Science, medicine, and quackery

[sevenperforce]

Posting this here in the hopes that someone has more expansive medical science chops than me and can shed some light on this.

There are a whole host of certifiably fake diseases out there, which usually go by names like "chronic candida", "adrenal fatigue", "non-celiac gluten sensitivity", and the lovely "[Wilson's Temperature Syndrome](https://sciencebasedmedicine.org/naturopathy-vs-science-fake-diseases/)" (which is supposed to be some chronic thyroid dysfunction). With a perpetually hypochondriac parent who bounced from fake disease to fake disease for my entire life, I am familiar with many of these.

My elementary-aged oldest son has high-functioning autism. We reject pseudoscientific nonsense about vaccine injuries; all of our kids are fully immunized.

My son has tested positive for food allergies in the past, but only peanuts appear to prompt serious reactions.

He recently began exhibiting some persistent edema and irritation in his extremities; we took him to the pediatrician and she was unable to diagnose but did do some blood tests. He came back positive for exposure to Lyme disease, so we started him on antibiotics. He has an upcoming appointment with a specialist referred by the pediatrician.

My wife has become very interested in the AIP (auto-immune protocol) diet and a lot of surrounding ideas. It has every indication of typical quackery, but despite significant searching I haven't been able to find any actual doctor giving a comprehensive discussion of it. It focuses on identifying "inflammatory foods" and eliminating them from the diet. I haven't been able to find any actual explanation of how the numerous lists of foods to avoid or include are generated, or what is actually supposed to make something an "inflammatory" food. Of course it has glowing reviews; if you eliminate 70% of your diet, you're likely to see SOME difference in your life, if only due to having more regular meals because you now have to plan everything days in advance.

Is there a doctor in the house who can shed some insight into "leaky gut syndrome" and the auto-immune protocol diet? Or even anyone with better google-fu than me?

[Green Baron]

I am not a doctor (archaeologist), so my answer is as good as anybody else.

Feeling the urge to answer, since apparently these guys write "palaeo" on it which might (or not) refer to some ancient mysticism or what they imagine "palaeo" people have eaten and that in this may lies some sort of health.

Nothing i can see on the first 3 pages of a duckduckgo search seems to have a scientific background, no clinic tests, no "official" links, no published papers, neither English, German or Spanish. But a whole lot of "popular" links. That does not necessarily mean its nonsense, at least i don't find any warnings. It apparently does not harm, but as always with these cases at the fringe of medical science, if it is used as a surrogate for a real world diagnosis and therapy, it might be harmful through "omission".

Also, in principle humans are omnivorous animals. A diverse diet is best for us. Which does not mean that omitting some things will harm us, especially all those cases with allergies must take care.

The best would be to ask a specialist for dietary things. If he/she gives an ok, then why not ...

But this is just an opinion.

 

Edited January 1, 2019 by Green Baron

[tater]

Asked my wife (surgeon), but she doesn't know about it.

I had heard a guy (might have been on Rogin's podcast, unsure) who's a prof at U of South FL who works on therapeutic ketogenic diets (it's standard of care for certain people with CP, apparently). His name was Dominic D'Gostino (sp?) I don't recall him mentioning that syndrome, but I wouldn't, it was over a year ago. My nephew is autistic, and has GI issues, which I think might be a common complication.

Generally, I got the impression that a goal is partially anti-inflammatory with insulin being the agent they try and mitigate (not a med person, either, this is from memory). It's apparently also in studies as an adjuvant regime for cancer treatment (with some success). Dunno if/how it relates to that AID you mentioned.

 

(I remember the interview primarily because the focus on cancer treatment and improved wellbeing during chemo (a friend of mine was going through that at the time).

Edited January 1, 2019 by tater

[Scotius]

Like Green Baron wrote, we are omnivores. Balanced and diverse diet won't harm anyone - until food allergies make themselves known But, that is a work for allergologist (sp?) not  concerned parent trawling the depths of Internet. Also, the term "Inflammatory food" sounds suspiciously broad to me, especially knowing how wide is spectrum of food allergies - from seafood to nuts to cocoa to eggs to tomatoes. Heck, there are people legitimately allergic to water, of all things. It looks like pretty much anything can be an "inflammatory food". Tread carefully there, my friend.

[YNM]

7 hours ago, sevenperforce said:

inflammatory foods

*sensitivity, allergy.

