleep) and (b) I had the necessary expertise to do research. I discuss this here.

Thanks to Anne Weiss.

Cold Showers Raise Mood

Todd Becker pointed me to this post which is negative about the notion that cold showers raise mood (“empty science”) but you can ignore the negativity and go to the comment that gives a long list of studies that support the idea. Todd has blogged about his use of cold showers.

Todd calls this hormesis. About the mood-raising aspect of cold showers, I’m not so sure. There is a broad correlation between being sleepy and being in a bad mood.  So anything that wakes us up is likely to improve our mood. But if cold showers improve one’s response to stress of all sorts — which is less clear — it does seem like hormesis in other contexts. When I think of hormesis I think of two sorts: intra-cellular (e.g., x-ray-like radiation breaks stuff, activating repair systems — radiation hormesis) and extra-cellular (microbes in fermented food activate the immune system). But there are other examples of similar stuff: exercise breaks muscle fibers (which is why you shouldn’t exercise the same muscles two days in a row) and longer-term increases them; bones when broken grow back stronger. If we need a certain amount of thermal or other stress to properly respond to stress that would be another example.

Epilepsy’s Big, Fat Miracle …

… is the title of a New York Times Magazine article about the ketogenic diet, a treatment for childhood epilepsy, which I’ve blogged about several times (here, here, here, here, here). It’s a very-high-fat diet. It interests me for two reasons: (a) It connects a high-fat diet with proper brain function, as my self-experiments have done. A curious feature of the ketogenic diet is that it isn’t permanent. After several years the child can go off it. My self-experimentation suggests that Americans eat far too little of certain fats. Perhaps eating enough of these fats would prevent childhood epilepsy. (b) It shows how someone who cares enough — in this case, Jim Abrahams, whose son had epilepsy — can be more effective than professional researchers and doctors. Abrahams rediscovered the diet. He saw its value, the professionals didn’t. I’ve argued that this is part of why my self-experimentation found new solutions to common problems: because I had those problems. I cared more about finding a workable solution than researchers in those areas, who had several other concerns (publication, funding, acceptance, etc.).

The details of the article reminded me of something I learned in the BBC series The Story of Science. For hundreds of years, medical students were told, following Aristotle, that the liver has three lobes. It doesn’t. You might think that examination of thousands of actual livers would have dispelled the wrong idea, but it didn’t. The article contains many examples of doctors ignoring perfectly good evidence in favor of nonsense they read in a book or heard in a lecture. Epilepsy is easy to measure. If a child has 100 seizures per day, and has been having them at this rate for years, and this goes down to 5 shortly after he starts the ketogenic diet, and goes up again when the child goes off the diet, there is no doubt the diet works. As early as the 1930s, this had been observed hundreds of times. This was overwhelming evidence of effectiveness. Doctors ignored it, probably based on the modern equivalent of the three-lobed liver. They complained, according to the article, that there was “no evidence it worked” or that the evidence wasn’t “controlled” or “scientific” (whatever that means). A study published in 2008 “answered doubts about keto’s clinical effectiveness” — as if doctors needed the equivalent of a very-large-type book to be able to read what most of us can read with normal-sized type.

According to the article, “by 2000, more people were asking about keto, but most pediatric neurologists still would not prescribe it” — as if the parents needed the approval of their doctor to try it. You don’t need a prescription to buy food.

Thanks to Tim Beneke, Michael Bowerman, Alex Chernavsky, David Cramer, and Peter Couvares.

How Wonderful is Lipitor? (continued)

In response to my previous post about Lipitor, someone named Brian commented:

I recently stopped taking Zocor [a statin, like Lipitor, and the most prescribed anti-cholesterol drug]. I started taking it at the same time I started using a CPAP machine to treat sleep apnea. While my sleep was more restful, I remained fatigued. After a year of Zocor, I was diagnosed with ADHD. Following this diagnosis, I tried a string of medications — adderall, stratera, and ritalin. I even became depressed and was put on an SSRI. My memory and mental prowess faded and became extremely spotty at best. I would use IQ apps on my iPhone to measure my mental prowess — and usually scored in the 75-100 range! (Prior to Zocor, similar computerized IQ tests would yield answers from the 130s to the 170s.) . . .

