Tuesday, 29 July 2008

Are we Underrating the Anecdotal?

There is an ancient British superstition which says if a child rides on a bear's back it will be protected from whooping-cough. Perhaps it’s just as well we destroyed the bears and their habitat centuries ago or we’d have a serious health and safety issue on our hands.

Such absurd beliefs can arise because of how we are programmed. There is a survival advantage to making associations between things that turn out to be true (such as poisonous berries and death) but no particular disadvantage to making associations that turn out to be false. This is how superstition develops. If I rub olive oil into a wound and it doesn’t get infected, why not do it every time I get a wound – just in case that’s what provided the protection. If you are interested in a full explanation, see this article in Scientific American.

Evolution has taught us to hedge our bets. So when someone tells their doctor about something they are convinced is curing their condition, the doctor is right to be cautious.

On the other hand, you sometimes read about a study finding evidence to support a piece of received wisdom and can almost hear the cries of “Well I could have told them that!” being uttered in kitchens up and down the country. I guess if you have an infinite number of monkeys randomly making superstitious connections, eventually they will come up with some genuine cures.

As someone with a science degree, I do have a reasonable grasp of the meaning and importance of controlled experimentation and empirical measurement – but as someone with a keen interest in nutrition who has experimented extensively with my own diet I am aware that anecdotal evidence often contradicts the advice given by the establishment; when that happens, it’s hard not to question whether sufficient value is attached to the potential value of that evidence.

Some years back a friend of mine was diagnosed with ulcerative colitis. It came as no surprise, since it ran in his family. Purely by chance, he was introduced to a ‘juicing’ diet by someone. This involved living, more or less, on the juice of various fruits and vegetables.

My friend decided to do some research. Naturally, he did not rent a medical facility and conduct controlled clinical trials with a recruited sample of colitis sufferers. Instead he read the testimonies of fellow sufferers who had tried juicing.

There are concerns around adopting radical diets like this which a doctor would quite rightly raise. Nevertheless, my friend went ahead with it for several months, over the course of which his symptoms started to disappear. I know, I know – what else was he doing during this period? It’s likely that his whole outlook on life had changed. Maybe as well as adopting the diet he had stopped sleeping for 3 hours a night and pouring half a litre of scotch on his cornflakes.

Nevertheless, whilst the symptoms were gradually disappearing for whatever reason, his specialist was suggesting fairly powerful drugs that would help slow down, but not cure the illness and telling my friend to prepare for the possibility of a life with a colostomy bag; he was not very interested in my friend’s supposed miracle cure.

Disillusioned by the advice he was getting from his specialist, but excited by his apparent reprieve from a life with a colostomy bag, my friend spoke to someone he knew in the medical profession, who laughed and said “Don’t expect them to be interested in anything that’s not in the textbooks.”

I understand why medical professionals would feel like this. If they took the time to fully explore every patient-reported treatment, they would barely have time to see a fraction of the patients they are expected to handle. Moreover, both practically and ethically, doctors can only recommend treatment for which there is clinical evidence and can only sanction lifestyle choices the establishment generally accepts to be safe. My friend’s specialist would have been irresponsible to say “Wow, sounds like that worked for a bunch of people and it sort of makes sense – so I would stick with the juicing instead of taking these clinically proven drugs.”

Don’t get me wrong, clinical researchers have looked into (and no doubt continue to look into) the connection between diet and ulcerative colitis and it would be a mistake for me to try to establish just how much was known when my friend was advised; but for me this story is important because it illustrates how a collection of anecdotes can be a powerful indicator that clinical research is required.

It’s possible my friend’s story was one of many that percolated into the medical research community and contributed to the anecdotal ‘noise’ driving clinical research on the condition – but given the reaction of his specialist, I doubt it; and this is what concerns me. The percolation process feels inherently inefficient. Do all the anecdotes get through? Many anecdotes may not even get as far as a specialist if patients have the impression there is no interest.

