## Tuesday, December 17, 2013 ... /////

### Useless or harmful: hand soap, vitamin pills, raw milk

Today, the news outlets are full of reports that some "common supplements" of the modern life that are believed to aid our health are claimed to be useless if not harmful. I will mention three independent major stories:

FDA against anti-bacterial soaps
Papers against vitamin pills
Paper counting illnesses caused by raw milk
The common theme is that it seem incredible to me that after so many years and after the sale of tens of billions of these products for hundreds of billions of dollars, the question whether these things are helpful seems completely open.

A typical Czech raw milk vendor machine.

This uncertainty is a stunning testimony to the low standards of the soft sciences, the hunt for 2-sigma bumps, and similar things. When some calculation says that the chance is just 97% that something is good (or bad) for you, you should treat the number 97% as pretty much the same as 50%. It is not solid enough evidence. It may be just a fluke – or a fluke that "someone helped" to arise. If there is a genuine effect, it isn't much harder to get a 5-sigma i.e. 99.9999% certainty! I do believe that if the health sciences followed some rules of particle physics or other hard sciences – e.g. the requirement of 5-sigma deviations to claim a discovery – they wouldn't be in this mess.

When we come to details, I have mixed feelings about the individual stories.

Let me start with the unpasteurized milk. In general, I have been sort of confused by this bizarre fad. I have believed that Louis Paster was a pretty important man – and shockingly enough, he was mostly important for his discovery of pasteurization.

Pasteurization means to heat up the milk (or other food) to some high temperature and then to cool it quickly. Germs get killed. It seems rather simple and I have some trouble to see why the procedure should be bad.

The decrease of nutrients such as vitamins is insignificant, of order 10%, and it may be neglected. What may be more significant is the decrease or liquidation of the "good bacteria". But this loss may be somewhat immaterial because the key home for the good bacteria are the intestines and they must be able to survive there without an external help - a vast majority of the bacteria fail to survive the stomach's acidic environment. I believe that one probiotic pill per week or month (which gets down there) would have to be equivalent to a permanent drinking of unpasteurized milk.

Ivan Mládek: A Cow in a Dairy, late 1970s. A cow becomes upset that it or she is never allowed to taste the milk products. So it or she visits the dairy. In the chorus, it is determined that after the cow ate too much of a crushed creamy blue cheese branded Niva (=Meadow, a Czechoslovak Roquefort competitor), it or she began to feel not well around the psalterium. A visit to a veterinarian will be needed. – If a trained economist and Václav Klaus' ex-classmate may analyze the detailed impact of various milk products on cows' complex stomachs, and publish the findings in a musical form, why can't tens of thousands of highly paid medical researchers do the same thing (at least without the song) with the much simpler human stomach?

One liter of raw milk costs \$1 or so in Czechia – something like 50%-100% higher than the normal pasteurized milk in the tetrapack boxes. Why do people pay this extra bonus for something that looks like a disadvantage to me? I think that the rational ones among them must believe that they will avoid antibiotics or pesticides. I don't really understand why they think that they're protected against all such things just because the milk is being sold in an old-fashioned "do-it-yourself" way. Pasteurization itself doesn't add any antibiotics or pesticides. And "bio/organic" labels attached to a farm don't isolate it from all the chemicals that are around us – and that must sometimes be used, anyway.

On the other hand, a decade of the usage of raw milk has led to 93 illness outbreaks, 1837 illnesses, 195 hospitalizations and 2 deaths just in the U.S. Some data say that every sixth person drinking raw milk gets sick. It almost sounds like a joke but they are serious.

To summarize, I do tend to think that the "raw milk vendor machine fad" is just one of the Luddites' fad that isn't really good in any way. Correct me if I am missing something.

Now, the FDA demands the producers of anti-bacterial soaps to prove that they are safe. The U.S. government institution claims that there is no proof that they're helpful for anything – and there is a risk that they bring us new threats as they help resistant mutated microorganisms to evolve.

Well, I think that the evolution of antibiotics-resistant strains is an issue that the mankind will increasingly have to wrestle with. However, it seems at least questionable to me whether these soaps actually make the situation worse. The evolution of viable, resistant strains requires some "training" – the microorganisms have to face tough enough conditions for the most aggressive ones to be selected - but I believe that a sufficiently large number of the microorganisms may also be needed. If one kills a vast majority of some bacteria, he is surely reducing the room for the vulnerable bacteria but he may be reducing the living space for the more resistant strains, too.

There are two factors standing against each other – the inhospitable environment is "directly" bad for the microorganisms but it may be good for them in the long run because it forces them to become more resilient. The survival and evolution of the Nordic ethnic groups (the life is arguably harder in Norway) is something that I can't avoid thinking about when I look for a good enough mental model (I will insist that it is politically correct for the "impartial" people at the very center of Europe to think about all these matters).

