Categories
Science Skepticism

Flu vaccines might be ineffective, so try… water (otherwise known as Oscillococcinum)?

A friend forwarded a press release issued by “LeBron Health” to me, and the quackery it contains is too delightful to keep to myself. But because the press release also trades on fear-mongering of a rather pathetic sort, it’s also an reminder of how uninformed or unethical some medical “professionals” are, and of how quackery can harm in scaring people away from effective treatment.

The press release discusses the upcoming flu season in South Africa, and in particular, how to cope with the H3N2 strain of influenza. The H3N2 strain of influenza is indeed deadly, having reportedly killed dozens of children during the most recent US winter. That’s not good, of course – we’d like the number of deaths to either be 0, or much closer to 0 than that.

However, the number of deaths and hospitalisations this winter have not been significantly out of the normal range – the flu is not killing more people than it typically does. Furthermore, it’s also quite routine for the CDC to “issue a health warning to doctors”, as they are reported by the press release to have done. A “health warning” is not an advisory broadcast regarding an impending apocalypse, but (typically) simply information that the CDC thinks practitioners might find useful.

The health warning itself also reports something quite mundane on an aggregate level (though of course not mundane at all if you’re someone who has had flu-related illness or death in the family). It simply says that the current vaccine can’t compete effectively against H3N2, and that everyone should be prepared for a bad flu season.

This is also routine – vaccine developers select flu strains in January to May (for the US), based on which strains they predict will be most prevalent, and vaccination then begins in October. Things can change between those two phases – they are 5 months or more apart, after all – and one of the things that can change is the seriousness with which you could have (with perfect hindsight) regarded the threat of a particular influenza strain.

But you can’t know, 6 months in advance, and so you make the most informed predictions you can. Some years, the vaccine works very well, because you picked the right strains, and other years it works far less well.

And here’s the frustrating thing: in December last year (when the flu season hit the USA), the same scaremongering was prevalent. We read that the CDC had “admitted” that the vaccine doesn’t work, just as in this local press release’s headline, which claims that “flu vaccines may not work”.

Well, the CDC admitted nothing of the sort, and the flu vaccine “works” just fine, within the parameters of how it normally works, where the reasonable standard is never “perfectly”.

Even though this might be a particularly bad year for the vaccine’s efficacy, it’s still going to be better at helping you to avoid influenza than certain other “remedies” would be. It will help more than prayer, it will help more than avoiding cellphone towers, and it will certainly help more than homeopathy (with the caveat that hydration is good, so homeopathy in extreme quantities might help a little bit, because water).

Homeopaths disagree, as you might expect them to. One of those homeopaths is Dr Erika Coertzen, who suggests that we take a “reputable medicine such as Oscillococcinum, the most popular homeopathic product for flu symptoms in France”.

homeopath
This box contains as much medicine as a microscopic box of Oscillococcinum does.

That quote tells us that Dr Coertzen and my understanding of what the word “reputable” means is as orthogonal as our understanding of the word “medicine”. We can also note that a “medicine’s” popularity is only relevant to sales, profit, and analysis of marketing and gullibility – it tells us nothing about efficacy.

As with all homeopathic “remedies”, there is no good clinical data to support the claims made in favour of Oscillococcinum as treatment for influenza. It’s not going to help you to “rebalance and heal”, and even if it is true (no citation is given for this claim) that a “majority of patients who take Oscillococcinum at the onset of flu-like symptoms show improvement or resolution of symptoms after reduced time”, if this is in comparison to patients who take nothing, then the placebo effect is a perfectly good explanation for this observation.

But I suspect that the data is more… what’s the technical term?… made up than that, or that it at the least involves some fairly extravagant inferences being made from a poor data set. Dr Coertzen says that patients “symptoms show improvement or resolution of symptoms after reduced time” – if this is true, the data should support this claim. Unfortunately, they don’t.

As assessed by the Cochrane Collaboration, where trials do show favourable results for Oscillococcinum, “the overall standard of research reporting was poor, and thus many aspects of the trials’ methods and results were at unclear risk of bias. We therefore judged the evidence overall as low quality, preventing clear conclusions from being made about Oscillococcinum® in the prevention or treatment of flu and flu‐like illness.”

