*Skip to below the videos if you don’t care about an aside about doctors.

I almost feel bad focusing this piece on one article in particular. I’ve been squinting skeptically at the talk surrounding epigenetics for months now. Because of that, much of what follows is directed at pop science journalism as much as anything.

I can’t bring myself to actually feel all that bad because Dr. Hyman is a doctor. Not only is he a doctor, but he brings up his doctoryness pretty much everywhere. And that’s fine, but training to be a medical doctor doesn’t necessarily provide special training in nutrition, exercise physiology, et cetera. It’s a problem because people respect doctors. It seems to me that people also tend to respect medical doctors (Dr. Hyman’s flavor) more than PhDs. Unfortunately for reality, the converse should often be true. The brief training medical doctors get in nutrition and exercise physiology has a higher probability of being dated (however slightly) when it comes in the form of chapters of generalized books and/or when it is taught by non-specialists. It’s certainly true that some medical doctors have stepped up their game and are exempt from this criticism, and that isn’t the point. It’s a problem of automatically granted authority where none should be granted. A recent exchange between Deepak Chopra (and M.D.) and Sam Harris (Ph.D. in neuroscience) illustrates this somewhat.

Scientific claims by Deepak Chopra

Response by Sam Harris (rewind to beginning for a funny moment: Michael Shermer calls Deepak “woo woo”)

Hilarious: Leanord Mlodinow (theoretical physicist, co-authored 2 books with Stephen Hawking) pwns Deepak

The Meat of It

“Science is now proving what we all knew intuitively—that how we live, the quality of our relationships, the food we eat, how we use our bodies, and the environment that washes over us and determines much more than our genes ever will.”

Propaganda 101: The False Dichotomy

The above (and below) quote is from a blog post, ‘Secrets to Health are in Diet and Lifestyle Not Human Genome: The Failure of Decoding the Human Genome and the Future of Medicine‘ [it actually starts with “Secretes”, but I assume that’s a typo], by Dr. Mark Hyman. There is some value here, but when I’m being offered “secrets to health” and instead given fluffy science, appeals to intuitive folk psychology, and hyperbole, I have a hard time recommending you endeavor to dig for nuggets of truth. The way the article is framed is misleading, and… well… wrong. It’s not wrong to say that epigenomics is real and important, but it is wrong to dismiss genetics in favor of epigenomics. That approach is not only a logical fallacy, but an advertising/propaganda tactic. Claims along these lines are madness when we consider that all epigenomics can ever do – by its own definition – is influence the expression of genes. Knowing this simple fact refutes the sensationalist claim that, “Science is now proving [that] the environment… determines much more than our genes ever will.” [emphasis mine]

So at first I was put off by the article. But that was before I remembered that I’ve recently been working on a theory proposing that, while beneficial to plants via chlorophyll, our yellow sun presents a contra-optimal environmental input to epidermal vitamin D synthesis. If we were able to find suitable habitat on a planet orbiting a red sun, the spectrum phase-shift would cause a hormone balance reconstituentialization switching the protein cascade of certain genes to unlock the potential for conscious human negation of both gravity and friction. Failing that, I have high hopes for the venom of radioactive spiders.

Now… if I actually believed in the Superman or Spiderman hypotheses, statements similar to those made by Dr. Hyman would enable their theoretic viability.

The Epigenome: Bypassing Darwin and Evolution

More important than our collection of genes, it now appears, is how those genes are controlled by both internal and external factors—our thoughts, stress, social connections, what we eat, our level of physical and mental activity, and our exposure to microbes and environmental toxins. These factors are switches that turn genes on and off and determine which proteins are expressed. The expressed proteins, in turn, trigger signals of disease or health.