I'm allergic to improper preservatives. If the sea-foodstuff that we bought and/or cook (or eat) isn't properly 'fresh' and has been preserved with lord-knows-what preservatives I'll get allergies.

I suppose you just need to see what works from your child's perspective. It's likely to be similar to you or your wife - if you've had problems with it, maybe your child will too, though it's never guaranteed.

[KSK]

Restless Legs Syndrome is my favourite 'sounds like a fake' complaint but apparently it is an actual thing.

Back on topic, inflammatory foods certainly sound like quackery but immunology (and by extension, inflammation since inflammatory responses are immune responses - I think!) is one of those fields where I know enough to know that the actual answer is probably extremely complicated but not enough to have an inkling as to what that answer might be. 

My gut (haha) feeling though is that the AIP diet might be legit but probably only in connection with GI inflammation, and that its proponents have probably vastly overstated its merits.

From aiplifestyle.com, for example. Comments added in parentheses.

"The Autoimmune Protocol is a diet that helps heal the immune system and gut mucosa (possibly. At least we're talking about food having an effect on the parts of your body responsible for processing food). It is applicable to any inflammatory disease (doubtful, or at least I remain skeptical unless presented with more data. Inflammation is complex, hence I'm not inclined to believe in this supposed one-shot cure for it)."

"The Autoimmune Protocol (AIP) diet works to reduce inflammation in the intestines. Many elimination diets are not complete enough and often do not remove immune triggers that promote inflammation in the gut. (Not completely implausible. Remove the antigen and watch the immune response disappear. And given that damn near anything can be an antigen...) AIP works to calm inflammation in the gut and also calm inflammation in the body. (Ahhh - this is where I get skeptical again, without more data, or at least clearer definitions of what we're talking about here. Removing the cause of an immune response is one thing. Actively damping down an immune response in progress is something else altogether.)"

As an aside, my wife suffers from irritable bowel syndrome, which seems to be a blanket term for 'something is wrong with your guts but we're darned if we know exactly what.' She can and does treat it with a mild elimination diet, since certain foods have a predictable (and painful) effect. As far as I know, IBS (unlike Crohn's) is not an inflammatory condition but still - seeing one medical condition treatable through diet makes me disinclined to reject something like the AIP diet completely out of hand.

Edited January 2, 2019 by KSK

[KSK]

This thread got me remembering about laminitis in horses (my folks used to run a riding stables). Very nasty, basically inflammation of part of the hoof, and my mum was always aware of it and the need to avoid feeding her horses too much 'overheating' food that could bring it on.

To me, 'overheating food' doesn't sound too far away from the concept of 'inflammatory food', but it's also consistent with respectable veterinary advice. Diet isn't a treatment per se but it is important in managing laminitis. I would assume its important in prevention too, as per my mum, but I don't have anything to back that up. However, from that website (the Royal Veterinary College at the University of London):

"Laminitis is a medical emergency and horses should be treated as soon as possible. Various medicine can be given to control the pain. Vets may give non-steroidal anti-inflammatory drugs (NSAIDs) such as phenylbutazone or flunixin and opiates like morphine and pethidine."

*snip*

"Box rest along with dietary changes are important. Rather than grass, horses should have poor quality hay and no or minimal concentrates. Roughage rich foodstuffs like unmollassed sugar beet and the Hi-Fi feed product can form part of a revised diet. If the laminitis is the result of an underlying condition, such as an endocrine disorder, that disease should be treated accordingly."

Obvious caveat is obvious - humans aren't horses. But still, I thought this was an interesting and validated example of the inflammatory foods concept.

[Xd the great]

Well, maybe it is a lack/imbalance of probiotics. Dunno.

Leaky gut symptom can be caused by ilness such as loss of control of the muscles around the anus, or because of drinking milk. Better tell the specialist.

[lajoswinkler]

The thing with gluten has become a very good opportunity for selling products, but there are indeed people who simply get sick after eating wheat even if they don't have coeliac disease. It's not a made up thing, I can assure you of it. It's food allergy. The gut is a very complex place and its biochemistry isn't yet known in a decent extent.

You should talk to a specialist and do a wide spectrum of antibody tests.

