Thinking in English words makes "clean" and "dirty" sound like single-dimensional vectors that directly oppose each other. But that's not true. What is actually true is an n-dimensional vector, with an enormous variety of "cleans" and "dirties", and even more complicated when you start combining the vectors. Plus you don't get to custom-design them; you have to take what exists in the world. So when you "clean" yourself with a certain soap of the "dirtiness" you currently have, you don't get to custom design a cleaning agent that precisely knocks out only the portions of the "dirty" vector you have, you can only use things that exist, with all their side effects.
A lot of things in the real world work like that, but the medical world, since it involves biological bodies, the most complicated things in the known universe, seem particularly prone to this problem. Similarly, if you have a genetic disease where X is overexpressed, but its action is opposed by Y, it isn't necessarily a solution to just increase the expression of Y, because where English makes "oppose" sound nice and clean, in reality that's a summation of two complicated vectors. For all you know, X and Y also have a way in which they work in the same way, and having a system that overexpresses both will suddenly expose a pathology where the combination of both becomes fatal even so. Biology's a nasty place. The engineering is profoundly non-human.
I think "inflammation" is the modern day's "bad humors". We don't really understand the relationship between inflammation and illness and yet inflammation get's sold to the public as an important cause. Unfortunately, anti-inflammatory drugs don't improve outcomes for heart disease or Alzheimer's, even though inflammation is somehow implicated.
So mucking about with worms or other parasites to give the immune system something to do is most likely not a good idea until we better understand the underlying mechanisms.
Sports medicine has always been a bit more pragmatic than other branches of medicine. "We have no idea how this works, but it makes people run/swim faster, so let's do it!"
I think a lot of work 10 or 20 years ago went into reducing inflammation. Less inflammation = could train again the next day! Pound down that Advil at the end of your workout so you are ready to go!
Over the last few years, it seems more and more people are saying "The inflammation process is what makes your body stronger - you can't stop it without losing the benefits!"
On the other hand, I do still see inflammation stopping treatments around. i.e. football players after a game getting into basically a freezer for 15 seconds to reduce muscle inflammation. Possibly the logic there is that they are already trained and not looking to get "stronger", just recover from the days damage as fast as possible to get ready for the next game.
I've heard that the goal for many football players is not long term health but to get out there and play while the opportunity is there. Reducing inflammation works so that you feel like you can go out and play again without adequate recovery. When the average football player has only a few months for a few years to make their mark, playing through injury or pain is the goal rather than the proper recovery.
Which then makes sense for them in a way, but makes treating inflammation something that maybe isn't as important for the general population (as most of us are hopefully in it for the long haul)
Sports medicine seems to forget about the placebo effect.
I've seen players, weekend warriors, even former amateur athletes trying to improve injury recovery times/performance with procedures, folklore, gadgets, or just "This is what my coach said".
I believe we need to get the strong science into sports medicine. And when pointed to studies, they are like studies
done in too many psychology studies--"The study compared twenty athletes to blah, and no follow up with larger objective studies.
The athlete is the perfect candidate for placebo cures, in so many cases.
Sports medicine seems to hurt a lot of athletes with the whole, "Hay--it works!". Yea, and it kills, and shortens life spans in athletes(professional) too?"
I don't want to argue, but I believe Lance Armstrong won most of those wins with the placebo effect.
Yea--scream all you want. Lance didn't come across as that knowledgable. He belived everything those doctors were telling him.
I'll never forget something his Italian doctor said when he was being roasted over all the drugs. I won't get the quote right, but it was after all the villagers/authorities busted the two of them. Lance one one race without anything in his system. He might have had blood transfusions? It doesn't matter, his doctor said, "Lance won on the placebo effect! Probally all along?"
Not one reporter asked what the placebo effect was. I have a weird feeling most of those drugs were hampering his performance. But the super powers of that placebo effect were magic?
> I believe we need to get the strong science into sports medicine.
Professional sports already bring on board the best (applied) science that money can buy. The approach is practical because there are billions of dollars on the line. If that is not good enough for you uppity sense of scientific purity, too bad. When you own a team, you'll be free to do as you please with your own money (just don't complain if your team is beaten by all the others that do not share your scientific sensitivities).
Professional athletes and their coaches will not stop doing what is well known to work just because a bunch of nerds have a quasi-religious taboo against the "placebo effect".
> Sports medicine seems to forget about the placebo effect.