Amusingly, the Oscillo.com website – of course not a neutral scientific arbiter – claims that “unlike other flu medicines, Oscillococcinum does not cause drowsiness or interact with other medications”. Given that Oscillococcinum is a homeopathic “remedy”, therefore containing nothing that might cause drowsiness or negative interactions, this claim only gains traction if you’re able to persuade people that homeopathy is at all respectable or efficacious – surely nothing that any “reputable” healthcare practitioner would do?

In her defence, Dr Coertzen isn’t ever quoted as directly suggesting that you not take real medicine also, which might be the only thing that prevents the Health Professions Council (HPCSA) Medicines Control Council (MCC) from chastising her for this batshittery.

However, if she is the “medical expert” quoted in the headline, telling the public that vaccines might not work and that they should consider alternatives does seem to be a direct encouragement to forsake medicine in favour of homeopathy, and I do hope that a complaint is laid so that the MCC HPCSA can then rule against this idiocy.

Briefly, on Oscillococcinum itself, you’d be amused to read up on it, as the story of its origins and composition is quite the catalogue of pseudoscience in action. While there might be nothing that trumps Scientology for batshittery, Oscillococcinum gives it a damn good try…

 

PRESS RELEASE (source)

Flu vaccines may not work, consider alternatives — medical expert

Global health authorities have cautioned that current flu vaccines may not prevent a severe new strain of influenza, highlighting the need to seek alternative ways to protect against falling ill this winter.

The US Centers for Disease Control and Prevention (CDC) issued a health warning to doctors during the northern hemisphere winter about the severity of the 2015 flu season. It said the current flu vaccination protects against three or four strains but is not a match for the dangerous H3N2 strain which has mutated and has contributed to more deaths and hospitalisations of children and the elderly. (See: http://www.health24.com/Medical/Flu/Preventing-flu/Flu-vaccine-missing-its-mark-20150112)

Nearly 30 children died in one of the worst flu outbreaks in the US over their winter. In SA, a new modified vaccine is now available to match two of three new strains, including H3N2. However flu can still be contracted if other strains are not covered by the vaccine (See: http://www.health24.com/Lifestyle/Winter-Wellness/South-Africans-warned-of-severe-flu-strains-20150420).

SA doctor and homeopath, Dr Erika Coertzen, suggests boosting the immune system naturally by following a healthy, nutritious and balanced diet, getting enough sleep, regular exercise and taking preventative natural or homeopathic medicines to counter the onset of flu symptoms.

“A reputable medicine such as Oscillococcinum, the most popular homeopathic product for flu symptoms in France, has shown to help alleviate flu symptoms such as body aches, pains, chills and fever without drowsiness or the worry of negative interaction with other medication. Oscillococcinum works with the body to help rebalance and heal, and is suitable for all ages. Oscillococcinum’s efficacy in reducing the severity and duration of flu-like symptoms is well-known. A majority of patients who take Oscillococcinum at the onset of flu-like symptoms show improvement or resolution of symptoms after reduced time” she said.

For product info visit http://www.lebron.co.za/, www.oscillo.com or call 021-403-6390.

Categories
Morality Religion Science

Assisted dying: not only God can decide – in fact, She can’t decide at all

It’s doubtful that you’d be able to find any medical school that still uses early translations of the Hippocratic oath, never mind the original Greek version. But if you read the unrevised English version, it would open with something like this:

I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses as my witnesses, that, according to my ability and judgement, I will keep this Oath and this contract.

It will furthermore ask that physicians comport themselves in a “Godly manner”, and do so without “seeking reward”. The point, in short, is that it’s nothing like the modern understanding of the oath, where that understanding is typically summarised in the phrase “first do no harm”.

This, in turn, means that when you appeal to the Hippocratic Oath to justify (or to rule out) some course of action, you’re already appealing to an interpretation of that Oath – and you’ve already admitted that the Oath is therefore a guiding principle, rather than an absolute rule.

Which, in the context of a discussion about euthanasia, means that we are able to discuss further interpretations of that principle, including the question of whether more harm might be caused by keeping someone alive if they are in pain versus allowing them to die – or even hastening their death.

We are not obliged, in short, to think that a life ending is automatically and always a harm that trumps any other possible harm.

6f1216d4022843899161cdba9aeee7f0Not only because interpreting the oath as offering guiding principles rather than absolute rules allows for “avoiding harm” to (on balance) mean “cessation of life”, but also because physicians already don’t follow the oath to the letter anyway. I don’t know about you, but if I heard my surgeon swearing to Apollo, I’d try to find a new one before the anaesthetic kicked in.