The question which of the factors is more important, especially in the long run, is a very subtle question and I feel that none of the answers should be viewed as the "default one". Someone might want to use the "precautionary principle" saying that one better shouldn't train microorganisms to be more resistant. But the opposite "precautionary principle", one saying that one better shouldn't allow any bacteria to reproduce, is at least equally natural. The point is that there exists no recipe for the human behavior that makes the human – and the mankind – completely safe. In other words, the basic problem is that the precautionary principle is a fundamentally flawed way to think about the real world. In almost all real-life situations, we face trade-offs and we must think about them in terms of costs and benefits.

So I have a trouble with any policy that looks like the application of this flawed principle. A priori, the situation is symmetric but in my opinion, the Western rule of law is based on the presumption of innocence. So the producers of these hand soaps might equally well (or even more justifiably) demand the FDA or other apparatchiks to first prove that their products are dangerous. It just seems strange to ban products just because someone is "afraid" of them or because he invents a vague "story" that would imply that the products are dangerous if the story were true.

Finally, a paper says that enough is enough for multivitamin pills. They don't reduce the cancer rate, they don't protect you against the decrease of mental capacities when you get older, they don't increase your life expectancy. I don't believe such general, far-reaching propositions. I have a trouble with the "collective treatment" of all multivitamin pills if not all supplements. It seems likely to me that most of the antioxidants must be helpful as a compensation against the radicals and some extra "modern threats" in our environments. It sounds natural to me to believe that collectively, the supplements including hand soaps and vitamin pills have contributed to the higher life expectancy that the people enjoy these days.

But I don't have any clear proofs of the helpfulness of any multivitamin-like supplements (although I know many compelling "stories" that would prove that they're helpful if the stories were right) and the observation that the world of the medical and biological research doesn't seem to have proofs in one way or another seems kind of shocking to me.

What do you think?

#### snail feedback (65) :

I'm not even sure how the multivitamins cure cancer idea came up. Most people take multivitamins to compensate various deficiencies (chronic or due to food choice/availability) or just as a boost (eg bodybuilders).

The titles these stories are running with are just retarded and quite harmful.

I don't think even the exact role of antioxidants is clear. The studies done so far are incredibly lacking. This true for pretty much everything regarding nutrition, especially in relation to pretty holistic goals (anti cancer, body composition, etc).

For example, just until recently it was thought that eating high cholesterol foods leads to high blood cholesterol. This has been disproved.

Hi, antioxidants are mainly believed to be a prevention against cancer, at least at some stages, see e.g. this paper with over 2,000 citations:

http://webmail.stuba.sk/~marian.valko/PDF/Chem-Biol-Interact_2006.pdf

I find it bizarre to say that the "studies are incredibly lacking" if there's literature with over 2,000 citations per paper.

Quality of raw milk depends mainly on hygienics in milking. I used to live near a farm that sold direct, so I was happy to buy raw milk. Never had problems. Because quality is critical here, I would never buy raw milk without knowing which farm it comes from.
From what I've understood, it's not pasteurization but rather homogenization that drives people to buy raw milk. Pasteurization may have some adverse effects, but they seem to be on the scale you mentioned: slightly lower vitamin content. Homogenization OTOH doesn't seem to have many upsides, only downsides. People who can't drink homogenized milk often can drink raw milk.
As organic milk may be pasteurized but not homogenized, I've settled on buying that. Of course there's price premium for being organic (if people pay more, of course market charges more), but it's small enough for me. Organic whole milk (fat content not controlled for) is probably closest you can get to raw milk, as all that has been done is pasteurization.

Sorry, could you please explain why you think that there's something wrong about homogenization?

It just shakes the milk, cuts the accumulated fat, and makes the milk homogeneous, right? If you drink raw milk from various herds for a long enough time, you drink exactly the same thing as if you drink homogenized milk, don't you?

I just don't understand why some people are not trying to sell "organic water"...

I agree with you of course with the low standards of soft science, but the issue here is oversimplifaction for commercial purposes..

hey are we even sure that drinking milk is good for some populations?

sorry , i think you re wrong about the risk assessment of raw milk...
OR you test your milk if it is contaminated by bad germs or you pasteurized... there is no other option to be sure your milk is bad germ free...
i used to drink raw milk from our farm too but i know how easy milk can be contaminated .
fortunately the risk is low but it exists even if you know or you are the farmer.