When my friend was researching his condition, the internet was embryonic and certainly lacked the kind of community-based interaction that now abounds. 15 years later there are millions of voices talking about the things that matter to them most – and health comes pretty high up the list. The internet is a huge database of case studies – the question is whether we are taking full advantage of it. The market research industry (obvious candidates to leverage this medium) is only just beginning to tap into the potential of social media as a research tool. It seems a safe bet that the medical profession is no further forward. The difference is, the stakes are so much higher for the latter. If market researchers don’t have a big push on harnessing social media, Acme sells fewer widgets. If the medical profession don’t, progress in researching important health issues is slower, so more people suffer.

But as well as being under-used in aggregate, are individual anecdotes sometimes given less importance than they deserve?

There was recent controversy over Dr John Biffa’s criticism of a diabetes organisation. He implied they are wilfully giving bad dietary advice to diabetics and subsequently received a grilling here and elsewhere. It was a pity that Biffa so poorly dealt with an issue that has been widely debated on the web – are low carbohydrate diets a better way to treat diabetes than the low fat diet recommended by most diabetes organisations?

If you trawl the web for testimonies on the subject, it is possible to find many from people who say they have self-treated type 2 diabetes with a low carbohydrate diet - and people appear to have been talking about it for a long time. Indeed I was unable to find any testimonies from people for whom such a diet had failed. I came away with the impression that this is the best diet for diabetics.

Of course this means nothing – it’s circumstantial, anecdotal and subject to recall bias and the placebo effect (not to mention my own ability with Google.) Plus, there are also testimonies from diabetics whose lives have been improved by the recommended low fat diet. Nevertheless, it seems that one organisation is indeed changing their advice and it would be fair to say that there is now a fair bit of research taking place in the area.

My question is this: can’t a single anecdote be considered powerful in its own right if it contradicts advice positioned as being for everyone in a certain group? For example, if an organisation is recommending a diet for people with a certain condition, yet one person is shown to improve significantly on another diet, doesn’t that prove the advice is flawed? Surely the advice should either be re-positioned or withdrawn, pending further research? If we believe it does then Biffa’s insinuations of chicanery sullied a valid criticism about the quality of advice to diabetics by this organisation.

To return to the question about anecdotes driving research, I would like to offer a final thought. Trials to evaluate the effects of diet are often expensive and difficult to run, and for potential funders like pharmaceutical firms there is rarely a pot of gold at the end of the rainbow; but this is all the more reason why we should make sure the research that is done is the right research. Instead of ignoring people who publish internet testimonials about themselves and others on the basis that it’s ‘purely anecdotal’, why not find a way to proactively engage with them? This would create a double benefit.

First, there would be the potential for more case studies to drive research in the right direction. The internet is teeming with people documenting their own experiences and supposed cures. Just because they are talking about it on the web instead of in a consulting room, does it make their story any less valid as a case study?

Second, by engaging with people who are potentially disillusioned with the medical establishment, a better understanding between all concerned could be fostered – it is a PR opportunity not to be missed. After all, in this case it may turn out they had a point.
... Read more

Saturday, 26 July 2008

Cone Theory and the Mystery Doctor

Barry Austin - heroic
I once got talking to a doctor on a train about health, nutrition and longevity and was fascinated to learn about something called ‘Cone Theory.’ Apparently, at any given time, a person’s physiology can be defined according to its current level of resource and the level to which the resource must drop for him or her to die. As we age, the current resource level slowly drops and the death threshold slowly rises, creating a graph of two slowly converging lines. When the lines join and you reach the tip of the cone, it’s curtains. Most people, he said, were not aware of the size of their gap at any given time.

Recently, after several years, I remembered the conversation and decided to look into Cone Theory for myself; but I was surprised to find that Google returned no hits for anything meaningful. If such a theory officially exists, it’s certainly not called ‘Cone Theory’. Maybe I just got the name wrong – or perhaps the man was not a doctor but a pathological liar. We are unlikely to find out unless he happens to read this blog and is gripped with a desire to come clean.