Which brings me to Health Minister Aaron Motsoaledi, who seems to think Apollo is still relevant to modern medicine. Well, he talks about “God”, so it’s difficult to be sure that he’s talking about Apollo, but whichever God he means, he seems convinced of the fact that it’s God who gets to decide when you die. As quoted in the link above, he says:

“Doctors are human and make mistakes too. They can say a person has a few weeks left to live, based on medical observation, but only God can decide when a person dies,” Motsoaledi said.

He said as much as doctors played an important role in bringing life to this world, “they should not be given the right to end it because they did not create it in the first place”.

“When doctors begin their career, they take the Hippocratic Oath and pledge to do all they can to preserve life and not do anything that will intentionally harm or result in the death of a patient. Nowhere in the medical curriculum were doctors taught to kill,” he said.

This is all in response to the ruling on Robin Stransham-Ford, last week, in which Stransham-Ford was granted permission to seek assistance in dying, and the Judge furthermore ruled that the physician who so assisted him would not be prosecuted. Motsoaledi intends to make sure this does not set a precedent, for the reasons summarised in the quotes above.

Minister Motsoaledi has, on the whole, been a very competent, and even often an excellent, Health Minister. On this matter, however, he’s letting us down. Here’s why:

  • South Africa is a secular country. While the Health Minister can believe in whatever god(s) he likes, he has a responsibility to make laws that allow for secular justifications. When he speaks as Minister, he should not be suggesting that a certain policy should be motivated by anything to do with what a god might hypothetically want or not want.
  • He’s arguably wrong on the facts, and is relying on an uninformed gut feel rather than the evidence regarding the consequences of assisted dying being legal. He claims that we’ll soon see “families colluding with doctors to end the life of their loved ones because they wanted to cash in on insurance policies”, but as far as we can tell from the Netherlands and Belgium, you can eliminate much of this risk through devising legal safeguards for when assisted suicide is permitted and when not.
  • To that, he might say that safeguards are not enough – that risking even one death for this sort of profit motive is one death too many. And here is where our interpretations of “harm” are directly relevant – physicians are always or at least very often making decisions about treatment that might cause harm, but on balance are thought to stand the best chance of avoiding harm. Ending a life is one option in a range of interventions, for the purpose of serving that same goal.
  • And, ending a life can only be treated as uniquely forbidden as a form of “treatment” if we hold the view that life is somehow “sacred”, which we cannot do in a secular country.

As for the “playing God” sort of argument, Minister, it’s entirely spurious. We all play God when we walk across a street wearing our spectacles, because without them, the bus that God hypothetically sent to run us over would have succeeded in its mission. We play God when we take antibiotics, or when we fly to foreign countries in devices we’ve invented and constructed for that purpose.

With assisted dying, we get the chance to play God in a way that She doesn’t seem that interested in, and we should seize the chance to do so. In this case, we can – and should – play God through alleviating the pain of someone who is dying, and who wants their life to end.

It is to God’s discredit if she doesn’t want to permit or condone this course of action. And it is to our discredit also, if we instead choose to rely on self-serving interpretations of a centuries-old Oath, to evade the moral responsibility of eliminating suffering wherever we can.

Categories
Science Skepticism

Roundup – 2015 LCHF Summit #OMHealth #LCHF2015

This entry is part of 30 in the series Noakes

In news that came as a surprise to some us who are here, myself included (thanks to the generosity of the organiser, Karen Thomson), critics of Noakes and the low carbohydrate, high fat diet are apparently “boycotting” the Old Mutual Health Convention, that wraps up today.

The convention took place over 4 days – the first 3 operating as a professional event, with healthcare practitioners earning continuing professional development (CPD) points for attending, and the last day defined as a public event.

Categories
Science

Standards in science journalism – #LCHF, #Banting and @BiznewsCOM

This entry is part of 30 in the series Noakes

If you only get your news from people and places that agree with your pre-existing view, then you are living in a filter-bubble. This is not a good thing, as it means that you’re (relatively) impervious to discovering any errors in your beliefs, while simultaneously getting constant affirmation that you’re “right”.