In the context of this article, the claim that epigenomics bypasses Darwin and evolution seems to be more of a political hope than a scientifically defensible position. Now everybody, in your best Beach Boys harmony:

Wouldn’t it be nice if genes were over
‘Cause selling magic-bullets never would be wrong
And wouldn’t it be nice to live forever
In worlds where supra-malleable human beings belong

No, I am not saying Dr. Hyman made this argument explicitly. Yes, I am saying the implication of the argument unlocks false hope in a world in which epigenomic influences wield supreme power. Invoking the concept of control by external factors is problematic. It implies that, if only we can find the right environmental factor(s), we can positively or negatively bend genetic expression to overcome any malady or limitation. If genes and/or evolution don’t matter, nothing can stop us, comrades!

Yes folks, I regret to inform you that it’s the “nurture trumps nature” argument all over again. Not only is the mind a blank slate (as others claim) in this warm and fuzzy world,  but now the body is as well. Bla bla fracking bla.

It could be rightly said that I’m attributing more weight to Dr. Hyman’s mention of epigenomics than is appropriate. However, the other factors he discusses (exposomics, nutrigenomics and microbiomics, and toxigenomics) fall under my same criticism asserting an interactionist framework. In fact, while trumpeting the “failure” of genomics, he simultaneously admits “the dynamic interplay of the environment” and genes. Nutrients, microbes, toxins, and (catch-all term) exposomes all collide with the human genotype and phenotype in ways that can’t accurately be cast in a binary light in which genomics has been deemed a failure. And despite the equivocations and qualifications invoked to temper his message to be mostly accurate-ish, there’s no hope of escaping Darwin and evolution in Dr. Hyman’s position.

Three neo-Darwinist points about epigenetic switches

*Note the switch from “epigenomics” to “epigenetics”. For our purposes, epigenomics can sufficiently be thought of as a macro view of epigenetics.

As is always the case in the “nature vs. nurture debate”, there is no “nature vs. nurture debate”. The false dichotomy only exists in the polemical propaganda of the nurture Nazis (think Seinfeld’s “Soup Nazi”, not reductio ad Hitlerum). No, there is no versus, there is only synthesis amidst a continuum. The 3 points below are from Oana Carja‘s excellent answer to the question, “Is it time to revise evolutionary biology textbooks to reconcile Darwin with Lamarck?” They have been edited, but the two quoted paragraphs that follow appear in their original form:

1. A property of the DNA sequence itself is the ability to switch epigenetic state, and is therefore subject to natural selection on conventional mutations.

2. Natural selection will  eliminate switches with maladaptive effects but perpetuate, and refine, those with adaptive effects.

3. The additional ‘information’ represented by a  DNA sequence’s particular epigenetic state is repeatedly being reset.

Thus, epigenetic switches do not involve cumulative, open-ended evolutionary change. Switches are wonderful tools that increase the options available to  DNA sequences but, in themselves, should not challenge the beliefs of a neo-Darwinist. The high rate of epigenetic change is also important because the level of achievable adaptive precision is limited by the  fidelity of replication. Adaptation is constantly being degraded by copying  errors and the higher the rate of errors, the larger the selective advantage that is required to maintain previous adaptation. Thus, small selective advantages are  unable to be maintained in the presence of low-fidelity replication.

Therefore,  significant adaptations are expected to be encoded genetically rather than  epigenetically. Modern neo-Darwinists do not deny that epigenetic mechanisms play an important role during development nor do they deny that these mechanisms  enable a variety of adaptive responses to the environment. Recurrent,  predictable changes of epigenetic state provide a useful set of switches that allow genetically identical cells to acquire differentiated functions and allow facultative responses of a genotype to environmental changes (provided that  ‘similar’ changes have occurred repeatedly in the past). However, most neo-Darwinists would claim that the ability to adaptively switch epigenetic state is a property of the DNA sequence (in the sense that alternative  sequences would show different switching behavior) and that any increase of adaptedness in the system has come about by a process of natural selection.

In other words, epigenetic switches themselves are subject to evolution. Thus, I must sincerely apologize for my current inability to christen epigenetics as the long-awaited mechanism to bring the DC vs. Marvel debate into the scientific realm.