[kerbiloid]

Spoiler

On 1/2/2019 at 12:27 AM, Green Baron said:

I am not a doctor (archaeologist),

A post factum doctor studying the quackery patients. Needing no xray to see bare truth.

Always interested what do the palaeodiet fans mean: eating mammoths or mollusca? So different palaeos...

[Green Baron]

Well, we have quite a good picture of what people ate through the times, from direct material remains over landscape reconstruction, pollen analyses, residuals, charcoal etc. to stable isotopes.

Naming something "palaeo" and sticking a sciency looking badge on it is a modern way, it is more an expression of our own culture than an ancient way of life. Normally, in most cases, it doesn't harm if we omit things from our diet. It is still diverse enough for us omnivores. But in combination with other individual sicknesses, inabilities, deficiencies (that i don't have the slightest idea about) things may be disadvantageous for a given individual.

There are specialists around for almost anything, it is never a mistake to consult them. If they don't know the answer then it may well be that there is no answer (yet). Some sicknesses, infections, viral mutations just happen statistically. It's biology :-)

[tater]

The whole "paleo" nonsense is sort of interesting, since I think there is something likely buried in there worth looking into.

I read Harari's book, Sapiens, and he mentions that agriculture enabled human expansion, and civilization, but tended to make the lives of the average individual worse, largely due to the labor involved and move to larger villages/cities, and partially because their varied diet became much more constrained (typically to grain crops, and the food that resulted).

When I read that it certainly made me think about the whole paleo thing, and if there is any merit hiding there---which would require controlled study of large numbers of people to work out, so I'll not hold my breath. It's also worth noting that the obesity crisis in the US and other countries has got to be related to diet, and likely the ease of consuming vast quantities of empty carbohydrates (sugars, in particular, but they're mostly the same thing from a dietary standpoint). Insulin resistance leads to inflammation, so I suppose there could be something real with some dietary changes. Finding real studies is non-trivial. That's what reminded me of the guy working on therapeutic ketogenic (nearly or actually no carbohydrates) diets in a controlled way.

Note: while in the modern world we can easily consume as much of anything as we like, it's easy to eat loads of chips, bread, cookies, etc, and much harder to eat too much meat or vegetables for example, since they tend to fill you up, and you don't want to eat any more.

[YNM]

9 minutes ago, tater said:

agriculture enabled human expansion, and civilization, but tended to make the lives of the average individual worse

But now you can crack open a cold one in the evening.

[tater]

Only tangentially related, but phys.org just retweeted this article in my feed (they retweet a lot of medical stuff, which is the only such content I see in my space/physics feed, lol):

 

[Green Baron]

19 minutes ago, tater said:

I read Harari's book, Sapiens, and he mentions that agriculture enabled human expansion, and civilization, but tended to make the lives of the average individual worse, largely due to the labor involved and move to larger villages/cities, and partially because their varied diet became much more constrained (typically to grain crops, and the food that resulted).

Generally archaeology tends to see it that way. One can indeed imagine that for the contemporary mesolithic groups living alongside with the "Bandkeramik" settlements in central Europe there were few reasons to adopt the new way of life. People had to work much harder than hunter/gatherer groups, it must have smelled in the "thorps", folks there generally had bad teeth from corn rich nutrition, traces of infections are found on bones, skulls, teeth, and sometimes they even beat each other up. But once that way of life starts, there is no way back. Population grows, and work draws work after itself, no time for questioning and every hand is needed ... scrub that, don't cite me :-)

But it is different in the area where the story began. There the change took thousands of years and each single step was not visible during a human lifetime. Life changed too slowly (yet ever faster than before) for disadvantages to be visible. So, maybe, folks just slipped into it. Proposals for explanations of the "why" are still welcome, the "how" is no mystery.

Be it as it may, "paleo" can't be defined in a qualitative way, that's where these things get a little "smelly", as if somebody searches for an explanation in mystery where there is no hard data to support his/her view. Which leaves these things more to the realm of "belief" than hard data driven finding. Imo.

[kerbiloid]

39 minutes ago, tater said:

he mentions that agriculture enabled human expansion

The agriculture exists just for ~10 ky, while the sapienses had populated entire Earth several times in waves since ~ -60 ky or so (except Australia, probably due to their immigration and sanitation laws).
It finished the expansion letting to make armies.
 