That’s true for individuals as consumers of news, but also presents an opportunity for producers of news to reflect on their responsibilities. If you purport to be an objective – or at least balanced, seeing as objectivity is impossible – purveyor of news, then you need to take care to publish fair representations of the current state of knowledge.

One South African site that constantly abrogates its responsibility to present a balanced view is Biznews.com, and the headlong rush towards partisan propaganda is led by Marika Sboros, who seems to have taken on the position of journalistic praise-singer for the low-carb, high-fat diet, and for Professor Tim Noakes in particular.

To be clear, I don’t have a problem with self-confessed fans – rather than people who present themselves as journalists – doing praise-singing. Whether they are right or wrong about the facts, individuals have no responsibility to be fair with regard to the totality of evidence, and/or how it’s interpreted, on their personal websites or Twitter feeds.

This doesn’t mean I’d encourage that sort of epistemic irresponsibility, in the least. As I say, they have no responsibility to us to be fair – I’d say that have that responsibility to themselves, but that’s not what’s at issue here. In this case, we’re talking about a news website that isn’t set up as a promotional vehicle for LCHF, and a “journalist” who presents herself as objective.

Sboros’ most recent piece of misrepresentation arises as a result of the USA’s Dietary Guidelines Advisory Committee announcing that they are set to reverse their cautionary stance on dietary cholesterol (so, the cautions against the cholesterol content of food, rather than the cholesterol content of your blood).

A second piece of new research is also described in the link above, namely a meta-analysis by Harcombe et. al. arguing that the dietary fat guidelines in 1977 and 1983 (cautioning against fat) were never justified by evidence from randomised controlled trials (RCTs).

The piece begins with nonsense, where Sboros’ italicised introductory text includes “In 2013, Sweden became the first country to ditch low-fat dietary guidelines, restoring cholesterol in eggs and bacon to its former glory”. That’s literally false, in that a Swedish advisory body, rather than “Sweden”, made certain recommendations. Second, that’s a gross misrepresentation of the recommendations they made, as even the advisory body themselves have noted.

Let’s take them one at a time, starting with the case of the USA. First, the headline Sboros chooses is “Science says Tim Noakes is right on cholesterol”. “Science” is rarely, if ever, dogmatic – pseudoscience is. Science – meaning what the totality of evidence suggests – points in one direction or another, and sometimes by very fine margins.

What I mean is, evidence in support of one particular point of view (Noakes’, for example) tips the scales in favour of their point of view, rather than “proving someone right”. And in this case, the misrepresentation is particularly bad, in that the only support for Noakes in these guidelines is for one leg of his argument, namely that cholesterol consumed has little impact on cholesterol in the blood.

As the Washington Post write-up makes clear,

The greater danger in this regard, these experts believe, lies not in products such as eggs, shrimp or lobster, which are high in cholesterol, but in too many servings of foods heavy with saturated fats, such as fatty meats, whole milk, and butter.

The new view on cholesterol in food does not reverse warnings about high levels of “bad” cholesterol in the blood, which have been linked to heart disease. Moreover, some experts warned that people with particular health problems, such as diabetes, should continue to avoid cholesterol-rich diets.

So, we see continued warnings about saturated fat, and continued warnings about blood cholesterol. Noakes says that saturated fat is fine, and that statins (to lower blood cholesterol) are bad, even toxic – he even uses the perjorative “statinators” for those who prescribe or recommend them. In other words, two key pegs of the Noakes argument are directly contradicted by this research.

Sboros, meanwhile, Tweeted a link to that same Washington Post piece, saying:

Well – if those doctors or dietitians actually read the linked piece, you’d imagine that they would carry on prescribing the statins, seeing as nothing in it recommends that they stop doing so.

Another interesting thing to note is that these guidelines seem to have been developed with the support of the Egg Nutrition Center and American Egg Board. Now, I don’t think that this automatically taints the research – as I’ve said before, “the fact that something is funded by a pharmaceutical company doesn’t guarantee bias. There’s a difference between being cognisant of potential biases, and writing something off in advance, just because of whence it came.”

I note it just to make the point that Sboros, Noakes and other LCHF supporters constantly use alleged taint via funding to dismiss research they don’t like – but then somehow seem to forget that principle when the research says things that they happen to agree with. For example:

Before moving on, read especially that second link for a contrasting view on what the revised guidelines mean, and on how they should be interpreted according to the holistic framework of knowledge related to diet. My concern here is about misrepresentation, rather than the science itself.