Thinking about it now it just seems like another way of saying that when you get unhealthy you die and that susceptibility for an individual varies with time and also varies between individuals. In other words, common sense.

Yet it got me thinking about something else that has bugged me for years – the fact that some people appear to have a totally different discomfort threshold from me.

Some years back my Dad had a friend he cycled with. His friend showed up each Saturday without fail, despite having invariably drunk half a litre of scotch the night before – and the night before that. In fact this guy was Jack Daniels’ best customer. Yet he was able to keep up with, and often out-perform my Dad, a pretty fit guy. We were astounded by his ability to function happily in this way in spite of his drinking habits.

Similarly, I have friends who in years gone by were able to drink for most of the night, get perhaps 3 hours sleep, go to a football match and then continue to drink for the rest of the day, perhaps rolling into bed in the early hours of the following morning. I’m pretty sure I could have done the same thing if you’d offered me enough money, but I would have hated it – my body would have been screaming at me in all kinds of ways, urging me to go home to bed. My friends were offered no such incentive and they loved every minute.

I can think of a few reasons for this apparent disparity.

My friends may simply have been built of sturdier stuff. There is a documentary that has aired on UK TV called ‘Inside Britain’s Fattest Man’, about a guy called Barry Austin. When the program was made, Barry had been eating and drinking to heroic excess for several years and achieved a weight of around 50 stone. The narrator asserts (with no real evidence I should say) that Barry was able to do this and remain in apparent good health because he had incredibly well lubricated intestines and an uncommonly strong liver. Needless to say, it was mentioned that even Barry’s top drawer organs would begin to feel the strain if he continued with his lifestyle. Clearly in Barry’s case, one of the reasons he was not currently feeling the strain was that he had a better body.

On the other hand, it could equally be that my friends were no sturdier, but simply had a different attitude to discomfort. As children they may have learned to associate the body’s signals about wear and tear with opportunities for enjoyment. The whole framework of their perception could have been skewed towards decreased sensitivity – or conversely mine towards increased sensitivity for some other reason.

Finally, I wonder whether as well as varying genetically in our robustness, we also vary in the strength of the signals our bodies send to our brains? Perhaps my friends were simply getting weaker signals from their bodies and therefore genuinely didn’t feel as bad as me even though they were in the same shape.

A word you hear a lot in this context is “constitution.” I once heard Rod Stewart being interviewed about his partying experiences with Elton John. On one occasion, says Rod, when Elton was at the peak of this cocaine use, they stayed up all night, drinking and doing, as Rod calls it ‘How’s your father’. Abruptly, at 8am Elton stood up and announced they would go and watch Watford play football. I can’t find the interview on YouTube, but I recall the phrase “He’s got an incredible constitution.”

The word ‘constitution’ seems to encapsulate the three explanations perfectly. However, my experience is people tend to assume it’s the first one that applies – in other words, they feel okay, therefore they are.

In my wanderings around the blogosphere I often call in on Arthur Devany’s blog. He likes to talk about the difference between the most you can do and the least you can do, saying that “When the two are equal, you are dead.” There is clearly resonance with the phantom Cone Theory here, and Devany’s arguments for this and other theories of longevity are compellingly made.

So in spite of the fact that I have apparently been hoodwinked by a pretend doctor with a pretend theory (I have been confidently telling people about Cone Theory for years) I find myself warming to its theme.

For me, the main takeaway is that no one can really be sure whether they are getting the full story from their brain. Rather like the president or prime minister, they only have their advisors’ word for how things are looking outside the office. Do I have a congenitally weak body and will therefore hit the peak of my cone at the same time as my hard-drinking friends in spite of all those nights I went home?

Or am I blessed with a set of uncommonly honest advisors, whose candour will ultimately add years to my life? Another roll of the dice, I guess.

See Also:
When it comes to Nutrition, the Glass is Half Empty
Roll the Dice
... Read more

Tuesday, 22 July 2008

When it comes to Nutrition, the Glass is Half Empty

Being the sanctimonious type, I find my friends volunteering information about their diet without prompting. It comes with the territory. You only have to harangue someone about their diet a couple of times and are forever thereafter assumed to be interested in what healthy food they have been eating.