Well I just ignore these things because otherwise I'd get angry.
.
This is probably due to the fact that my father was a medical doctor and used to tell us that sweating and hot honeyed tea can't mostly be beaten by modern methods of medical science. Therefore when I was a kid, he rarely prscribed chemistry but brewed us hot tea instead. Of course he was prescribing chemistry, analysis etc to his customers because that's what they expected from him and they could help at least as much as hot tea.
.
While it is (and was meant to be) a caricature, like every caricature there is a deep meaning that my father wanted me to understand too.
Namely that medicine is no exact science and that different empirical procedures and behaviours that have been validated over 1000 years, will probably also work today even if we don't exactly understand why.
.
This experience created in me a general philosophy which is that basically what doesn't harm explicitely and directly is not a problem which I should waste my time.
My father also used to say that everybody had to die from something and this something has been unpredictable in the vast majority of cases.
Your 3 examples are squarely in the domain of "no direct and explicit harm" so I won't think about them.
Vitamins are generally OK and I don't like raw milk what solves the questions.

Well I just ignore these things because otherwise I'd get angry.
.
This is probably due to the fact that my father was a medical doctor and used to tell us that sweating and hot honeyed tea can't mostly be beaten by modern methods of medical science. Therefore when I was a kid, he rarely prscribed chemistry but brewed us hot tea instead. Of course he was prescribing chemistry, analysis etc to his customers because that's what they expected from him and they could help at least as much as hot tea.
.
While it is (and was meant to be) a caricature, like every caricature there is a deep meaning that my father wanted me to understand too.
Namely that medicine is no exact science and that different empirical procedures and behaviours that have been validated over 1000 years, will probably also work today even if we don't exactly understand why.
.
This experience created in me a general philosophy which is that basically what doesn't harm explicitely and directly is not a problem which I should waste my time.
My father also used to say that everybody had to die from something and this something has been unpredictable in the vast majority of cases.
Your 3 examples are squarely in the domain of "no direct and explicit harm" so I won't think about them.
Vitamins are generally OK and I don't like raw milk what solves the questions.

The are also studies that antioxidants causes cancer (sorry, I am lazy to find them just now, but I read about it ca two years ago on OSEL).
Your body produces radicals to kill cancer cell and if you use a lot of antioxidants, they neutralize the radicals before they can do their useful work.

When I was living in Sweden we were advised to take vitamin D supplements during the long dark Winters. I never did... I've lost my hair, my teeth, and my eyesight has gone so bad I can only see things in black and white ever since.... Jesus, I was only joking ;-)
Sorry but I just think this whole multivitamins market is a scam. It's only through what you eat that your body gets what it needs. There must be some natural balance that is no good to disturb. I would also tend to think that Nordic people would naturally store vitamins for the Winter in their body. It's like in their genes. If you send a Pigmy in the North Pole in Winter his metabolism might burn all the vitamins faster than his Scandinavian friend, don't you think ?

Organic water would be rain water ? ;-)

The FDA is forever for sale to the highest bidder. The US faces a crisis of retired people who will not die for decades demanding promised unlimited return on the skinning their salaries took for social services. Sometimes it all comes together - filth plus improper nourishment.

"Minimum daily requirement" saved 50% of 1950s rats from deficiency diseases. "Recommended daily requirement" is two sigma higher dosage. It is entirely rational to believe taking a daily generic multivitamin pill with supper is an unblemished good thing.

My 92-year old mother is still kicking butt, extracting near six figures/year from Medicare holding her together. Government outlaws keeping the money you earn lest you breach a monopoly of spending it unwisely.

I stopped washing with any soup altogether, do not drink milk as
I am lactose intolerant, never bought any vitamins and I am still a healthy
twenty five year old. Must be the vodka that is keeping me that way.

Back in the 1970s I made a few visits to Ireland. At the time, I was developing a strange, distressing medical condition, which I still have and which has never been identified. I decided to see an Irish doctor, on the off chance that he'd do any better than my American ones. He examined me and then said, "If you were Irish, I'd guess brucelosis. Comes of drinking unpasteurized milk. But I know no one in America does that, at least in civilized areas." I laughed and said, "Yes, they do! In fact, there are a few dairies that specialize in it." He said, "Oh my God, you Yanks are crazier than I thought."

In other words, the basic problem is that the precautionary principle is
a fundamentally flawed way to think about the real world. In almost all
in terms of costs and benefits.
Oh how I wish these words could be tattooed into the foreheads of the climate insaniacs -- in reverse so they can read them every morning in the mirror.

One can buy insurance against every conceivable risk under the sun: fire, accident, major illness, losing your job, losing a limb, losing your marbles, hailstones, flooding, drought, too high voltage, too low voltage, and probably bad breath, too. When you add up all insurance premiums you will have zero left over for such trifles as food, housing and clothing.

It's because of this that I'm doubtful that the much-hyped Nassim "Black Swan" Taleb's investing strategy, which is basically hedging against "unforeseen", rare events, can work. The cost of buying those hedges should drain your reserves before the black swan arrives.

Disclaimer: I’m a layman, not a scientist. I don’t work in farming, milk, or dairy production.