On the second issue (the Harcombe study), a key thing to note is that, as ever in the case of this “journalist”, only one view is being presented. The Harcombe study has already been subjected to a fair amount of criticism, some of which seems rather compelling. You might fall on either end of the contrasting views, or somewhere in the middle, but a piece of journalism, rather than praise-singing, would include relevant and plausible dissenting views at the same time.

To conclude, another recent Sboros post is worth highlighting, titled “Are you a vaccine zombie? Risks versus benefits of jabs debate goes on“. The piece expresses anti-vaccine fears, primarily the standard one amongst cranks, namely the risk of autism. The debate does not “go on”, except to the extent that those who hold fringe views pretend that it does – the scientific consensus on vaccines is clear, and long-settled.

This post embeds a video from (quoting Sboros) “one of my favourite sources of health information: Mike Adams, AKA the Health Ranger”. Mike Adams is the man behind “Natural News”, the site that argues that Microsoft are developing eugenics vaccines. And that HIV doesn’t cause Aids. It also publishes David Icke, the man who thinks the world is controlled by reptiles from outer space, who live in underground tunnels and take on human form.

This is a health journalist’s favourite source of health information?

To quote Ben Goldacre, speaking of Zoe Harcombe but with words that might apply equally well here, “you may disagree, but in a busy world, I’m not sure I see the point of a Zoe Harcombe”.

Categories
Science

Noakes, #LCHF and the Professoriate of the Twitterati

This entry is part 1 of 30 in the series Noakes

LCHF SummitIn the conclusion of my previous post on Prof. Noakes’ Big Issue column, I mentioned that he had spoken of addressing the malignant influence of scientists via the power of crowdsourcing research findings on Twitter.

Today, I’ll conclude with my description of how much that Big Issue column gets wrong, and also provide a fresh example of shoddy thinking from the LCHF crowd, in the form of a debate topic that is being proposed for the upcoming “First International Low Carb High Fat Summit“.

(I don’t think it’s relevant here, but in case you think it is, I’ve been invited – and have accepted – to attend the LCHF summit as a guest of the organiser, Karen Thomson. So if you see me becoming all soft on LCHF in late February, you’ll know that I’ve either been bought off, lost my senses, or “seen the light”.)

Let’s first return to “The Digital Doctor” (the title of the Noakes column). One of the things he’s right about in the column is that increased availability of information via the Internet has undoubtedly given consumers and patients more power.

You’re able to shop around, whether through using Dr. Google to find out what your fellow sufferers have tried, or for crowdsourcing information about who seems to do good work in a certain area, for what price and so forth.

Patients can enter the consulting room armed with some understanding of what ails them, and I’m sure that can help (and also sometimes hinder, no doubt) the process of diagnosis and treatment. We’re no longer victims of as large an information asymmetry as we once were.

But this doesn’t mean that truth becomes something that is resolved via democratic process. The majority can be wrong, and this is especially the case when we’re dealing with a majority drawn from a select population, and where the audience does further filtering of what they think worth listening to and what worth ignoring.

In short, this is again the problem of the filter bubble, writ large.

To quote Noakes:

But the growth of social media and the internet has changed that reality irrevocably.

Today as a result of these very modern developments, patients now have access to the experiences of hundreds of millions of others producing what has been termed The Wisdom of the Crowds.

Exposing millions of people with common issues to a multitude of different interventions soon determines the relative efficacy of treatments more effectively, cheaply and swiftly than any other testing method yet invented. (Indeed, these crowd-based, uncontrolled experiments will add a new model of “scientific” research that will overcome the weakness of traditional laboratory-based research, which by its very nature is “unnatural”.)

We have access to the millions of anecdotes shared by the population that self-selects to be on Twitter, yes. But we have no way of verifying the (literal) truth of those anecdotes, and we also know that because they are uncontrolled experiments, there is no way of verifying their truth in the sense of having confidence that the right cause for the observed effect has been identified at all.

This is precisely why we have and value the scientific method: to rigorously test hypotheses, in a way that minimises errors that might result from selection bias and so forth. We’d should take care to compensate for – and not celebrate – the fact that all of our case reports come from a demographic (because they are on Twitter) that was perhaps on average wealthier, and with more leisure time, than the typical person.