“I had some broccoli with my dinner on Wednesday and a salad yesterday for lunch,” was the statement proudly and cheerfully sent my way recently, apropos of nothing. When I hear this sort of thing, depending on my mood at the time, I either offer congratulations and change the subject or tell them a version of what follows.

Nutrition does not work like a distance learning qualification or a bank account, where you can contribute positively when it suits, make progress each time you do and yet during the periods you are not contributing see no erosion in value.

If you eat nothing but lard, your health will deteriorate to the point where you eventually die. Your bank account will be closed with a zero balance - even if you had built it up to a five figure sum with daily broccoli and salad in the preceding 30 years.

It is primarily the lack of vitamins and minerals that lead to the decline in health. It is therefore reasonable to assume that the absence of vitamins and minerals in your diet for several meals in succession will also affect your health, albeit that it may be imperceptible. It could be the difference between catching a cold and not catching a cold – not that you will never know for sure. Over several years, the effect will no longer be imperceptible, but again, you won’t know for sure what caused what.

What else was my friend eating during the 48 hour period her ‘story’ spanned? I dread to think. Even if the rest of her diet was not composed of junk, one has to conclude that it also did not include fruit or vegetables of any kind, or she would have included them in her story.

The fact is that where nutrition is concerned, the glass is always half empty. Long term, optimism will not serve you well.

See Also:
Cone Theory and the Mystery Doctor
Roll the Dice
... Read more

Saturday, 19 July 2008

Why (Refined) Sugar is Bad: Some References

In my post We're all Junkies I ask the reader to go to Google and find the evidence for why sugar is bad.

I did some digging myself this morning, and found a couple of sites which appear to be reliable sources.

On Sugar Addiction: Society for Neuroscience [link removed] - this seems to be an organisation with a good reputation. Update, 3rd Oct 2010: this link was removed because it no longer works - however, this article summarises the content of the paper that was published in 2003.

On the damage sugar does: Mercola.com - whilst Dr Mercola is selling products, the references he gives in this article are from respected medical journals. Note that one or two of the articles he cites refer to the consumption of high concentrations of simple sugars, not specifically refined sugar.

See Also:
We’re all Junkies
Cigarettes, Sugar and our Innate Short-Termism
The Worst Sugar Pushers of all - Health Food Stores
... Read more

Cigarettes, Sugar and our Innate Short-Termism

We continue to be amused by adverts from the 50s depicting smiling, young smokers and now deeply ironic catch-phrases (here's an example). There’s a sense in which we see those adverts as a reflection of our naïve past – how could we have been so stupid that we thought cigarettes should be promoted in this way? Yet the more profound irony - that we continue to permit their sale today – means the joke is on us.

Are humans afflicted with innate short-termism? It would make sense that our mechanisms for perceiving peril are geared around dangers whose effects manifest themselves immediately or in the near future. After all, we spent hundreds of thousands of years learning to avoid primarily animals, poisons, cliffs and dangerous water.

In the modern world, abundant with insidious and unproven risks, the context of danger has changed in a way that we seem ill-equipped to comprehend. One explanation could be that in the past we never lived long enough to have to worry about the long term effects of anything; but perhaps more to the point, it’s almost impossible, without the scientific rigour that has developed in the last few centuries, to connect dangers with their long term effects. Evolution, or natural selection, is our natural way of dealing with long term dangers - but that helps the species, not individuals.

Two things keep the cigarette bandwagon rolling – the unwillingness of the authorities to ban them and our willingness to smoke them. Together, these factors could be taken as a measure of how dangerous society thinks smoking is. In other words, not very.