Well, people who make gadgets are well aware of it - and use it to make a LOT of money :)
On the other hand, sports performance is 50% mental. If wearing one green sock and one red socks makes you think you are faster, then why not? You may really be faster.
I am not sure I would want a FDA Like body over sports gadgets.
* These sunglasses have NOT been shown in blind studies to make you run 5% faster. Any statements along those lines are by paid actors.
Is that the same case? It seems like the sports coaches are reducing acute inflammation, for a specific, short term performance goal. With probable long run damage.
Whereas the information people warn against generally is chronic inflammation. The kind that wouldn't occur in a healthy person. But the kind that does occur, and is measurable, in someone who eats poorly, doesn't exercise, sleeps inadequately, and is stressed. I believe C-reactive protein is the main measure.
That doesn't mean inflammation is the cause of the problems associated with those lifestyle problems. I'm sure that's a complicated question - targeting it specifically might be pointless if the underlying causes remain. Just noting that the inflammation you're talking about is a different variety.
>Sports medicine has always been a bit more pragmatic than other branches of medicine. "We have no idea how this works, but it makes people run/swim faster, so let's do it!"
Doesn't sports medicine still blame lactic acid as the cause of muscle fatigue?
Ya some do, although it seems that it is starting to turn.
Remember - I said sports medicine was pragmatic not correct ;) While muscles are being used heavily, a ton of lactic acid is made faster than it can be recycled by the body. So no it's not causing fatigue there is a high correlation between lactic acid and muscles being fatigued. Lactic threshold is still a very interesting concept, the point at which you recycle lactic acid at the same speed as it is created. What the heck lactic acid does is maybe less important to sports performance...
Not really, some members of the public don't understand it.
Inflammation is a symptom, and chronic inflammation leaves you vulnerable to other problems. It's also pretty easy to measure.
As an example, when I was struggling with back problems, at one point my sed rate was over 90mm/hr (ie. really bad). It was 3 about 3-4 years prior, and 25 about 6 months prior to my spinal fusion. (I was 25 at the time) Drawing the conclusion "inflammation caused back problems" is wrong. Using the inflammation measurement to say "things are getting worse" as part of an overall assessment of my condition is a sensible conclusion.
* wash hands, and frequently (but you don't need an antibacterial soap -- they're bad for fish)
* use your well-seasoned wok/cast-iron skillet and not wash it with soap
* eat your fermented foods (from funky cheese to kimchi)
* eat things straight out of the garden without washing as long as there is no visible raccoon poop
etc. It is also possible to use different gradations of cleaning power for your body and house: bleach kills everything while vinegar and baking soda clean most things just fine; some soaps are less harsh than others. Showering regularly is a blessing in high population-density areas, but you don't need to sanitize every part of yourself every day.
The only area in my life where I'm fanatical about sanitization, in fact, is brewing beer. There a certain outcome is desired and my usually carefully cultivated lackadaisical attitude is not appropriate.
The problem with the hygiene hypothesis is that clinical trials to test it haven't really shown any results so far. Coronado Biosciences tried using pig whipworm eggs to treat Crohn's disease and other inflammatory conditions and the result was it showed no impact whatsoever.
Now that's not to say the theory is completely debunked, but so for our theory hasn't really held up with testing.
It kind of reminds me of antioxidants as well. Yes, there is a lot of evidence that oxidative stress plays a role in disease, but attempts at levering antioxidants hasn't shown any impact.
But, if the problem I'd that the immune system learned the wrong thing, then you can't fix it with whipworw, it's too late. Kinda like somebody learning a second language late in life.
The only to test a theory would be to use infants twin, raise half of them in clean conditions and expose the other half to all kind of bacteria, etc...
I read about a study that was using parasitic worms to cure autoimmune diseases. I'm guessing you're referring to a different one? Preliminary results for that study were promising though I didn't check back.
I can't be bothered to write a complete takedown, but two things come to mind:
1) The author falls prey to the naturalistic fallacy:
> We can actually achieve a good mixture of gut bacteria very similar to that of our hunter-gatherer ancestors by adopting a good diet high in fiber and low in processed foods.
2) I've read studies to the effect that some infectious diseases can affect intelligence. Particularly when children are young - apparently there is a mechanism to either further develop the immune system or the brain depending on the environment (this might partially explain the Flynn Effect). I can't find the exact study (this used to be in this section - https://en.wikipedia.org/wiki/Impact_of_health_on_intelligen... - but I think it was edited out at some point).