Homogenization breaks down fat globules. Membrane of those globules consists of lipids and proteins. Because lipase is activated by breaking of globules into lipids, pasteuraztion is necessary as lipase activity leads to bad taste. Fat broken to small particles gets covered partially by the former membrane matter but also by casein. While the fats themselves haven’t changed, their distribution and covering membrane have. Also, large part of casein in milk is now tied to fat globules.

Homogenized milk feels smoother in mouth than raw milk, while tasting a bit blander. It behaves a bit differently in eg. baking where whole milk is “thicker” than homogenized milk. These small issues (essentially taste) are my main reasons for prefering raw milk to homogenized milk — for as long as the price premium is not too big.

Living in France i eat a lot of rawmilk products. Provided the milk comes from a sanitary farm imho the bugs only help to stimulate your immunity. Never had any illness. As for soaps go, imho anti-bacterial soap is hazardous to normal peoples health. If you don't work in a bacteria laden environment it also serves to make you less resistant. As for pills, there are useful and useless pills. Finding the right ones is hard. That multivits don't do anything for yr health depends on yr lifestyle. Hard living its better to take them, however if you do a calm 9-5 job, eat regular wholesome meals it is superfluous imho

Multivitamins can be good if you're living on the street and eating stale doughnuts. :-)

Nah. Toilet water. :-)

Often forgotten is that we all are unique and have our own health. If you expose 100 people to almost any germ or environmental toxin, some will die, some will get ill, and some will be completely unaffected. That is why there will never be a 5 sigma result in a medical trial. We are all different - different nutrition, different immune systems, different activity level, different reaction to hormesis. My parents and my siblings and I all had rotten teeth. My kids have no cavities at all. Why? No answer exists, but any asshole has a theory. (by luck, good or bad, we avoided fluoride water)

Just live your life well and die satisfied that you extracted all that life had for you, and leave the vitamin lunacy and germophobia to others. Or not. Merry Christmas.

So then the rule is, only take them if you can't afford them.

5 sigma has nothing to do with how some people are not affected by a pathogen.

It just costs a lot of money to get a 5 (or even 3) sigma result from something as complicated as a drug study. Not that it should't be done.

The milk here in Canada is not UHT - which I hate the taste of, but must be refrigerated, and is only pasteurized 'normally'. I see more UHT milk in Europe and hot places like Mexico (it makes sense in Mexico).

Any milk in north america in a tetra pack is UHT.

Sorry, it's bullshit and I have explained why about 20 times.

Any signal smaller than 2 sigma should be considered as a random fluctuation. Any "science" that treats 2-sigma deviations from a null hypothesis as "discoveries" is bound to end up as a worthless pile of rubbish.

It only takes a 6.25 times greater dataset to increase the signal from 2 sigma (95%) to 5 sigma (=99.9999%) - and it's the increase that is needed to turn a junk science into a (basically) hard science.

Also, your remark about "someone's not being affected by a pathogen" is irrelevant. The need to have good enough statistics - like 5-sigma deviations from null hypotheses - is a universal feature of any scientific evaluation of the empirical data. It is true for hypotheses that a pathogen acts on everyone; it is also true for hypotheses that a pathogen only acts on someone.

One must first formulate what the hypothesis is and then he must look for the experimental data confirming or falsifying the hypothesis and whether or not the hypothesis talks about all people or just some people, something like 5 sigma is simply vitally needed!

Per your request (Correct me if I am missing something.):-) : You should not overlook that Pasteur also invented vaccinations, and he made significant discoveries in chemistry, most notably on the molecular basis for the asymmetry of certain crystals and racemization. He was the first one to demonstrate chirality of molecules.

Another comment: "It just seems strange to ban products just because someone is "afraid" of them or because he invents a vague "story" that would imply that the products are dangerous if the story were true."
Well, it is quite common business strategy. If you cannot compete on the market, you get the competitors product banned. (Think Saccharin/aspartam, think DDT/new pesticides.)

As for vitamins/supplements, it seems to be quite simple. There is usually some optimum. Too much and too little is bad.

Another effect of homogenization would be, that it also shreds the bacteria (dead or alive) to pieces. Typical size of particles in homogenized milk is at the bottom range of bacteria size.

No no no. It is not that there is no answer, it is that the answer is analog. If you take genetically identical hosts and innoculate tham all with a genetically indentical parasite, some will die, some will get sick, and some will not get sick at all. Take the ones that get sick, and give half of them the test medicine, the other half placebo. Some will get better, some will not - from both groups. What medical science does is say, give them all the medicine. Some will get better, some will not. That's the best they can do with biological systems, but it amounts to applying the laws of big numbers on small numbers. They take a shot, make the best choices they can, but there will rarely be a single treatment that will conquer any disease in all subjects.

My niece is a raw milk drinker. I visited her last Christmas. I'm a big milk drinker anyway -- need it to swallow after oral cancer radiation -- and the only thing I can say is that I thought it tastes better. So unless it is really dangerous and you can afford it, that's a pretty good argument.