The astute among us may have realized by now that my criticism of Dr. Hyman’s article relies almost entirely on just four of his words. If “failure” wasn’t in the title, and “control” wasn’t used in reference to extra-genomic influence, and “bypassed” didn’t precede Darwin and evolution,  and “determines” wasn’t attributed to epigenetic influence, I may not have been forced to write this. In actuality, those four little words poison an otherwise interesting article in a way that misleads casual readers. I’ll just put aside the problems with the use of “much more” in the lead quote unless someone raises further concern in the comments.

Epigenetics is interesting. Epigenetics is useful. However, epigenetic influence remains confined by genetic potential and Darwinian selection. Let us not make it out to be the panacea it is not. Beyond that, I believe we’re at, or even beyond, the point at which there needs to be some push-back on pop science framings of epigenetics as something that somehow undermines neo-Darwinian evolution. From a strategic perspective, misconstrued epigenetics can be taken out of context far too conveniently by the Creationist and/or Intelligent Design programs.

Oh, and for those of the paleo persuasion… Dr. Hyman’s prescription for gut health? “Eat whole unprocessed foods with plenty of fiber… beans… and whole grains.” Beans and whole grains for gut health!? I don’t feel bad about picking on this article for four words after all. Please don’t take that as ad hominem; it supports the thoughts in the preface.

  1. Charles Frith 13 years ago

    I like Deepak's bling specs.

    • Andrew 13 years ago

      Yeah, he’s rocking the hip-hop televangelist look pretty hard these days. One of the questions toward the end (11 or 12 of 12) was directed at him… something along the lines of… “Due to the lucrative nature of spirituality related to non-spirituality, how are you able to remain objective in this kind of debate?” He totally punted of course.

      [youtube cdcB7FIrXXI youtube]

  2. Charles Frith 13 years ago

    Sure. He's a human and takes a shit like all of us on this painfully extraordinary planet but equally it's hilarious listening to Sam Harris trip over his snooty superiority and resort to ad homs on non locality plus I can't ignore that funniest for me so far (and thank you so much for putting this my way) is Michael Shermer answering the question of whether it's him or his x squllion neurons firing off when he's thinking and he replies it's his neurons.

    Chopra calls him a Zombie. The Scientist snookered on logic and the mystic hurling epithets? This is what Youtube was made for.

    Maddeningly frustrating is the inability not to join in and take both sides on as I have my own point of view which is deeper and darker heresy 😉

  3. Emily Deans 13 years ago

    At first I would say that Deepak Chopra is not a fair representation of MDs – however, there can be a smug misplaced surety based on experience with mortality and illness that most people (living) in the modern world don't have. Actually, there is a good book called "Of Two Minds" in which an anthropologist compares the training of psychiatrists (MDs) and psychologists (PhDs) and how MD training makes one at odds with patients by it's very nature (years of sacrifice, midnight call, patients coming onto your service are "hits" – the "arrow of harm" goes from the patient to the doctor in MD training – among psychologists the training is opposite… Let's just say that MD training can make one develop distaste for human weakness, and thus make MDs particularly vulnerable to ignorance and rejection about their own weaknesses. Thus Dr. Hyman and this fairy-tale wish to discount our hard-wiring in favor of tinker bell style epigenetics.

    There, you got me to discuss psychology.

    • Andrew 13 years ago

      I don't think Deepak Chopra is a fair representation of anything.

      There are lots of doctors who simply go about their business. There are lots of doctors who use their credentials as a fair representation of their training and education to signal authority and transmit messages. Fine and fine. However, there is a subset of the doctor kingdom that too casually flashes their doctor badge as a shortcut to unjustified authority. I have elsewhere made the same criticism of sociology PhDs flashing their PhD credentials to authoritatively (read: not scientifically) dismiss fMRI studies.

      Yes, I have a problem with authority. I get extra suspicious when the semiotic value of credentials is targeted at the cognitive biases of the viewer.

      • Emily 13 years ago

        We're just trying to help.