The rule seems to be this: the less serious the immediate consequences of doing something once and the longer it takes for more serious consequences to become evident, the less dangerous an activity is perceived to be; and this does make sense when there are no additional influences on the frequency of the activity. If you bang your head against the door once in frustration it’s fairly harmless. Do it 100 times a day for 30 years and you’ll be in pretty poor shape – but why would you? Sensibly, we have not taken steps against head-banging.

Yet if a third factor, such as addictiveness – increases the likelihood that we will continue the activity for prolonged periods, we would fundamentally re-evaluate our assessment of the danger, right? Apparently not.

Clearly I am taking a deliberately black-and-white standpoint here to illustrate my point. In truth we do know how dangerous smoking is. The government knows, smokers know - everyone knows. It’s not our perception of long-term danger that is faulty, it’s our willingness to do something about it. We know that smoking is bad, but because each smoking incident does not generate the kind of highly charged emotional event we are hard-wired to respond to, our collective will to do something about it is profoundly weakened.

Instead, we are content to let the ponderous machinery of science, commerce and regulation steer us inexorably towards an eventual ban on cigarettes, seemingly indifferent to the ongoing misery their continued sale causes to millions. If smoking a single cigarette caused immediate and significant damage to our respiratory function, you can bet we’d have bullied the authorities into banning them years ago – even if the next 100 packets made the problem no worse.

Thanks to our innate short-termism, the ability of science to protect individuals against the long term dangers that would previously have taken natural selection thousands of years to achieve, is diminished. People continue to die from smoking related diseases long after it was proven beyond a shadow of doubt that smoking causes cancer.

Yes, I know there are powerful tobacco lobbies at work and that governments make millions from the tax revenues - and now that we are where we are, expecting an immediate ban is absurd; but my point is that we got where we are in the first place. The speed with which democratic governments act tends to be in proportion to the extent to which people care about something.

So – an addictive substance with low-level, cumulative effects which ultimately cause significant damage to our bodies. Seems like a description that could be applied to refined sugar – see my post here. Except with sugar the real kicker is that it’s everywhere and we don’t know how dangerous it is – or at least it is not as widely accepted.

I leave you with this question - in 50 years time, will we regard today’s adverts for sweets depicting happy, healthy children with the same wry derision as today we view cigarette adverts of the past? If so, I hope it will be under circumstances free of a deeper irony.

See Also:
We’re all Junkies
Why (Refined) Sugar is Bad: Some References
The Worst Sugar Pushers of all - Health Food Stores
... Read more

Thursday, 17 July 2008

We’re all Junkies

I want you to try something. See if you can go for two whole days without consuming any sugar. Sound easy? I guess it depends what you think I mean by sugar.

For the purposes of this challenge, sugar means ‘refined sugar’ – the stuff that comes in white or brown granules and has been created in a factory from sugar cane or sugar beet; but you can’t just stop putting sugar in your coffee for a couple of days and pass the test - you must also forgo any food which has ‘sugar’ on the ingredients list.

Before I go any further there is another distinction it’s very important to make, one which many people are not clear on. ‘Sugar’ is not the same as ‘sugars’. The nutritional listing on food packaging will often break down the Carbohydrate component further by stating ‘of which sugars’ and giving a value. Sugars are a family of substances naturally occurring in food that could also be called ‘Simple Carbohydrates’. Examples of sugars are glucose and fructose, which commonly exist together in varying proportions in fruit. Since the word ‘Sugar’ is the singular of ‘sugars’, it would be appropriate to refer to fructose as ‘a sugar’. However, the word ‘Sugar’ when not preceded by the word ‘a’ typically refers to a particular form of sugar that is produced in a refinery and therefore should more properly be named ‘refined sugar’.

So when you see ‘Sugar’ on the ingredients list, this means ‘refined sugar’ and is therefore out of bounds for the challenge. If, on the other hand, it is absent from the ingredients list, yet the phrase ‘of which sugars’ appears in the nutritional breakdown, the food or drink is consumable within the rules.

One more thing – if you were planning on eating out on one of your two days, your challenge just got a whole lot harder. Few chefs take kindly to being quizzed about the sugar content of their sauces and even fewer have many dishes on their menu that does not contain any.