As for anti-bacterial soap or protecting people from bacteria in general, I tend to go with the view that even exposure to bad bacteria may be good to the extent that it helps build up a large repertoire of antibodies in the immune system.

Another pet peeve of mine is the idea that fat is bad for you. For some years now my view has been that anything that tastes that good can't be bad for you. Lately I notice that science is starting to agree.

Actually, the idea that "anything that tastes good can be bad for you" makes sense in some way. You can see, how you evolutionary develop taste for anything that you need, but that is in short supply. It can be sugar and fat, rather than roughage ... all the stuff you need to survive in the time of shortages and starvation tastes good. Naturally at the point when the stuff becomes abundant, your urge to eat as much as possible will lead you to consume more than optimal amount. In past it was practically impossible, today it is easy.

It is just problem of using the rule of thumb (eat all the sweat you can get your hand on) in conditions very different (sugar everywhere) then those which were used to devise the rule (nothing sweet in sight).

Lubos, what do you think about the organic food movement? This includes fruits and vegetables that are grown and processed without adding any preservatives, and no use of pesticides, etc.

I have some friends that make enormous claims about this stuff -- you can't ever get cancer or heart disease or millions of other diseases, and it can completely reverse deadly diseases. They are completely unshakable from this view point.

I think you are making the same mistake as the FDA.
What does it matter whether Raw Milk is better or worse ? It is one thing for the government to - maybe prohibit producers to make claims for their products that are not substantiated - maybe. It is something entirely different for government to ban them.

Maybe you analysis of Raw Milk, Anti-bacterial Soap, and multi-vitamins is correct - you do not seem to have the 99.9999% certainty you demand, or maybe someone else's analysis is better.

The question is not who is right - it is possible we may never know, but who gets to decide and for whom.

If people get sick - even die from Raw Milk, so long as the people getting sick and dying are those who freely chose to consume raw milk - why does government need to interfere ? Same with soap, multi-vitamins, and self service medical and genetic tests.

Lots of things that lots of people - even our government believe are stupid. I spend lots of time arguing with people who beleive unbelievably stupid things. But then our president and politicians say unbelievably stupid things all the time.
Regardless, they are all perfectly free to beleive stupid things. What they are not free to do is impose their views stupid or not on me.

Boo, my avatar prefers organic chicken and organic apples and will turn nose nose up at many commercial foods. But his tastes are otherwise those of a child. He is at work just now compactifying tori. He turns many a box of Cheerios into powder.
I personally can not tell the difference between most organic and other products but he usually can. As to raw milk , it is dangerous especially for immune compromised individuals like parrots.

"there will rarely be a single treatment that will conquer any disease in all subjects."

This is actually not too rare occurrence within evidence-based medicine. I can think of a number of treatments off the top of my head that conquer a given disease in >99% of subjects:

-Vitamin C supplementation to cure scurvy
-Antibiotics to cure a number of afflictions, including Syphilis, Gonorrhea, and Trichomonas
-Rehydration treatment for Cholera
-Insulin supplementation to control diabetes
-Quinine and related derivatives to cure malaria
-Mass vaccination as a public health measure has eradicated dozens of diseases such as polio, smallpox, etc.

I agree that there is still a large amount of hand-waving and insufficient data/treatments available present in modern medicine, but this doesn't mean that biological systems in principle are impossible to effectively control and that we will always be subjugated to the god of chance in medicine.

I agree that the lack of sufficient experimental verification within the medical/nutritional field is rather shameful in many ways, but I think it might help to look at things in historical terms:

Medicine as a truly evidence-based field of science is still extraordinarily young in a historical sense. Whereas the fields of, say, physics and astronomy have something like a >400 year history of rigorous observational and experimental verification at this point, medicine in the West has, for the vast majority of its existence, been something more akin to witchcraft and sorcery than to any sort of scientific endeavour. In fact, the idea of what is now termed "evidence-based medicine" or "evidence-based practice" as a framework and philosophy for the application of medicine did not even EXIST as a concept (quite shockingly) until the late 1960s.

So, in other words, medicine as a field of human was not even introduced knowledge is only about a half-century removed from hocus-pocus, and therefore in many ways we cannot expect it to have the same level of rigour as other more well-developed fields of study. Which is not to say, of course, that we should not do all in our power to nudge it further away from hocus-pocus and toward actual reality :-)

I am not banning anything, I am making no mistake, I am just saying that drinking raw milk is an irrational fad, and I fully support these people's decisions to die faster - the more dead stupid people, the better.

Sorry, Michael, your attitude is not science, it is irrational, and it doesn't work.

Even if one says that "some people will get better because of XY", it is a scientific statement that needs to be tested, and if it is rejected or accepted, one needs the appropriate amount of evidence. You can't reduce the demands for evidence just because the statement is a bit complicated.

