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Six Degrees Of Separation In Pseudoscience

Birds of a feather flock together.
You know, like the 6 degrees of Kevin Bacon game.

I'm still kind of trying to pull this idea together in my brain so bare with me. I was thinking for example, a lot of people have sworn off grains and are hell bent on convincing everyone else to do the same, and the usual instruction is to "read Wheat Belly & Grain Brain and you'll see".

Grain Brain being a book written by David Perlmutter who I suppose people have accepted as a credible source of information.

Now I would put it to you that the anti-grain thing is almost mainstream now, and many quite reasonable and intelligent people are avoiding grains "for their health". The majority of those people probably aren't on board with more extreme "health" campaigns for example the anti-vaccination movement. Most people rightly are quite horrified and outraged by the nonsense that comes out of the anti-vax movement, intent on driving us back to the dark ages with a mistrust of the scientific community and the medical and pharmaceutical industries in particular, and allowing terrible diseases to make a come back, costing the lives of children and others who are vulnerable to infection.

Speaking of the anti-vax movement. One of the most financially successful anti-vaccination advocates is a bloke you may have heard of called Joseph Mercola.

Wikipedia has rather a detailed entry about Mercola covering many of the controversies he has been embroiled in, including the warnings he has received  from the US Food And Drug Administration related to his activities.

See also this quote from Business Week magazine:
Mercola gives the lie to the notion that holistic practitioners tend to be so absorbed in treating patients that they aren't effective businesspeople. While Mercola on his site seeks to identify with this image by distinguishing himself from "all the greed-motivated hype out there in health-care land", he is a master promoter, using every trick of traditional and Internet direct marketing to grow his business... He is selling health-care products and services, and is calling upon an unfortunate tradition made famous by the old-time snake oil salesmen of the 1800s
The anti-vax movement is still rather an extreme, fringe group and I think it is fair to say that most reasonable people see them as lacking credibility, to say the least. Therefore it is probably safe to say that many people who might see Perlmutter as a credible source of information and give credence to his views on the health effects of eating grains and cereals, would not see Mercola or any other promoter of anti-vaccine propaganda in a similarly favourable light.

But here's the thing.

If someone you accept as a credible source endorses, or is endorsed by someone you rightly recognise as a dangerous or disingenuous charlatan, how should that affect your perception of the supposedly "credible" source?

Now it would be fallacious logic to suggest that something "can't be true" on the basis that the author has been involved with someone else who we consider a charlatan. However... hopefully when presented with an idea such as "no one should eat grains" we assess the evidence and make a judgment on whether we feel the hypothesis has merit. How credible we consider the source of that information does come into this. How much faith can we have that we are being given the whole story, all of the evidence, and not just that which supports the authors assertions?

Here's what I've noticed. When it comes to pseudoscience, birds of a feather flock together and all of these people tend to be in cahoots with one other, lending the facade of credibility to one an other and so on. They tend to have a few fingers in a few different pies as well, so to speak, so there might be enough overlap in their areas of advocacy that the "clean eating" bloke can be interviewed by the "anti-vax" guy seemingly without specifically supporting the anti-vax cause.
Pointing out Mercola's anti-vax activities is
one of many good ways to find yourself
#blockedbypete on facebook.

I would suggest that getting on board with an anti-vax propagandist and presenting them as a credible authority on health matters is benefiting the anti-vax cause whether you discuss anti-vax matters or not. I would suggest that doing so while trying to hush up the anti-vax connection is even more disingenuous and deceitful.

So while it is interesting to note that peddlers of pseudoscience do seem to be happy to pair up and cross promote with other peddlers of pseudoscience, even when their primary areas of interest are seemingly unrelated and may not be something that one of them particularly wants to be associated with. What is perhaps even more noteworthy is how often a peddler of pseudoscience will cross promote with another who's pet theory is actually in conflict with their own.

For example the "paleo diet" advocate will cross promote with the "low carb high fat" proponent, who will cross promote with the "alkaline foods change your Ph balance" health guru, who will also be in cahoots with the "these foods unclog your hormones" guy, and so on with the "sugar is toxic and addictive" people and the "anti-GMO" people as well.

Believe it or not, they even offered me a slice of the pie to promote an online weight loss summit with featuring the who's who of made up pseudoscience a few months back. I told them they could jam it.

Now while all of those approaches to diet may appear quite similar as in the choices of foods that are advocated and the choices of foods that are to be avoided at all costs, the pseudoscientific explanations of why we must all adopt that particular diet are at odds with one another. But interestingly, while they would insist upon the validity of their explanation in debate with an actual dietitian or a flexible dieting advocate, they seem to their differences aside when working together and focus on the common goal.