If you take up my challenge, I anticipate your experience will have two key components – first the inconvenience of having to find foods devoid of sugar; and second, the craving for sugar. Many of you will fail, others will succeed ruefully. Only a few, if any, will pass the challenge with ease.

For advanced challenge-seekers, the next phase would be to go for a few weeks without sugar, instead seeking alternative snacks and ways to cook without it. You would explore the sweet flavours derived from naturally occurring foods, finding that after a while your palate adjusts to these new foods and you can enjoy them in their own right. In spite of getting used to the natural foods you’d probably still find yourself craving the profound sweetness of refined sugar during those few weeks; and yet if you returned to sugar, the first time you had it you’d be surprised by how intensely sweet it tastes.

What does all this tell us?

First, that we are, in effect, addicted to sugar. Clearly addiction can be defined a number of ways depending on your standpoint and I don’t wish to get into quibbles about semantics; but for me the parallels to the characteristics of drug addiction are clear.

Second, that sugar is added to most prepared food, either by us or by someone else.

Okay, so maybe we are all addicted to sugar. We’re all addicted to water too, right? We’re addicted to food. Just because we like something and want it all the time, it does not necessarily make it a problem.

Well it does if that thing is bad for us – and sugar is indeed bad for us. I do not intend to back this statement up with references. There is plenty of discussion around the subject on the Internet, so if you doubt my assertion go to Google. In fact, go to Google anyway – don’t take my word for it. It’s important to be aware of the range of possible ill effects to appreciate the point I am making. I won’t pretend that there is no one out there who disagrees – but let’s face it, that is true of the moon landings and pretty much anything else you’d care to mention; but the fact is there is also a good deal of empirical evidence too. Make up your own mind and if you end up disagreeing, then for you this post ends here.

There are arguments to be developed around why regulatory bodies allow things that are bad for us to be put into foods, and the extent to which we should be allowed to eat what we want since it is only our own bodies that come to harm – but these issues are for other posts. Instead I want to leave you with a more philosophical perspective.

Former drug addicts often report that they never lose the sense that they are missing out – that the highs a drug-free life has to offer never quite match up to the highs they experienced on the drug. Presumably, they feel they would be in a better position had they never experienced the drug in the first place. There is a similar (although clearly less profound) response to the removal of sugar from a one’s diet – note that I base this solely on my experiences and those of people I know.

So if sugar is bad for us, but once it has been a part of our diet for a while we will always miss it, then surely it would be better if we had never tasted it in the first place? Imagine a world where sugar was banned from all food so no one ever ate it or had ever eaten it, all the natural food they ate tasted great and there was no craving for sugar because no one even knew what it was. We’d all be healthier and therefore, all other things being equal, happier.

Yet this is clearly a Utopian dream. There is no more chance of this happening that there is a chance that we will rid the world of drugs. In both cases, it is difficult to challenge the assertion that if a magic wand could be waved to make the offending substance disappear in a flash, the world would be a better place; but when something is already here, some people are enjoying it with apparent impunity and other people are making money from it, there is no earthly way to remove it.

So sugar is here to stay. If you want to be healthier, I recommend you try to kick the habit….but if you succeed, expect to spend at least a few minutes a week, as I do, daydreaming about cheesecake and profiteroles.

See Also:
Cigarettes, Sugar and our Innate Short-Termism
Why (Refined) Sugar is Bad: Some References
The Worst Sugar Pushers of all - Health Food Stores
... Read more

Sunday, 13 July 2008

Role the Dice

So what am I afraid of? In a word, regret.

I picture myself at the age of 60, having recently learned I have a condition that will see my quality of life deteriorate too quickly for me to come to terms with my death or its implications for those around me. I have never lost someone close to me or had to witness the deterioration of a loved-one’s health - but I know people who have and know that one day, I will too. Despite this, at times I can quite vividly imagine how I might feel if it were me. I envision a strange mix of vertigo and claustrophobia as I see my timeline stretching backwards into infinity, yet in front concertinaed into a few months. I imagine panic and regret tightening my chest for weeks as I reflect on the choices I made that may have led to my condition, whilst trying to focus and stay chipper for others.