Spoiler

39 minutes ago, tater said:

the lives of the average individual worse, largely due to the labor involved and move to larger villages/cities, and partially because their varied diet became much more constrained

To porridge, eggs, bacon, toasts, butter, coffee. And tea at 17⁰⁰.

 

Edited January 3, 2019 by kerbiloid

[Green Baron]

1 minute ago, kerbiloid said:

The agriculture exists just for ~10 ky, while the sapienses had populated entire Earth several times in waves aince ~ -60 ky or so (except Australia, probably due to their immigration and sanitation laws).
It finished the expansion letting to make armies.

The latter is a sad reality ...

[kerbiloid]

I guess, the main key ingredient of the real palaeodiet was a 30 km per day walking before eating.

And no fridge. That's important.

Edited January 3, 2019 by kerbiloid

[Mr. Peabody]

Lymes is bad, bad stuff. I've got family members who took the recommended antibiotics for the required period, but failed to kill the lymes bacteria. (Tested positive again after completing antibiotics.) They all developed chronic pain and other adverse symptoms. You can't be too careful. Lymes can also trigger many other secondary infections. Those with lymes in my family found that supplementing antibiotics with herbal/natural supplements and specific diet was the most effective.

Edited January 3, 2019 by The Dunatian

[tater]

51 minutes ago, Green Baron said:

Be it as it may, "paleo" can't be defined in a qualitative way, that's where these things get a little "smelly", as if somebody searches for an explanation in mystery where there is no hard data to support his/her view. Which leaves these things more to the realm of "belief" than hard data driven finding. Imo.

That's my relatively uninformed opinion as well.

The keto research is interesting, because it's literally eliminating a variable (all carbs). The part I think has merit in the paleo concept (if it was ever to be made scientific, which it is not) is to look at what we evolved to eat, and if eating largely outside that regime is harmful at any level.

In addition to walking more as @kerbiloid says, I assume people ate far less regularly. Get up with the sun, and if you are lucky and have leftovers from yesterday, maybe you eat that, otherwise you start looking for food. You might have a day with very little forage, and then you find a kill (or make one), and you have meat/marrow as a bolus of nutrition. I know there are people who talk about the benefits of intermittent fasting, as well.

[KSK]

2 hours ago, YNM said:

But now you can crack open a cold one in the evening.

If we're talking about paleo diets, surely these cold ones (skip to end of clip) are more appropriate?

[YNM]

13 minutes ago, KSK said:

If we're talking about paleo diets, surely these cold ones (skip to end of clip) are more appropriate?

That's after the one I mentioned - then that one you mentioned becomes more appetizing ! Amazing, right ?

Edited January 3, 2019 by YNM

[DDE]

On 1/3/2019 at 7:10 PM, Green Baron said:

The latter is a sad reality ...

There was an extra step involved. Until there was a singnificant surplus of food, you could only campaign outside of harvest time (pretty sure this somehow applied to nomads, too). I think this was definitely the case for Greek poli.

But then, warfare became a permanent profession. And it’s pretty notable that as soon as the legions stopped being a militia, they marched against Rome.

[Green Baron]

Sure, my remark was on @kerbiloid's hint to the onset of agriculture some 10.000 years ago. He pointed to the fact that humans spread all over the earth long before that, and to the fact that with agriculture and division of work we have clear evidence of intraspecies violence among humans, while all cases before (from the paleolithic) can be attributed to for example hunting accidents. This is all long before bronze (Greek) and iron age (Greek/Romans).

Anyway, off topic and nothing new at all.

Edited January 5, 2019 by Green Baron

[lajoswinkler]

Never bluntly accept modern dietary fads. It's all made up by stupid narcissistic nutters, pushed by preppy people who expect to live forever if they guzzle down a barrel of water each day, and commercialized by companies that, in the end, just care about the money, regardless of how eco/bio/organic/natural (or other stupid meaningless word) their face is.

And you can seriously love up your health if you suddenly and radically push your diet into a lack or overabundance of some crucial nutrient. If you're healthy, just eat diverse stuff, don't stuff your face with food, use stairs instead of elevators where applicable, walk if you can manage the distance, etc. That's statistically the best thing you can do. And just hope you don't lose on the lottery of life and get aggressive cancer because your genetic makeup was prone to it. You can't do anything about that.

 

But if you're not healthy, work with professionals to find the root of it, and adapt your diet in accordance.