      • Tyler Link 13 years ago

        Andrew, you really have a way with words: there is a subset of the doctor kingdom that too casually flashes their doctor badge as a shortcut to unjustified authority.

        I make that argument all the time less eloquently.

        I have tremendous respect for Dr. Hyman despite his un-paleo ways. It was Dr. Hyman that first introduced me to the evils of gluten and inspired the elimination diet that helped me diagnose my gluten intolerance. In fact, to this day that's all the evidence I have of my gluten intolerance and all the evidence I need. One of the most frequent retorts I hear all the time from friends and family when I tell them I self-diagnosed my gluten intolerance is "I'd like to see your credentials, how are you capable of making such a claim when you aren't a doctor." Sadly, doctors have convinced themselves that their status should not be called into question by the layman and even more sadly, the layman has convinced himself that he should not question the all-knowing doctor.

        I also have a problem with authority.

        My research on gluten intolerance and celiac disease led me to the paleo diet and I'm not sure why smart people like Dr. Hyman haven't quite make the leap yet. He seems to have the same skepticism necessary for challenging established beliefs, even those of his own so I still have faith that he might shift his stances on whole grains and legumes.

        Having said that, he is definitely not alone in his advocacy of whole grains. Dr. Lustig and other doctors I respect hold similar views and I wonder if we *cavemen* (ugh) overstate the role of lectins and phytic acid in gut health and nutrition. I 100 percent buy into the role that gluten plays in poor health, but admit to taking the arguments on lectins a bit on faith (just not as familiar to me, not that I don't have some understanding).

        Is it possible we overstate the problems? If not, why have these not even entered the consciousness of people like Dr. Hyman who are otherwise smart and skeptical. The word lectin never appears in his book Ultrametabolism and to my knowledge Dr. Hyman has never discussed the anti-nutrients in grains and legumes. Is it possible he just doesn't know about them or does he simply believe that the good far outweighs the bad?

        I wish we could get Dr. Hyman, Robb Wolf, Dr. Mercola, Dr. Lustig, Dr. Weil, Mark Sisson, Stephan Guyenet, Chris Masterjohn, and other open-minded people into a room and hash these things out and map the points of disagreement. That would be enlightening.

  4. Phocion Timon 13 years ago

    The more worrisome facet of this, to me, is the political. If this theory does indeed get into the (pseudo-) science media in big way, politicians, while shedding copious tears and wringing their hands over "The Children," will decide again we are too stupid to live our own lives, re: Ancel Keys and Sen. McGovern and their low-fat dietary fiasco.

    Epigenetics is tailor-made for healthcare-by-fiat to control our personal environments, thus controlling health-care costs.

    • Andrew 13 years ago

      Exactly. The political implication of a "blank slate" mind in social science is that "we" can somehow come up with the "right" educational system to shape humanity into a social Utopia. It's ironic that professional social scientists tend to be politically left because the implementation of such a program would require an absolutely authoritarian regime. I would argue that this is because the important distinction between the progressive-conservative spectrum and liberal-totalitarian spectrum is lost when we reduce everything to left-right. In the social science example, it is problematic when someone is left in the progressive sense, but right in the totalitarian sense. To me, the liberal-totalitarian spectrum is more important. If one is left on the liberal-totalitarian continuum, prescribing the imposition of hair-brained social programs becomes impossible.

      Applying the "blank slate" concept to the body opens the door to the same quest for the "right" program of health and fitness to shape humanity into physically perfect humans. Meld that with the veg*n political program and Soylent Green starts to seem like a potential reality. 🙂

  5. Jorge 13 years ago

    Watching Chopra or Popoff make me (in chronological order):

    a. Cringe. Painfully
    b. Acknowledge that most of the population is, and will probably always be more receptive to emotionally comforting arguments than cold, hard facts.
    c. Consider losing the little faith in humanity I have left
    d. Wonder why are we still trying the same approaches to push the masses into the rationality realm.