What is that common goal? Well... if you ask them you might get a different answer, but the common goal is in undermining established scientific method and fostering a mistrust in qualified professionals and regulatory bodies. The idea that qualified, experienced professionals in health, medicine and dietetics aren't "up to date with the latest research", or that "science sometimes gets it wrong, so we can just choose what we want to be right and insist that anyone who disagrees is on the take, getting paid to be a damn dirty liar". Aka "the shill gambit". 

The problem with all this is that... well... it actually kills people.

Infants contracting diseases that 10 years ago we considered eradicated, people with conditions that could have been treated only turning to conventional medicine when it is too late, after having been convinced to go the "just eat clean and think positive thoughts, you don't need that nasty chemo" route, just as a couple of examples.

What else is interesting is that many of the anti-scientific consensus type people don't actually realise that they are anti science. They see the mainstream as people who just blindly accept what the establishment tell them without question. This is far from what I am advocating here. People should be skeptical and choose carefully whom they should take advice from. Why should I believe this person is likely to be in a better position to know the details of this complex subject than that person? Does what he or she is telling me seem plausible, does it match up with what I can see happening with my own eyes, and even then... has this theory been tested and do the results of those tests stand up to scrutiny?

We're all to some extent afflicted with a confirmation bias, which makes it easier to see the flaws in an argument that we already disagree with, and harder to see the flaws in an argument supporting a position that we believe to be correct. However if we are really reasonable, enlightened adults with an interest in learning the truth, we should be encouraged to over come our biases and not be so emotionally invested in our opinions and beliefs that we would not consider changing them in the face of new and credible evidence.

What pseudoscientists and snake oil pushers of any subset all tend to have in common is... well, the opposite of what I suggested above. Rather than encouraging people to be aware of their own biases and to think critically and objectively, the overwhelming message and example set is to simply choose an opinion that best suits you, insist that it is correct, and dismiss any evidence or research that suggests otherwise as being inherently flawed or falsified out of hand. Similarly, insist upon the validity of any research that can be cherry picked to support your position, regardless of glaringly obvious flaws in the methodology or inconsistency between the data collected and the conclusion being presented.

I have digressed a little as usual.

Ideally, people are free to do what works best for them. When it comes to diet that could be any of a dozen approaches with countless permutations of possible food choices. If you have stumbled on to one that works for you, that you enjoy and that you feel is producing the changes in health and condition that you were aiming for... that should be enough. It should not be necessary to insist that this is the "only" way to achieve or to deserve similar results in improved health and condition, or to argue that certain foods are the issue rather than overall appropriate or not appropriate eating habits... especially when you're insisting this to people who've had a similar, or perhaps even greater level of success with some other approach that happens to suit them better.

When it comes to diet, consider the root source of the information when someone is trying to convince you "it can only be done this way" or "it can't be done that way", especially if they are going against the consensus of the vast majority of qualified and experienced professionals in the field. While it's not impossible that they could be right where everyone else is wrong, you should require some solid, convincing evidence before you accept it as fact. It might be quicker and easier though to find out what other "alternative" theories they are on board with first.

If it is anti-vax, anti-fluoride, anti-conventional medicine and so on... if you wouldn't take their word for it on those matters why should you when it comes to diet and nutrition?

Side note: we had a productive discussion recently on how research is supposed to be conducted and how qualifications such as degrees are attained which might be helpful or interesting.
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Calories In Calories Out Is Bullshit?

Shame about cutting off the top of my head,
but at least my arms look nice.
Another one of these articles with the above title came up in my newsfeed just now, and I typed a response but then I thought "oh, what's the use I don't have the energy for this anymore" because GOD people are just so frustrating, aren't they?

Anyway as it turned out, this particular article did a good job of explaining why the way people usually treat calorie counting doesn't work out, although I disagreed with the conclusion.

I've seen other articles with the same title from trainers with no success in staying in shape themselves, writing about how calories aren't the issue and the answer is to eat paleo style and avoid these here other, bad foods like cereal for example that "causes you to get fat" because of some fanciful reason that absolutely does not include how it effects your total energy intake for the day. And of course this particular trainer is out of shape because those bad foods are really hard to avoid and it is all the supermarket's fault for putting them on special because it's some great big conspiracy or something.

And meanwhile you know plenty of people who still start the day with a bowl of cereal but are successful in staying in shape and seeing nice results from their training program. I assure you, you do know at least one person doing that.

Look.

Whether you are eating paleo style, whether you are doing intuitive eating, clean eating, whatever else. If you were previously overweight or obese, changed your eating habits and are now no longer (or just less) over weight or obese, you are consuming less energy (aka calories) over all.

Whether you know how many calories you ate before and how many you eat now, or not. You were consuming enough to support your previous weight, and now you're consuming a less excessive amount more suitable to support your current weight.