Or not. Maybe I’d just take it all in my stride and shrug philosophically with the knowledge that I’d had a good innings. The trouble is, right now I don’t know which it would be. Do you?

Just to hammer home this point, indulge me in an analogy. I took part in a running event recently. The event was due to start at midday, so being someone who suffers badly from stitches, I was careful to avoid eating a large breakfast and resolved to have lunch after the race, not before. Unfortunately for me, I had the opportunity at 11am to eat a bowl of fresh fruit with lashings of coconut cream. Here are the rationales I employed:

If I get a stitch I’ll just tolerate the pain and take it easy until it passes

I don’t care too much about this race anyway so what the hell

So I ate the fruit and the coconut cream, then proceeded to drink the remainder if the tin of cream on the basis that I’d already messed the whole deal up.

During the race, I did indeed develop a stitch, but my rationales broke down in two ways. First, I discovered that I did care about the race after all, something that I must surely have known deep down, being the competitive creature I am. Second, the pain of the stitch was much worse than I expected and was made doubly bad by my determination not to let it ruin my performance.

So, for the final 10 minutes of the race I found myself deeply regretting the pre-race binge and cursing my lack of discipline and foresight.

My point is this: you don’t know how you are going to feel.

In my story, the stakes were low. In life, they are not.

The impression I have is that as a general rule, the older you get, the more ready for death you become. If this is true there may be many reasons for it, but I would offer two here. First, you have had longer to understand death and contemplate the meaning of life. You will have watched more people die and spoken to more people who are dying. Second, you have seen more of life and, depending on your disposition, perhaps grown weary of what it has to offer.

I have also noticed that with increasing age comes increasing bitterness. An unfair stereotype? Perhaps – but stereotypes are often rooted in trends, and trends can legitimately form the basis for decisions. The classicists amongst you will recognise this line from Oedipus the King, by Sophocles.

Alas, alas, what misery to be wise when wisdom profits nothing!

I am only 36, but already I am aware of the profoundly shifting sands of my own perception of the world. Roughly every 5 years for the last 15 I have looked back to my self of 5 years before and thought “Shit, I really knew nothing about the world then.” I can only assume that this incremental wisdom continues in many people throughout their lives.

I would not be saying anything original if I pointed out that the decline of our powers in conjunction with the rise of our wisdom is one of the tragedies of the human condition and that this is one of the key drivers for age-related bitterness.

To get to the point, what I want is this:

- to live long enough to come to terms with dying
- to have the power to act on my wisdom while I am alive

How can I make sure this happens? The short answer is, I cannot. I have to roll the dice like everyone else; but I do get to choose the dice - and so do you.

See Also:
When it comes to Nutrition, the Glass is Half Empty
Cone Theory and the Mystery Doctor
... Read more

Tuesday, 1 July 2008


About Pay Now Live Later | About Me

Keith Richards at about 60
Pay Now Live later is an inversion of Live Now, Pay Later, a saying generally understood to refer to a lifestyle in which immediate gratification is sought without concern for the later consequences.

Art Devany at 70
The name of the blog is a statement of a philosophy - that it is worth paying now (having a healthy lifestyle) for the sake of living later. There are two subtly different meanings to live later (both intended) - by deferring gratification you may well live for longer, but equally you may also be able to live (in the sense of enjoy life) later on, when you are older.

On Pay Now Live Later I discuss issues around nutrition, the food industry and medicine. On it's sister blog, Train Now Live Later I discuss training and fitness, the natural allies of nutrition in the pursuit of living later.

On these blogs I write about what I believe is the most effective way to pay now - by living our lives more like our ancestors did. Palaeolithic, Primal, Hunter Gatherer - all names given to the lifestyle I follow and discuss here.