So I quit taking Zocor. (Initially, I tried using COQ10 to moderate the effects, but it proved ineffective.) . . . My mind is back, as are my computerized IQ scores. I no longer arbitrarily stop talking in the middle of sentences after losing my train of thought.

Apparently Zocor caused serious mental problems. Is this rare or common? Common. Here is an article about it. The idea that statins have bad mental effects is old. At first it was dismissed. Here is one dismissal:

The issue of low serum cholesterol and depression was directly examined in three randomized, placebo controlled trials of statins in which indices of depression were measured in all the participants—a total of 7400 people taking active treatment and 2400 taking placebo. Depression was no more common among those taking active treatment.

Apparently these three large randomized placebo-controlled trials got the wrong answer. Curious.

Perhaps statins cause mental impairment in everyone. Everyone’s brain uses cholesterol. If you are going to start or stop taking a statin (such as Zocor or Lipitor) and would like to learn how the drug affects/affected your mental function, please contact me. I am interested in helping you do that.

In the top 15 most prescribed drugs, Lipitor (#7) was the only non-generic. The profits are large, the benefits small and plausibly outweighed by the costs. There is great room for improvement in determination of how much Lipitor and other statins impair mental function.

How Wonderful is Lipitor?

John Cassidy, a staff writer at The New Yorker, understands clearly the poor judgment of economics professors. In How Markets Fail he said the Nobel Prize in Economics has made things worse, because it has often been given for worthless work. Outside of economics, however, he can write this:

during a period in which American companies have created iPhones, Home Depot, and Lipitor, the best place to work has been in an industry [the financial industry] that doesn’t design, build, or sell a single tangible thing.

That such a smart well-informed non-party-liner can believe Lipitor is wonderful shows Orwell was right: with enough repetition, people can be convinced war = peace. Here is the truth about Lipitor:

Statin therapy is extremely efficient in lowering cholesterol numbers, but unfortunately not without adverse effects on the body. To prevent a first heart attack, for every life that is saved – 1% over 10 years of use – statins cause an equal number of adverse deaths due to accidents, infection, suicide and cancer — 1% over 10 years’ use and significantly greater levels of serious side effects and suffering. . . . In a study to see the effects of raising the Lipitor levels from 10 to 80 mg (more sales) on patients, those taking 80 mg had increased liver problems, that is the rate of raised liver enzymes was six times higher than those given 10 mg of Lipitor. Even though the total deaths due to CVD in the 80 mg group was fewer (126) than in the 10 mg group (155), the total deaths due to other causes was higher in the 80 mg (158) than the 10 mg (127) group. There was no difference in the overall mortality rate.

Lipitor, the miracle drug. Taken by millions at a cost of billions. This is what happens when you — such as those in charge of health care — have little understanding of a problem: You aren’t good at solving it.

Cardiologists believe that high cholesterol causes heart attacks. Their depth of understanding was illustrated by the cardiologist at my Quantified Self talk about butter who said that the Framingham study showed that diet caused heart attacks (no, it found new correlations between heart disease and “risk factors” such as cholesterol — see also this) and that the recent reduction in heart attacks is evidence of our improved understanding (e.g., the science behind Lipitor). That a thousand other things changed over the same time period he apparently hadn’t considered. He simply couldn’t defend — at least then — his core belief that butter was bad. A cardiologist! How many thousands of people has he told to eat less butter?

Cassidy’s article about the harm done by the financial industry, from which that quote was taken, is excellent.

Flaxseed Oil vs. Fish Oil

You can find statements like the following in a hundred places:

Both fish and flax are good sources of omega-3. Flaxseed oil is less expensive, which can be an important consideration. The main difference is that flaxseed oil contains only alpha-linoleic acid (ALA), which is the parent compound from which other omega-3 fatty acids are derived. This leaves it to your body to do the conversion to the other forms it needs, eicosapentaonoic acid (EPA) and docosahexaenoic acid (DHA). The problem is that the conversion is not always that efficient, and the body often uses the ALA for extra energy, leaving less for conversion to the other types. The body uses various enzymes to convert ALA to other omega-3s, and the process is not very efficient, especially as one gets older. Estimates of the rate of conversion range from 5% to 25%. In order to make sufficient amounts of EPA and DHA, one needs to consume 5-6 times more ALA than if one relies on fish oil alone. Fish oil, on the other hand, contains the other forms and delivers them directly to your body with no conversion necessary.