Your point one sounds like a fallacy fallacy, i.e., just because some conditions of a fallacy are present, does not mean it applies.
The article does not state that every aspect of the hunter gather microbiome is superior to the modern day ancestor, rather just acknowledges the complex and long process of evolving mutually beneficial microbiota which is being disrupted by modern technology. That statement is not as controversial as you imply.
Perhaps when you aren't so busy reading Hacker News, you might be "bothered" to give a more complete reposte.
Ironically, I think you may have fallen victim to a kind of fallacy fallacy fallacy, because the fallacy fallacy concerns the interpretation of an argument assuming a valid fallacy in it does exist. At least according to Wikipedia's definition of fallacy fallacy.
Rather, in this case the parent post merely misidentified a fallacy.
That's not a naturalistic fallacy. The author's claiming that our ancestors had lower incidence of bowel disease or were perhaps healthier in other ways. Feel free to refute that claim, but don't attack a strawman.
Well, the author has to back that claim first. The burden of proof is on the one who brings the original claim (despite modern advances in hygiene and medicine), not on me.
I think the habit of getting in touch with nature begins as kids - playing with mud, getting enough sun, swimming/playing in ponds/lakes/rivers. That improves our immunity to a good extent. However these are good only in natural settings and not so good in the nature-pockets in urban areas.
It seems like a focus on the internal human biome could be a Kuhnian paradigm shift -- but like everything else about health, it also presents ripe opportunities for quackery. Let's see some more real research on this before anyone starts trying to self-infect.
I believe there was an article about how one research study was wrong about the percentage of human mass being bacteria (I think the claim was 50% of our mass is bacteria). So, I expect Mercola and company to latch onto this craze soon enough if they haven't already.
Gah - that is a bad conclusion to draw from that study. There are some 39 trillion bacterial cells in a human body, and ~30 trillion 'human' cells in our body. EXCEPT that 25 of the 30 trillion human cells in our body don't even have any human DNA in them (red blood cells lack a nucleus, cannot divide, and do not contain human genetic information).
It's hard to count human cells, and non-human cells. Counting mass, nuclei, activity, etc. are all different.
The original hypothesis still stands - a truly significant portion of you is not human.
I've never heard it stated in terms of mass, I've always heard it in terms of a human body having many more bacterial than human cells. But that is being revisited (probably the research you mention):
And prokaryotic cells are much, much smaller than eurkaryotic cells. I think the mass of a eukaryotic cell is over 1000x the mass of a prokaryotic cell.
I think in our lifetimes we went from "antibacterial in everything" to "wait there is something about these bacteria that we want." Science is catching up to the idea because of the mistakes we've been making over the past decades. Hopefully they can figure it out in our lifetime.
Is dysbiosis being considered as a possible contributor to colorectal cancer? It's a big killer in the US. Lists of risk factors only include eating processed meats, type 2 diabetes, alcohol consumption and being overweight.
People claim a large benefit of a natural birth over a c-section is all the bacteria that gets dumped on the baby coming down the pipes. Our overall understanding of bacteria seems pretty crude..
Just fyi, everyone who has been on the internet in the past year has heard about poo transplants. We can stop with the breathless "I kid you not" at this point, it's a known thing.
My week old baby is already contributing to science. The doctors are collecting blood, stool, skin-, and nose-swab samples to try to build a corpus of data to track infection rates and see if they can draw correlations. They even took my blood and poo for it, as well as mom's blood, poo, saliva, and skin swabs.
About a year ago, after reading some material (I think posted on HN) I decided to stop using soap on my body, for the most part.
I have long hair, and I've struggled with dandruff in the past, so washing it with shampoo and conditioner seemed to be the only way for a long time.
But for the last year, I get up and do a relatively quick, hot shower. I use a tiny bit of soap between my legs. For the rest of my body, and especially my scalp, I vigorously scrub with my hands and fingernails.
My hair, scalp and skin have never been more healthy. I produce notably less body odor now.
So...I have been and remain a clean person. But now I'm not using substances that'll kill most everything on the surface of my body. And this has been a very good thing.
In my experience with a pair of friends who have gone the "no more soap" road, it isn't that they produce less odor (quite the contrary, and to the detriment of their careers, I'm really a bit sad to say), it's that they get accustomed to their odor.