Why? Because that characteristic might be associated with different dietary choices, or different levels of physical activity, both of which would be relevant to how we interpret the data. So the anecdotes can be useful, in pointing to what we should research, but they are not themselves the research we should treat as conclusive.

(Sidebar before moving to the next quote: I’m leaving the “unnatural” towards the end of that quote alone, but just to briefly note that it’s another example of the paranoid and conspiratorial talk Noakes seems partial to. Sure, lab-based research has flaws, but its lack of being “natural” – whatever that might mean – isn’t one of them.

One can say we can’t replicate some real experiences and effects in a lab, and there it becomes a potential problem, but describing this in terms of “natural” sets up an advantage for the Romantic Paleo argument, and poisons the well against anything positioned as non-natural, which might include GMOs, vaccines, etc.)

Then, we’d want to compensate for our own biases also. Later on in the column, Noakes says:

I soon learnt that Twitter is unquestionably the best way to acquire the most up-to-date information on my particular areas of scientific interest. By following a group of scientists who use Twitter to disseminate information they find interesting, I now have access to new knowledge within minutes of its first appearance in the scientific literature. The result is that acquiring new information is absolutely effortless, and dependent only on my choice of whom I follow on Twitter.

So, if I listen to the people who tell me things I like to hear, I get to hear a lot of things I like to hear. And, just to make certain that things I don’t want to hear don’t intrude on this, I’ll block people who post contrary research from my Twitter feed (he doesn’t say the latter above, but it is something he does, with me being one example of someone whose links to relevant research don’t get through).

The problem with the Big Issue article is that it takes a couple of sound points, and explodes them into such a grand narrative that they lose any sense they had.

Noakes tells us that “now it is only the advice that works that has long-term credibility”, and that is true, up to a point. You’ll get caught out on social media if you spread misinformation. But that doesn’t mean information gains credibility through being widely disseminated (on channels you’ve hand-picked) on social media. Those are separate issues.

It’s also true that professionals – in various spheres – were able to exploit the ignorance of the consumer to peddle quackery or defective goods, and that they are now less able to do so than in the past. But our easier access to information doesn’t mean that (proper) experts don’t often know better than we do. Those are also separate issues.

There’s a tendency in the LCHF narrative, at least how it’s playing out in South Africa, to continually hyperbolise the consequences of choice, and the lack of middle-ground options between one or another extreme.

To conclude, here’s a recent example of that elimination of the middle-ground (in logical terms, a false dichotomy), that comes from the Facebook page of the LCHF summit I spoke of at the top of this post. On that page, Karen Thomson says:

I am desperately trying to find medical professionals willing to debate: ‘Is the low carbohydrate diet the cause of, or the cure for the global epidemic of chronic ill-health?’ with our LCHF team.

Any thoughts? None of my invitations have been met with any success.

Here’s a thought: if a debate topic is framed so that only the pro-LCHF side have any chance of winning it, you’re unlikely to garner any interest from potential opposing speakers. The topic is itself a pithy example of the shoddy reasoning that I’ve written about so often here, in that:

  • The topic sets up a false dichotomy, because the truth might lie somewhere in the middle with LCHF being neither the cure nor the cause.
  • Second, the topic sets the non-LCHF people up for failure, in that it would be impossible to prove that LCHF is the cause of “the global epidemic of ill health”. This is true even on the simple grounds of chronology, where (leaving aside the contentious issue of what pre-social humans ate) modern humans haven’t been eating LCHF for long enough – or in large enough numbers – for LCHF to be identified as the cause of much at all except book sales, never mind a “global epidemic”. You might therefore think the topic indicates bad faith, but even if you don’t want to be uncharitable, the pro-LCHF folks have rigged the game here, by ensuring that they can amass at least some evidence for their position, while the opposition cannot.
  • Third, one can challenge the presumption of the topic that there is a “global epidemic” at all, in that despite diabetes, heart disease and the like, we somehow keep living for longer. So, simply accepting the premise of an epidemic accedes to one of the key claims made by the LCHF folk, namely that humans in the 21st Century are (in general) sick and dying, despite any appearances to the contrary.

 

Categories
Science Skepticism

Professor Noakes and the Echo Chamber Made of Lard

This entry is part 2 of 30 in the series Noakes

The 2014 “Collector’s Edition” of The Big Issue contains a number of interesting pieces, but there’s one specific piece that I’ve been looking forward to being able to share with you.