It isn’t that simple. Here are three things I rarely see mentioned:

1. The conversion rate is not fixed. It depends on the amount of the conversion enzyme, which increases with ALA exposure. The body makes the enzymes it needs and doesn’t make the enzymes it doesn’t need. You don’t have enzymes to digest food you don’t eat — but if you start to eat them you will build up the enzymes. The measurements of ALA conversion rate I have seen measured the conversion rate without giving the subjects extensive exposure to ALA before the test. (Measurements of glycemic index have the same problem.) They should be considered lower bounds of what would happen with long exposure.

2. Time release is good not bad. When you take a dose of flax oil, its ALA is converted to DHA and EPA, which takes time, thus smoothing out the supply versus time function. If you take a dose of fish oil, the brain receives a sudden burst of DHA and EPA. It is likely that a smoother supply is better.

3. ALA (omega-3) conversion blocks AA (omega-6) conversion. Omega-3 fatty acids and omega-6 fatty acids are almost identical. The enzyme that converts short-chain omega-3 to long-chain omega-3 also converts short-chain omega-6 to long-chain omega-6. Long-chain omega-6 probably has bad effects in your brain, at least in large amounts, because it displaces long-chain omega-3. For industrial reasons, our diets are high in short-chain omega-6. Having ALA in your system, which flax oil provides but fish oil does not, slows down the conversion of short-chain omega-6 to long-chain omega-6 by occupying the conversion enzymes.

Thanks to Gary Skaleski.

Effect of Flaxseed Oil on Arithmetic

After I moved to China in September, I was surprised that my arithmetic speed went down. (That is, I got faster.) I had lowered it from about 630 msec/problem to 600 msec/problem by eating lots of butter. I had no idea how to lower it further. I didn’t deliberately change my diet in China but it was quite different. I kept some things the same: the amount and brand of butter/day, the amount and brand of flaxseed oil/day.

I failed to figure out why I had gotten faster. I reduced the amount of flaxseed oil from 3 T (tablespoons) per day to 2 T per day. It made no difference. (In the beginning of my interest in flaxseed oil, change from 2 T/day to 3 T/day had made a difference.) Perhaps because of the butter.

Surprised that the change from 3 T/day to 2 T/day hadn’t made a difference, I went down to 1 T/day for two weeks, then back to 2 T/day. Both changes made a difference:

Each point is a separate test. Each test had 32 arithmetic problems (e.g., 3+4, 11-3). In the beginning of the data shown in the figure I tested myself once per day. After 12 days I started doing two tests/day, one right after the other. I was curious about the repeatability of the numbers; it wasn’t hard; it was a way to get better measurements. Averaging over the tests for each day to get one value per day, combining the 19 2-T/day (before) days and the 11 2-T/day (after) days, and comparing the combination to the final 7 1-T/day days, t (38) = 6.5. If you’re not familiar with t values, t = 2 is a barely reliable difference, t = 4 is a very clear difference.

This is more evidence that flaxseed oil improves brain function. It interests me because it implies the optimum dose is close to 2 T/day. It cost about $20 and took 1 person-month. In contrast, the DHA-Alzheimer’s study I mentioned two days ago cost about $1 million and took about 7000 person-months. And used (a) a cruder something-versus-nothing comparison, b) a less-sensitive between-subjects comparison, and (c) a more ethically-problematic placebo-controlled design.

The New Yorker Stories by Ann Beattie

Ann Beattie, a great writer, has a new book out called The New Yorker Stories. I loved her early stories. Her first story in The New Yorker (1974) was “ A Platonic Relationship“. I still remember this:

When he did have a beer he would take one bottle from the case and put it in the refrigerator and wait for it to get cold, and then drink it. . . . One night Sam asked her if she would like a beer. . . . He went to his room and took out a bottle and put it in the refrigerator. “It will be cold in a while,” he said quietly.

Last night I put a Diet Coke in the freezer. It will be cold in a while, I thought, remembering this passage.

Alas, I haven’t liked her work over the last 20 years as much, although I am looking forward to reading Walks With Men, her latest novel.