So, it is not essential to count calories. You can achieve a less excessive intake with a different selection of foods, smaller portion sizes, any number of ways really. The danger in my observation in trying to insist upon certain foods being "to blame" and certain foods being "good" is that some people might find it very difficult to strictly adhere to that list of "good" foods. Hell, as I mentioned, even many of the people who insist that this is how it is still struggle to adhere to it.

The danger then is that if people do not see progress, they blame it on isolated instances of "eating the wrong foods" rather than on not having established eating habits that are conducive to appropriate energy intake generally speaking, on average, most of the time.

To go from obese to not obese that is really about all it takes other than a suitable level of activity. Eating habits that are conducive to appropriate energy intake, generally speaking, on average, most of the time.

Now the issue this article quite correctly raised is that when people focus on calories, they just think "less, and less, and less". They start off with that stupid "3500 calories per week deficit" thing, and when that stops working they try to cut back further and create a bigger deficit, or they try to add an extra hour of exercise to burn more off. Or both things. And then more of both things.

It is a destructive approach that doesn't work and can't end well.

The "one line" answers that people like to use just don't apply to everyone. "Be more active" for example. For all we know someone might be quite active indeed even though to our eyes they do not have the appearance we associate with an active lifestyle, in which case we might want to work on not that whole thing about making assumptions based only on appearance. "Be more active" is not only a little insulting to those people, but it's not the right advice anyway.

What it actually comes down to is a suitable amount of activity and the appropriate amount of energy intake. Not "move more, eat less"... but "consume an appropriate amount to fuel your active lifestyle".

Making "effective training" a part of that active lifestyle will obviously make for more consistent results and more efficient progress. However, while we certainly won't see a change in weight, body condition or health while still in excessive total intake, there are minimum requirements that we must meet in order to facilitate a beneficial adaptation to training.

If generally speaking your total energy and macronutrient intake falls within a range that is adequate but not excessive, you will see progress towards your goal weight and condition. If you can get this right by intuition or by adhering to a selection of foods that are conducive to such an energy balance, good. If not though, you can always crunch the numbers and then plan to meet them with whatever choice of foods best suits you.

This is the reality of the situation, whether it fits into people's personal philosophy or not.
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Context Is Always King

Another one that should have been posted here and then linked to from facebook, rather than the other way around.

Context is always king.Self appointed "wellness experts" and apparently practically everyone else on facebook seem to...
Posted by Dave Hargreaves Personal Training on Tuesday, 31 March 2015
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Like it or not this is the truth about weight loss.

Sometimes I post things on facebook that really should have gone onto the blog for prosperity. Like this one.

I HAVE HAD IT WITH ALL THE BULLSHIT. Pay attention while I hit you HARD with the ACTUAL TRUTH ABOUT SIGNIFICANT WEIGHT...
Posted by Dave Hargreaves Personal Training on Saturday, 28 March 2015
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Origin story for benefit of the new people.

As you might be aware I’m a qualified trainer, with a special interest in “relapse avoidance” via productive training rather than calorie burning, and flexible dieting rather than restrictive fad diets or extreme calorie restriction.

Eating disorder recovery is no trivial matter and for the most part it is best managed by qualified specialists in psychology. What I am qualified to do and what I have become very good indeed at doing is to provide a training program and nutritional guidelines that will allow people in recovery to pursue their goals without an increased risk of relapse, and even to further their recovery as they see improvements in performance and body condition as a direct result of leaving restrictive and disordered measures in the past.

Of course this is also more than suitable for anyone else who wants to get into fit, strong and leaner shape without restrictive and destructive approaches, as well.

How and why did I end up doing this though?

To try to make a long story short; because people asked me to.
I’d been a trainer for a couple of years, had been quite successful with a small number of clients both locally and online, and I had started joining some industry networking groups to learn how to market better so that I could become more successful in business and help more people.

Well. Everything I kept getting told was hard for me to accept. I need to get all of my clients to eliminate all grains from their diets, all processed foods for that matter. Not too much fruit either, because of the sugar. No legumes either for some reason no one had an explanation for, and soy products too because GMOs are bad.

People had different labels for what everyone should be doing…. “elimination diet”, “paleo”, “clean eating”. Much the same rules and restrictions but just different labels depending on who you were getting lectured by, as far as I could tell.

Now right there, I had a problem because I’ve just described my own diet as the “half arsed vegetarian” that I am, and I was in stronger and more athletic shape than a lot of the people lecturing me about clean eating. Not to mention I’d had some clients getting very, very good results indeed without cutting out any of those food choices, either.

Apparently, I couldn’t possibly though. Because working to calorie and macronutrient (aka IIFYM) targets “just doesn’t work”, because the real issue is the hormonal chaos caused by the inherent badness of these particular foods and ingredients. Yep, including fruit and legumes.