    We evidently need to be more creative in how we deliver emotionally uncomfortable information in ways that it's accepted by the masses. Regardless, the rational groups persist in trying to convince people with cold hard data.

    Could it be that hyper-rationality comes at the expense of social/emotional proficiency, and thus prevents us from taking a more effective approach? We might be able to learn a few things from Chopra after all…

    • Andrew 13 years ago

      All good points.

      To my mind, the fields of Behavioral Economics and Evolutionary Psychology give us the tools to straighten out the messaging. I've added links to books by Geoffrey Miller and Gad Saad (the usual suspects) just before the comments above.

    • katherine 13 years ago

      +1. So I'll say "e" for "all of the above". (but especially "c")

      "Could it be that hyper-rationality comes at the expense of social/emotional proficiency" Possibly. Emotional proficiency anyway.

  6. Victoria 13 years ago

    Hmmm…. so sending you articles on nutrigenomics might not have been the best idea…

    I'll admit, it frustrates me how much play time DNA gets in pop science, with RNA and protein expression getting little or no attention. I am excited to see interest in epigenetics, however, to suggest that the expression of genes is more important than the original gene is non-sensical. You can't express something you don't have.

    The MD and PhD difference is interesting, and the level of automatic respect granted to someone with an MD is scary (hell, the level of respect granted to someone who is GOING to have an MD is scary). In my experience, MD training does not prepare or encourage thinking outside of very strict confines, nor does the current MD training attract individuals who enjoy questioning and thinking. Med School encourages maximal retention of facts, with minimal amount of thinking. Once you 'know', you accept the information as fact and move on, indoctrinating others, never questioning. PhDs, on the other hand, are encouraged to never stop questioning and exploring, realizing that there never is an end point to knowledge. By extension, they are generally poor at indoctrinating others, and won't give people the short answers they're looking for for those important human questions- like how should I live my life (because damn it I don't want to figure that out for myself). Hence the love of MDs, who will tell you what to do and how to do it. Are there exceptions? Of course, I plan to be one… or both… whatever…

    PS- Deepak's glasses? WOW

    • Andrew 13 years ago

      Keep the articles coming! I find the science absolutely fascinating. I just object strongly to political misapplications of it and any attempts to establish an either/or framework.

      Good thoughts on the perception MDs & PhDs. Are you saying that MDs aren't scientists? 🙂 'Cause it kind of sounds like that's what you're saying.

      • vlprince 13 years ago

        Is this going to get me in trouble with Emily? 99% of MDs aren't scientists… I don't think any of my MD classmates would have considered themselves scientists. In fact, most of them thought my interest in (love of?) science was 'cute' (or funny…). Most of them just wanted to get through the preclinical classes and get down to the business of 'practicing the art of medicine' (AKA making lots of $$). Before settling on a lab for my PhD I did a rotation with an MD PI (Primary investigator), and while he is well respected in his field, his lack of a scientific training was evident. He sometimes had difficulty understanding what data showed, or, more frequently, what it didn't show. He also sometimes failed to grasp what was possible to prove or do by experimental design. There is a reason to get both an MD and a PhD, and it's not just because someone else pays for your education. 🙂

        I'm not saying all PhDs are pillars of logic and reason, but if you're running the numbers, I'd think they're the safer bet!

        Back to epigenetics- above you write "From a strategic perspective, misconstrued epigenetics can be taken out of context far too conveniently by the Creationist and/or Intelligent Design programs." I'm kind of curious about that. How so? It's not an argument I've heard or can easily figure in my head, and if anything, I think many epigenetic factors are more easily proven by the scientific method than evolutionary changes (since the timescale is short and the conditions reproducible).

        • Emily 13 years ago

          The doctor scientist is a goal of modern MD training born with Osler, however a proper researcher is not really born without the extra MD/PhD years or mucho brains. (we always called them "mud-phuds") I'll come out and admit that my personal stats proficiency is rather horrendous, but then I am not a researcher – Ive always come in more on the "ideas" side of things.