For dandruff, I can highly recommend a mechanical solution (as opposed to a chemical one). The thing which has worked for me is a scalp scrubber. My barber explained dandruff to me as skin that has sloughed off of the scalp, but which hasn't come off the head yet. So you shampoo your hair, then scrub your scalp while the shampoo is still in your hair, this fully loosens the old skin (dandruff), which is removed along with the shampoo when you rinse. This has worked shockingly well for me and I only have to do it about once a week. The best part is that scalp scrubbers only cost $2. You can Google "scalp scrubber", but this is what I mean:
Uhm, that's all possible but 'sick' is rather general. IIRC there was an article here recently where children growing up on farms were compared to children growing up in cities and the consensus was that because the farmers were more exposed to typical 'farm dust' (think pollen, animal excrement, ...) they were less likely to develop all kinds of allergies (indeed: pollen, animal excrement, ...) than those from the city, and less allergies in turn means less prone to asthma and other respiratory problems etc. In other words, that article is like exactly the opposite of this title, in a way.
The story of Jasper Lawrence is pretty interesting. He suffered from severe allergies that incapacitated him much of the time. He got so deperate that he went to Cameroon and walked around in poop in open latrines to infect himself with hookworms. Couple of months later his allergy symptoms were gone.
That is a platitude to me when you have no idea what the range values are. We may be in an extreme end but if the dimensions are not defined in a meaningful way, where is the wisdom in this statement?
You might as well say the secret to winning a football game is to score more points than the opposing team.
To tell you the truth I don't really know (and understand) what you are talking about. Myself, I understand balance as not to be phlegmatic and not to exaggerate towards things, life. Hopefully you can understand what I wrote and tried to say (English is my 4th language) better now? Let's take washing hands as an example. Don't wash your hands every 15 minutes just because you touched door handle or shook hand with someone but be sure to wash it when you finish your toilette business...
Your football game example reminds me of :
"If you want to win you must not lose" – Number One (Alan Ford)
I have an autoimmune disease (Ankylosing Spondylitis) and I've been pescatarian for a little more than a year. I'm not on any biologics, my sed rate is pretty normal and I feel SO much better. Part of my diet change is that I eat a large amount of fiber (40+ grams a day generally), which is very prebiotic. I would say it really has helped me, its probably worth trying a diet change if you have an autoimmune condition.
There's really no evidence to support it. It sounds nice and may turn out to be true, but we can't say for sure. Riding the subway probably does more for immune development than playing in the dirt.
The evidence is soft and not fully linked to outcomes (ie, they live longer). The risk of contracting a serious illness that stunts development or even kills is almost certainly higher if you expose a young child to too much filth. There's likely a tradeoff and it's not clear which way the balance tilts.
The interesting thing about that study is that the protective effects only work if you're exposed before you're one year old. This makes it a bit late for most of us on HN.
To me it's obvious. Till now no one questioned pharmaceutical and body care products. We've been led astray. We used soap/shampoo when we wake up, antibacterial soap morning noon and night, lysol disinfectant spray on all surfaces, a pill for ADD before bed. So for 40 years we have been doing exactly the wrong things.
You can't unscrew this by throwing dirt on it. Dirt isn't the right bacteria either. Even bacteria has an order to it. There are a common set of bacteria on us and things and they needs to be there. We've been convinced by corporations selling a products, that bacteria is bad.
Blaming the allergy and inflammation epidemic on anti-bacterial soap and other similar products is a common hypothesis, which is probably why this article was written to argue against the hypothesis.
The article's hypothesis is that the cause is indoor living and processed foods.
Your statement does not agree with the article. Encapsulated in the sentence "cause is indoor living" implicates products such as antibacterial drugs used in soap, toothpaste, everywhere etc.
I read it as ADD medicine is wrong for most people, and that it was going that angle. I guess the wrong medicine at the wrong time of the day wins a double wrong?
A lot of things in the real world work like that, but the medical world, since it involves biological bodies, the most complicated things in the known universe, seem particularly prone to this problem. Similarly, if you have a genetic disease where X is overexpressed, but its action is opposed by Y, it isn't necessarily a solution to just increase the expression of Y, because where English makes "oppose" sound nice and clean, in reality that's a summation of two complicated vectors. For all you know, X and Y also have a way in which they work in the same way, and having a system that overexpresses both will suddenly expose a pathology where the combination of both becomes fatal even so. Biology's a nasty place. The engineering is profoundly non-human.