So, this doesn’t add up because you’re telling me that something I’ve done personally and helped several others do to “can’t be done” the way I’ve done it. But maybe I am misunderstanding. Perhaps what you mean to say is that there are certain medical reasons why someone might need to cut out these foods, and unless they do so the regular stuff that works for most people won’t work for them? In which case, surely they should be diagnosed by their GP and seek specialised nutritional advise from a real dietitian, rather than by a trainer?
Nope. I was told these restrictions were required for all people, and that I should keep GPs and dietitians out of the process as they don’t know about this stuff.

Well. That’s a pretty big red flag right there.

Obviously I couldn’t accept any of this. I was open to the idea that it might be something I should learn about for the benefit of “some people, in certain circumstances, as per doctors orders”, but I’m going to need to be convinced with some strong evidence. Just a blanket diagnosis for everyone who walks in the door just wanting to trim up a little in time for their summer holiday? Nah uh. Especially since it couldn’t possibly be true.

People all over the world have been “not obese” through out history while eating varying diets including some or all of these food choices. People have lost weight and gotten into great shape while still including some or all of these food choices. I’ve done it myself. You can’t possibly expect me to accept that no one, anywhere, at any time, has ever been “not unhealthy and obese” other than on this particular restrictive diet that you’re trying to push on me. The idea is ridiculous.

And of all things, the idea that fruit isn’t really a “healthy enough” choice of a snack that people can enjoy regularly? I remember saying “it actually sounds like you’re just trying to give everyone an eating disorder, making them afraid that any or all of these quite nutritious every day foods will mean they can’t be healthy and won’t see results from training.”

Then the pressure and the guilt started.
This is the direction the industry is moving in, so you can either get on board or be left behind. If you cared about your clients you’d set a better example by cutting out bread and cereals. Even though you really enjoy them and are getting great results while eating them.
I got really angry at this point, but at the same time what I started to realise was that most of the people arguing with me were victims who’d been sucked into this idea that if they wanted to be a trainer, they needed to be this shining light of dietary virtue, never eating anything “unclean” or indulgent, and so on, with every individual meal or snack choice chosen solely on micronutritional value plus some kind of “moral value” rather than on taste, enjoyment or convenience. So much of their self worth was tied up in their dietary choices, because not living up to those impossible standards would make them a fraud who had no right to be coaching anyone else towards a healthier lifestyle.

There were a couple of guys at the very top, mostly in the UK, who had made a hell of a lot of money from putting these ideas into people’s heads, and the people bought into it almost religiously. So for me to refuse to buy into it was offensive to them, and for them to try to use guilt and shame tactics to pressure me to get on board after failing to provide a logical reason to do so that held up to scrutiny was offensive to me.

I got to the point where I thought “well, if it’s a choice between being a part of this or failing in business… I guess I’ll go back to putting people on their arse for a living”. AKA security work.

At some point though… I must have ranted a bit about this all on my personal blog in frustration and anger at what was going on. People started to write to me saying, “that’s actually how my eating disorder started. Being given a restrictive diet, being afraid to eat everyday foods and being made to feel guity and ashamed if I ever ate something that wasn’t clean”, and so forth. Some of the stories I heard, and the depths of what eating disorder can do to a person, and the lengths they will go to to avoid eating or digesting something that’s “bad” were… well, you probably can’t even imagine.

And the senseless part is that all of these restrictive measures were the only thing stopping these people from actually seeing results from training. For that matter, a lot of the time I only really heard about the bad stuff 3 months after I’d given someone a program, in the context of “here’s what I didn’t tell you before we started. I’m not doing any of that anymore. I feel great and I love the results I’m seeing”.

When you find that you’ve been able to help someone like that, you want to help more people. Simply by giving people a training program that is actually effective, and emphasising that results will come from putting in enough nutritional resources to get stronger and healthier, and not by withholding those resources and restricting energy intake. You cannot starve or force your body into a healthier, stronger, more athletic state. That can only happen by utilising more energy and resources to adapt favourably to training.

When you’ve helped people like that and have heard their stories, you get angry with the people who are responsible for putting those ideas into their heads in the first place. And every time a new one appoints their self the new “health and nutrition guru” pushing more of the same nonsense to more people, you get pissed off all over again.

Now 5 or so years later and I am happy to report that the fitness industry is changing, and more and more people and organsiations are promoting positive, moderate and flexible approaches. Unfortunately though, we now have more mainstream and celebrity promoters of pseudoscientific, disordered nutritional nonsense on the public at large.

Fortunatley though, as these charlatans continue to align themselves with anti-vaccine activists, anti fluoride activists and any number of other variety of scare monger, conspiracy theorist and tin foil hat wearing nut jobs… they erode any facade of credibility they might have had.

The tide is turning and ethical, evidence based practitioners will win out in the end. But the battle is far from over.
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