The day for doing so has finally arrived, so here is the first instalment of some thoughts on “The Digital Doctor”, contributed by Prof. Tim Noakes, and freshly uploaded to the Interwebs (thanks to @BigIssueSA on Twitter).

As a framing concept for this post, consider the “echo chamber“, which you can understand as roughly analogous to, or intersecting with, confirmation bias and the “filter bubble“.

Participants in online communities may find their own opinions constantly echoed back to them, which reinforces their individual belief systems. This can create significant barriers to critical discourse within an online medium.

Another emerging term for this echoing and homogenizing effect on the Internet within social communities is cultural tribalism.

What the extract highlights is the problem of “groupthink”: if you surround yourself with people who say the sorts of things that agree with the sorts of things you’d like to believe are true, you all end up reinforcing each others’ beliefs, and opposing views have a difficult time getting heard.

So, it seems fairly obvious – given we know that we’re prone to weighting confirmatory evidence more favourably than disconfirmatory evidence – that someone who cares about keeping their mental furniture nearly arranged would actively seek out ways in which they might be wrong.

Supporters of Prof. Tim Noakes believes that he does exactly that, and that this is why he could famously change his mind on something so fundamental as the value of an entire category of organic compounds (carbohydrates, in case you aren’t aware).

But – and yes, I have said this before – one change of mind, no matter how fundamental or (in)famous, does not indicate anything about a general disposition, and it’s perfectly possible that Noakes (again, regardless of whether his conclusions are correct or not) has adopted (and is encouraging) sloppy thinking in this regard.

Which brings me back to The Big Issue, where it wouldn’t be unfair to describe Noakes’ contribution as a love-letter to confirmation bias, or an attempt to attract companions to occupy an echo chamber made entirely out of lard.

The piece begins with a rejection of expertise, where it turns out (according to Noakes) that an “exclusive clan who have climbed the academic ladder of success” “carefully programmed” Noakes and his fellow students to believe that what the clan professed is the “absolute truth, for now and forever”.

Alien_probeTo help this conspiracy narrative along, these evil people with their degrees and academic credentials are given the sneery nickname of “The Anointed”, which helps to set up the us vs. them dichotomy, where the everyday folk are victims of an intellectual aristocracy, preserving their privilege at our expense.

At this point, some of us are perhaps thinking about how odd it seems that one of the people who has climbed the academic ladder about as high as one can in South Africa thinks he should be trusted, despite his own membership of this shadowy clan.

But by definition, Noakes cannot be part of The Anointed, for he has seen the light, and rejects their gospel. Perhaps he might be part of the New Reformed Anointed or somesuch, because he makes it quite explicit that the outdated dogma he was taught is false, and should be replaced by something else.

The something else, though, is never expressed with qualifications, or room for being wrong – it’s presented as absolute truth. And this is the problem – replacing one dogma with more (albeit different) dogma doesn’t help the argument for being critical of received wisdom. It simply asks you to replace received wisdom with an alternative version of the same.

There’s a problem in this simplistic account of dogma also, in that it’s only unthinking consensus that’s a problem (what we normally call dogma) – consensus isn’t a problem of necessity. So, if “The Anointed” happen to be wrong in this instance, we shouldn’t use that as an excuse for discarding the idea of expertise in general.

Experts do exist, and “common wisdom” is frequently very far from wise. Yes, “experts” can also be wrong – but as ever, we can assess arguments on their merits, rather than throw the epistemic baby of expertise out with the bathwater of a few bad arguments.

Then – crucially – we’re dealing with a complete misrepresentation of what “The Anointed” say. On the Noakes narrative, dieticians and these sneaky academic folk are pushing the line that fats are bad, and carbs at least not as bad as Noakes would have you believe (some might even say that some carbs can be good).

However, the truth doesn’t support these caricatures. It’s (now) common cause that we used to over-emphasise the dangers of fats in general. It’s (now) common cause that refined carbs are bad.

The point is that “The Anointed” have modified their position over the years, in light of the evidence. Noakes might say that they haven’t modified their position enough, or that they are ignoring some evidence or over-valuing other evidence.

But either way, they are not dogmatically pushing one line. Their arguments have evolved (whether rightly or wrong, time will tell), and it’s untrue and uncharitable to present them as inflexible purveyors of eternal “truths”.