True Pavel, there are a number of studies indicating not only is antioxidant supplementation of no benefit but can also cause adverse events. The situation is complicated though, it seems if one is going to take antioxidants it should be those which promote intrinsic antioxidant capacity especially in relation to mitochondria but even then I'm not confident about that. There are even studies showing DNA damage arising from heavy antioxidant supplementation. Oxidation is just a chemical event and is essential to biological processes so I never understood all the fuss about it. There are certainly conditions where it is worthwhile to consider our antioxidant status but keep in mind that the very greater majority of oxidation events are intrinsic to the electron transport chain so boosting glutathione and dimutases is the preferred strategy. However I recall one study on alpha lipoic acid which found that yes the rats were smarter but they died younger and the bod stated this was a "class effect" ie. common to antioxidants. I have some way of conceptually approaching these conundrums but that is as very long and boring story.

It is in principle a similar fad to the raw milk - a more general one.

It is completely wrong to say that people eating "natural" products can't get cancer. There's been cancer for billions of years. Preservatives and pesticides are not just useless poisons that someone is adding to spread cancer among the people; pesticides and preservatives are there to protect the food against pests and parasites many of which produce carcinogenic chemicals.

Moreover, most of the "fought against" chemicals are completely harmless.

The correlation between a chemical's being "natural" (vs man-made) and it's being "free of pathogens" has the opposite sign than they suggest. To start, there is no correlation, but because the man-made chemicals were being and are still being selected to be least harmful, in average, the widely used artificial chemicals become less harmful than average "natural" chemicals.

Bizarre yes but to give you an example of the problem. A neuroscientist who did his Ph. D in QM used to visit his old physics buddies and related to them how it was so difficult to replicate results with respect to auditory processing in the brain because each run produced different results. His physics buddies claimed he wasn't doing the experiments right. They were wrong, they do not understand the overwhelming challenge of achieving replication in a dynamical system which is constantly in flux.
Long ago I gave up relying statistical analysis in biomedicine. 2 sigma is ridiculous and the field is littered with too many trashy experiments so that even the most rigorous meta-analyses can be contradictory. As a friend of mine says: when he sees "meta-analysis" he reaches for his gun. I developed a different method of analysis. Yes statistics is still important but it is nowhere near enough and that would be true even if it were 5 sigma.

Dear John,

some non-expert in biology may have naive ideas about how the systems work and how universal certain effects are (they are not too universal). But the existence of outsiders surely doesn't mean that the discipline can't be studied as a proper hard science, does it? A vast majority of people - including most biology PhDs - have no clue how particle physics works but that hasn't prevented particle physics from finding and confirming the Standard Model, aside from more ambitious things.

Surveys are the "social science" type of doing science so they're naturally less reliable. The bulk of the biology probably needs lots of testtubes, careful and accurate analyses what's happening with a particular human or animal or his tissue. All the excuses are just wrong. It is vastly easier to get tissues and do tests than to do particle physics experiments.

Cheers
LM

I take a daily multivitamin, but not for any reason other I stopped eating cereal and that unbalanced my diet. Vitamins probably don't offer additional benefits beyond just eating food necessary to get the various nutrients.

I will also ask whether one couldn't just irradiate the milk. While you couldn't sell that to dumb hippies, wouldn't it kill bacteria while resulting in less nutrient loss than heating it?

The problem Lubos is "hidden variables" For eg> cell slice studies on oxidation events are next to useless because the oxygen tension is completely different within the body and across different tissue types. Or consider the finding that presence of rat urine when studying mice stress responses seriously skews the results. Or the recent finding that animal cancer studies are skewed because the lab temperature is different than the niche temperature for the animal and his alters the immune response. So many thousands of experiments are basically useless because these variables were not addressed. In particle physics it is much easier to identify and control the relevant variables, in biological processes the variables can be so subtle and so incredibly difficult to identify that at this point in time it is foolish to think we have identified all the hidden variables.

There are no permanently hidden variables in Nature.

Organisms are complex objects but they're composed of non-complex building blocks and processes and their coexistence may be and should be studied by the proper methods of hard science.

Your examples only strengthen my point that the medical researchers were *not* following - and mostly are still *not* following - the requirements of hard science.

Doing an experiment at a wrong temperature (different than the temperature relevant for the statements we want to make) is a very stupid mistake of an experimenter. A physicist would get an F in an analogous situation. Some of your other examples are similar; in others the hypothetical influences don't really matter and you're just listing them to offer fog.

At any rate, in science, one must be careful what he's precisely saying or hypothesizing - including the conditions at which the effect is supposed to exist or not exist - and one must look for and find the relevant evidence for/against this statement which must be at the appropriate (5-sigma-like) level if the evidence is statistical and deals with some noise, and it almost always does in practice.

I am saying nothing else - I am saying that one should approach these things scientifically and it is not being done.