          You made an excellent point earlier – people want surety from me in clinic every day. They are suffering and struggling and they want me to look them in the eye and say "if you follow these instructions, you will feel better.". They don't want "if you follow these instructions, you are 60% likely to feel somewhat better and 30% likely to feel much better" – and in some sense neither scenario is true – by the time you get down to the epic complications and variables of a single person, at least with respect to a psychiatric issue, most of the time there are no stats, they fit no neat area of research.

          But medical training will select for arrogance and in the process hone and refine it to a science, and MDs must be confident or they wouldn't dare do what they do – my personal species of MD encourages more self-reflection and humility but believe me does not absolutely require it. The problem is also that, at least with my training, the hours, the knowledge, the level of training, that one can't get through it without feeling at least a little invincible, having survived it. Having beaten it. 6 weeks of boot camp expanded to 8 years – with the blisters and exhaustion to prove it. By the end you've brought lives into the world and shepherded them out, and held a child's working lung in your hand, and put your hand on the shoulder of someone who has an intractable pain or cancer or problem. The landscape is vast and no one is smart enough, anymore, to have a proper picture.

          • Victoria 13 years ago

            Emily, thank you for your very thoughtful reply. Yes- we're still called mud-phuds, though I'll admit I hid my phuddyness from most of my classmates for over a year until I was outed by an admin asking me about lab rotations in front of a group of classmates.

            I have a great deal of respect for you as a psychiatrist, and from what I've seen, your point about all the confounding variables and complications is definitely true. I'll admit that I find the idea of dealing with the brain very intimidating, which is why I've always said that, while I don't know what I'll specialize in, it won't be psyche or neuro (then again, I also said I'd never go to med school, yet here I am…).

            My point about certainty wasn't so much about telling a patient the likelihood of success, though in some cases I think this is an important conversation (just listened to a great response by Atul Gawande about the discussion of end of life care), but more about the certainty of cause and effect. For the most part, most physicians need to determine a diagnosis and prescribe a treatment. What strikes me is that many doctors' minds are more a compendium of symptoms, diagnoses, and treatments than a logical framework. We're so trained to go for a differential diagnosis and then eliminate options that we rarely think WHY is this the diagnosis, and what is this therapy doing to treat it. Of course, you don't need a doctor to go through the analysis of why, what, how, for all ailments, but in some cases it would be very helpful, and personally I think it would help us get out of many of our stupid medical hang ups (low-fat diets for diabetics, low cholesterol diets for those with high cholesterol, low purine diets for those with gout etc). I am being overly simplistic, but my experience with scientists has been 'the more you know, the more you realize you don't know', while MDs 'just know'

            You say that MDs must be confident to do what they do- and I definitely agree. While I've yet to be in a human OR, I have scrubbed into equine orthopedic surgeries… Seeing joints splayed apart, hanging in directions they were never meant to bend, and knowing that not only will that joint go back together, but it will go back together and WORK… it is amazing!

  7. None 13 years ago

    My god I just don't care about atheism/religion. Atheists are just as funny as most religious people. Can't we just stop talking about it…move on? I ignore people who talk stupid stuff about food rather than engage them in debate…do the same with atheists and other religious people.

  8. katherine 13 years ago

    ohmy(nonexistent)god. Listening to Deepak is painful. He cannot directly answer a single point with a reasoned response. "more scientifically credentialed" blah blah blah. It's really pretty embarassing for him.

  9. Kurt G. Harris 13 years ago

    Although it is true that most MDs are indeed not scientists, Deepak is more representative of the Genus “self promoting asshole who will tell you what you want to sell you something” than anything else. Chopra lives in a 10 million dollar mansion in La Jolla and prattles on about the insubstantiality of the material universe, yet he could not be more a materialist in both senses of the word. The glasses remind me of Jay-Z or Jackie O or maybe even Liberace.

    I am a big fan of both Shermer and Harris (no relation), but these guys are debasing themselves by debating with this charlatan. A more honest debate could be had with Howard Stern.