A brief history of my own journey:
  1. I was introduced to the concept by Natural Messiah about 18 months ago.
  2. He told me to read this seminal essay by Art Devany.
  3. I then read some work by Loren Cordain, interviewed here.
  4. I read Mike and Mary Eades' ProteinPower Life Plan.
  5. I spent time on Mark Sisson's blog, reading about the Primal Blueprint.
  6. More recently, I have produced some of my own material, such as the Nutshell videos.
What do I hope to achieve with the blogs? To contribute as much as possible to the growing community of people who are finding out for themselves the best way to live their lives - and learning that just because an organisation says you should do something it doesn't mean it's the best thing to do.

About Me | About Pay Now Live LaterFor the story behind the pictures, see this post on Life Spotlight...

...and for a more probing interview, read this interview on Primal Chat.

Comentary on my body fluctuating composition:
November 08
February 09
May 09
2-Week Mini-Graph of Yo-Yo Weight
Live graph of my body composition

Posts about my health:
My Yellow Skin Mystery
My Wheat Experiment
My Wheat Experiment Blood Test Update
Doctors and their Good Intentions: the Blood Test Fiasco Continues
[Blood Test Update in Post on Weight Loss]

My Vitamin D Defficiency
How I Got My Vitamin D into the Sweet Spot

Knee Surgery Part 1
Knee Surgery Part 2: Drugs, Muscle Wastage & Crutch Workout Videos

Posts about my holidays & trips:
The Great Cake Porn Tour (2008 Trip to America)
The Great Buffet Abuse Tour (2010 Trip to America)
Primal in the Pyrenees (Part 1)
Mountain Runs and Lake Swims in the English Lakes
Hunter Gatherer in Goat Herding Shame (Primal in the Pyrenees Part 2)
Entering the Arena of the Unwell (13-Day Binge on Asia Business Trip)
Two Weeks of Primal Workouts and Meals

First blog post - why I obsess over health: Roll the Dice

Contact me at: paynowlivelater at gmail dot com
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On this page I will feature posts and series of posts that are themed on bringing to account organisations who appear more interested in the bottom line or their own professional vanity than the well-being of those they claim to serve.

Roll Call of Shame: Companies Who Don't Listen - a summary and compilation of the companies mentioned in the articles below who had not the courtesy nor the foresight to engage with me on questions about their products. It includes their contact details.

Unhealthy Food Masquerading as Healthy Food

The Worst Sugar Pushers of all: Health Food Stores
Julian Graves Responds to 'Sugar Pushers' Post (Worst Sugar Pushers Part 2)
The Worst Sugar Pushers of All Part 3 - Holland and Barrett Takes Centre Stage
New York - Limited Cake Porn but Plenty of Sugar Pushers
New York Part 2 – Another Sugar Pusher and Cake Security Threat
UK Supermarket Redefines the Word 'Healthy'
GNC Peddles Sugar-Laden Supplement Chews

Product Labelling

San Francisco Part 1: Stretching the Definitions of Natural and Healthy

Food Additives

Sugar Peddling Kelloggs Pull 'Misleading' Advert
Why is there Sugar in my Chicken?
Sugar in my Chicken Part 2: Marks and Spencer Respond
Marks and Spencer Chicken - They Respond Once More (Part 3)
Marks and Spencer Chicken - the Final Word (Part 4)
Eat Natural? Not According to the Food Standards Agency
The (Un)Natural Confectionery Company: Schoolyard Logic Strikes Again
The Worst Cake in the World?
Dear Tropical Sun - "Why is there Crap in My Coconut Milk?"
"Why is there Crap in my Coconut Milk?" - Tropical Sun's Perplexing Reply
Tropical Sun Replies - "Our Additives are Okay"
After Much Searching... the Perfect Coconut Cream

High Fructose Corn Syrup and Those Advertisements

HFCS, the Little Man and Big Business (Part 1)
HFCS, the Little Man and Big Business Part 2 - Making a Difference
High Fructose, Low Budget: The Alternative Advertisement
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