You demonstrate the same hubris the neuroscientist I mentioned above stated. You are missing the screamingly obvious point that when you try to address the relevant variables you change other variables. The mere act observation perturbs sometimes critical variables. So go use the precious patch clamp to measure ion flow in neurons and you change the ion flow, if only because the mere presence of some EMFs changes ion flows. You presume that those in hard sciences would not make such errors. There are plenty of scientists trained in the hard scientists that have been humbled when confronted with the challenges of investigating biological phenomena.

Would you share with us your "different method of analysis"?

Nutshell: Mass action - I look for consistency from the molecular to the epidemiological. Painstaking but sadly there is no purely logical method of analysis. For example, multivitamins. I very occasionally take a multi but for the micro nutrients like selenium and iodine. A safety margin if you like. All the analyses of multis suffer a fundamental flaw because nearly all multis contain beta-carotene and the vitamin E type is alpha-tocopherol. Under certain conditions beta carotene does act as oxidant, exactly opposed to its purported benefit. It can also antagonise Vitamin A function, against exactly antagonistic too ... . Alpha T: the main reason they put this in is because it is easy to manufacture. But it is a very weak form of vitamin E and evidence suggests it impedes the much more potent forms of vitamin E and tocotrienols(related compounds). So if we want to truly know if multis work we must tease out those studies which account for the above findings but I think you will find that the relevant data is not included in the published material. Want more vitamin A types: try watermelon(lycopene). Want good vitamin E status? Walnuts are great. Realistically, I don't expect the majority of people, even the relevant professionals, to be able to keep up with all this information. Same goes for me, no doubt I am very ignorant about range of factors that are very important. It is probably impossible for any single human being to be able to synthesize all the relevant information, though von Neumann may have been an exception. Big problem because it is one thing to memorise all this, it is entirely another thing to recall it at the appropriate analytic time point. .

I'm amazed by these Czech raw milk vending devices. I would have never had thought it possible for such things to exist. The artwork on the sides is subliminally motivating but tasteful.

LOL, right, they sometimes look pretty yummy. See

for more images to make your view more representative.

They still remind me of the funny vendor machines in Sverdlovsk, our twin city in USSR, I visited in Summer 1988.

They had various vendor machines with lemonade etc. - much dirtier than the milk machines above. We figured out that Czechoslovak 0.10 CSK coin could have been used instead of 0.05 USSR ruble (5-kopeika) which made it 5 times cheaper for us.

Still, people were pretty much drinking lemonade from the same glass over there, and similar things. I don't remember it exactly but I believe it would look pretty bad to me today.

In the milk machines, you usually bring your own bottle or buy a new clean one, of course.

The query which of the aspects is more essential, especially in the lengthy run, is a very simple query and I think that none of the solutions should be considered as the "default one". Someone might want to use the "precautionary principle" saying that one better shouldn't practice harmful viruses to be more proof. But the other "precautionary principle", one saying that one better shouldn't allow any viruses to recreate, is at least similarly organic. The factor is that you can find no formula for the individual actions that creates the individual – and the humanity – absolutely secure. In other conditions, the primary issue is that the prevention concept is a essentially defective way to think about the actual lifestyle. In almost all real-life circumstances, we experience trade-offs and we must think about them with regards to expenses and advantages.

Die Abnehm Lösung

Milk,:raw versus pasteurized. You forgot the boiled :). I remember the milkman passing by our house balancing on his shoulders a stick from which two cans of goat/sheep milk hung. My mother would buy some everyday and the next morning for breakfast we had boiled milk whose taste I hated. It was only in 1958 when I got to the US and the college cafeteria had those machines we called "cows" where we could get milk as desired, that I started liking milk. (Of course pasteurized). I think people who prefer raw milk are more sensitive to taste. The smell of raw milk is mostly missing in pasteurized, ( let alone boiled) and smell is related to taste. People who have been breast fed might be conditioned to the smell .

Bacteria: when we were young my mother had a friend who came from Cairo Egypt with her two boys the same age as my brothers and we would go visiting them. Those two boys were allowed to get muddy and dirty and yucky to the point that an explanation was necessary. This is the story:

this woman when fourteen was married off to a business man from Cairo who came to his village looking for a wife shorter than he was. He found her and married her when she was fourteen and took her to Egypt. Two things happened 1) she grew a head taller than him in the course of a few years.2) she gave birth to two boys, not the ones we met. She was so disgusted with the filth in the streets etc of Cairo that she raised the boys as if in a hothouse, clean, washing everything not touching any filth. Both boys died of simple childhood ailments and her pediatrician told her it was because of her mania for cleanliness. The second batch, the ones we met, were allowed the freedom of the yard and dirt and continued to have it when they moved to Greece. They are still alive.
The moral: the immune system needs some enemies to be on the alert and efficient. In this sense excessive use of hygiene is bad for the balance of the body, imo, so I do have hand soap, but not bacteria killing ones, just cleansing. If there is a severe illness or weakening of the immune system I would consider using them.