    As far as the MD PhD thing, I agree with most of what Emily says. I think what makes you a scientist or not is how you think. I went to medical school and was friends with many MD/PhD candidates. I was for a few years an academic MD myself and published in the peer-reviewed literature. There were many PhDs that were no more real scientists (in the critical sense) than most MDs, largely due to the political constraints of the academy and the need to earn a living. The sad thing to me is not how few MDs think scientifically, as many do not even make the claim, but how few PhDs are allowed or inclined to think critically about what they do. It is often just a job, where you continue to research whatever minutiae were of interest to your post-doc supervisor or risk being unemployed. It’s often much more like being part of the house band than on an indy record label.

    • Victoria 13 years ago

      I love the music analogy!

      Your point about freedom of research is a great one, and I think it's good to think about in relation to MD scientists. Having an MD makes you much more fundable (especially if you have a PhD as well), when applying for grants. Funding for new investigators is very slim, but I've heard form different sources that having an MD makes getting that first grant much easier (though if you don't do anything useful with it you're on your own after that). Funding is a bear though… you're much more likely to get money to study the evils of alcohol than the evils of fructose, for example.

    • Andrew 13 years ago

      I'm not sure that anyone has mentioned this yet, but one charge that's lobbed at PhDs is that they can rapidly lose touch with the pace of the field if they diverge into other pursuits. I had the unfortunate experience of a blog comment exchange with a Harvard PhD who had known, studied under, or had conversations with, some of the early proponents of evolutionary psychology during post-grad (in the mid-80s). He used that proximity to assert he was qualified to proclaim the entire endeavor intellectually bankrupt without respect to any of the literature from the last decade(s).

      That isn't to say this one example is representative of anything, but MDs and PhDs suffer (or inflict) similarly when they're working from dated knowledge. That isn't exclusive to _Ds, but a trap all of us can fall into when we "know" something. I can see how the temptation for the credentialed to not only rely on their credentials, but self-reflexively believe to know, might be particularly strong.

  10. Scotlyn 13 years ago

    I couldn’t agree with you more about the magical thinking that people have around healthy lifestyles. Somewhere out there, people seem to think, there is a formula of diet, activity, etc, that will result in no disease or death ever! So people are surprised when someone gets heart disease or cancer – “he/she ate healthy food and exercised regularly, how did that happen?”

    MD confidence (some say arrogance), as described above, may in itself have powerful placebo effects, and therefore play a role in the patient “selection” of successful doctors. Reassurance, a feeling that your fate is now in safe hands, as conveyed by an MD’s confidence, can reduce a patient’s physiological markers of stress to the point where their native physiological healing faculties, which had been rendered less effective or ineffective by their pain/disease/fear, can be recruited to their full use.

    • Andrew 13 years ago

      Yup. It's amazing what people will do to avoid (at least psychologically) the inevitably of death. The similarities between doctors and priests are mostly separate today, but at the roots of mysticism and religion, the shaman and the healer tended to be one in the same.

  11. Tyler Link 13 years ago

    Just wanted to add that Dr. Hyman tweeted this on Dec. 7th: just read an article about a protein in wheat called wheat germ agglutinin that causes inflammation and heart disease- going to write a blog

    That blog post has yet to materialize. Makes me wonder how lectins are not even on the radar of a man that warns so strongly against the dangers of gluten. It also makes me hopeful that he'll shift his stance on whole grains.

    • Andrew 13 years ago

      It's more surprising to me considering that the logic of evolutionary biology informs us that various plants will develop various defense mechanism to thwart predation to the best of their ability to evolve. From that perspective we have a strong ultimate cause that only bolsters (and vice versa) the proximate causal mechanisms we know from biochemistry and modern science in general.

      I'm not saying it's obvious that grains would necessarily evolve toxins, but between evolutionary biology and biochemistry, it seems hard to justify "grains are good" as the null hypothesis.

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