Vitamins and supplements: The only vitamin I take to excess is vitamin C: I have found it stops colds developing and aches and pains in joints. Sometimes I do get some other vitamin supplements, but I try to eat a well balanced diet that includes all the necessary stuff. I would not be strict on the supplements if people find benefit, the placebo effect is also important so if they have found a way to trigger it, why not?

I do think the government should recommend and discourage, but not ban, until the medical tests reach five sigma accuracies :)

ReRead your own article. There is a tacit acceptance of organizations such as the FDA whose sole purpose is to prevent us from choosing to do something stupid.

The mistake of the FDA is not that they are making the wrong decisions or have the science wrong, it is that they can make those decisions at all.

Arguing that the FDA has made a bad decisions implies they could have made a good decision.

Nor is this specific to the FDA.
The consequences of restricting our choices, is not just that government sometimes makes bad choices for us, but that preventing us from making bad choices also prevent all kinds of un-imagined possibilities from ever occuring at all.

I probably agree with you, regarding which of the individual choices in your list is likely to be the best one or the arguably correct own. But allowing people to make choices I think are stupid, does more than clear the gene pool. It also allows for the possibility that I am proven wrong, as well as for possibilities that have not even been conceived.

This is about more than just the Freedom to make stupid choices.

The issue is clearer in another area - energy.
Few rational humans would compel us all to switch to so called Green Energy today.
At the same time it is relatively likely that at some time in the future our primary energy source will change again. That shift may be to solar, nuclear, biofuels or something that seem ridiculous or has not even been conceived right now.
It is just as irrational to try to force they switch now, or to favor a specific future choice as it is to pretend to know for certain what the future predominant source will be.

When our standard of living is at subsitance, our choices must be focused on our immediate survival needs. As our standard of living increases we shift from meeting needs to satisfying desires.

Raw Milk and Organic foods do not appeal to me.
But if they did, there is nothing wrong with chosing them - even if they are less safe, more costly, .... solely because I prefer them. The only thing stupid about those choosing them is the reasons they often provide for doing so.

As the world becomes increasingly affluent more and more of our choices are "objectively" erroneous.
We are not choosing based on efficiency or efficacy, but based on subjective preference. Someone is not stupid for having different subjective values. They are not stupid for taking risks that you do not.

it is not wrong to drink and pay twice as much for raw milk because you like its taste better. I am sure within your own life you can find something you pay alot for, for subjective reasons. Cars are a common instance of paying alot for subjective values.

A recommendation or a discouragement from any government would be misunderstood, by 5 sigma ;-)

I drink raw milk to expose myself to germs, and feed it to my children for the same reason.

Meanwhile, A boy in my neighborhood nearly died from eating a cookie containing peanuts. In all my youth growing up in a more rugged environment (we are city-dwellers now), I never knew such an allergy even existed, despite attending schools with a few hundred peers. Hmm.

Antiseptic western civilization has no use for "hardy stock" anymore... or does it?

Hmmm, you think that a pic of two blond
busty models with big mammary glands in tight T shirts promoting "raw" milk is "tasteful"? Interesting. It is, however, "subliminally motivating". :)

"I just don't understand why some people are not trying to sell "organic water"...
Hmm, isn't that what homeopathy is? It is James Bond water---shaken not stirred.

Your better off getting your kids to eat dirt and come in contact with animal hair. You cannot develop immunity to pathogens without exposure to them first, and the pathogens in milk have the potential to kill even the most heathy of individuals.

The human taste is evolved so that you can grow a strong body and reproduce. We are not evolved to combat old age diseases such as colon cancer, heart disease and diabetes since few people would live past 50.

Raw milk cheese is completely different to actual raw milk as there is enough time during production to test for pathogens. Pasturised milk cheese can also become contaminated during production and routine batch testing is conducted. The problem with the sterile western environment is the tendency for the an overactive immune system to attack the body, not a weak immune system. Parasites like intestinal worms release chemicals that impair the immune system and prevent these diseases.

Antioxidants don't prevent cancer, they merely reduce the amount of DNA damage caused by some types of DNA damaging compounds. Animal studies show that over a lifetime they reduce the risk of cancer. The problem with human studies is that they are conducted over the period of a few years on people who have already accumulated decades of DNA damage, thus no effect as they are a preventative, not a curative agent.

I have devoted much of my life to attempting to drink human breast milk. Unfortunately, my wife stopped lactating long ago, but I keep practicing just in case.

Hmmm. I was thinking about irradiation hile reading this as well. That said, there is no proof that your diet was balanced just because you ate cereal, Werdna. In fact one could argue that the entire "balanced diet" nonsense is just agri-business propaganda.