There’s only one dogmatic voice in this conversation, and as far as I can tell, it’s not that of The Anointed.

P.S. Noakes’ solution to the problem of The Anointed is to rely on The Wisdom of the Crowds, and especially Twitter, which is “unquestionably the best way to acquire the most up-to-date information on my particular areas of scientific interest” (this is no joke. Well, I mean it’s an accurate quote.) But more on that another day.

Categories
Academia and teaching Science

Is Noakes the North Korea of epistemology?

This entry is part 17 of 30 in the series Noakes

On November 25, I gave a talk with the above title at an event hosted by SAAFoST* and ADSA**. Unfortunately, the proceedings weren’t recorded, so you won’t be able to hear the superb presentation that preceded mine, by Dr. Celeste Naude, who focused on an evidence-based approach for differentiating between varying macronutrient-focused diets.

Those of you who are interested in the topic of diets, and specifically the role Prof. Noakes has played in popularising the LCHF approach to diet, might already know of the recent study by Naude and others, which found that low carb diets showed a similar reduction in weight to other diets. Noakes’ response to that study was to say that the “researchers have no clue”. I leave it to you to determine who you find more persuasive.

You won’t be able to watch my talk as presented either, but in case it’s of interest, I decided to record a version of it in any case, accompanied by the slides I showed on the day. By contrast to Dr. Naude, who focused on science, I focused on rhetoric, hyperbole, and sound scientific reasoning – or, the lack of it.

You can find that recording immediately below, followed by the approximate text of the presentation. It hasn’t been edited into essay form, so is telegraphic in places. Lastly, I’ve embedded the presentation slides at the end, for no particular reason.

*SAAFost: the South African Association of Food Science and Technology

**ADSA: the Association for Dietetics in South Africa

Is Noakes the North Korea of epistemology?

Betteridge’s Law – any headline that ends with a question mark can be answered with “no”.

Of course, “no” is part of the answer here – if we are asking the question of whether Prof Noakes is a propagandist who leads a repressive state, and is implicated in various human rights abuses, the answer is clearly no.

I’m also make no claims with regard to their relative levels of sincerity. In the case of Prof. Noakes, I’m of the view that he is utterly sincere, and desires nothing but to enhance the health and wellbeing of those he engages with. He’s received far too much abuse related to claims regarding a profit motive, for example, and I think that sort of abuse unjustified, and deplorable.

But that’s not what my title is alluding to. Instead, I’m highlighting the fact that the North Korean press machine has a habit of making hyperbolic claims, and Kim Jong Un for appearing in various baroque, grandiose, and sometimes merely perplexing situations, all to buttress his mystique and support a particular narrative.

This narrative is of him being misunderstood, a maverick, and a person who has privileged access to knowledge and opportunity that he is able to share with the enlightened or anointed. He serves as an inspiration, and in doing so, the impression created is more important than the evidence – marketing is the point, rather than content.

This is the sense in which Noakes is the North Korea of epistemology. As I will show, he displays a pattern of what philosophers and psychologists call “motivated reasoning”, which can be defined as confirmation bias turned up to 11.

You all know what confirmation bias is, I’d imagine: our predisposition to take evidence that confirms what we believe seriously, while discounting contrary evidence. What motivated reasoning adds is a substructure or foundation to this, in which the agent develops background rationalisations to justify holding the beliefs that others argue are false, or at least not settled conclusively at this point.

The motivated reasoner might see conspiracy instead of disagreement, and tends to react defensively to contrary evidence, seeing conspiracy, or dismissing it out of hand for other reasons instead of responding to it on its merits.

I ignore what I consider not to be evidence” – Noakes.

The goal of my talk today is quite simple. I want to suggest to you that regardless of any debate on the virtues of the Banting diet – which I’m not interested in discussing, and haven’t expressed any public view on – there’s a language, method, and character that we should all value in scientists and scientific enquiry.

I believe that any of us who work in fields including science, education, or journalism have a responsibility to encourage a responsible epistemic approach, rather than to aim for persuasion above all else.

By this I mean an approach that is objective as regards the evidence, where we are willing to be wrong, and where we resist attacking the character or motives of opponents when arguments are the relevant issue.

Prof. Noakes has frequently set a bad example in these regards, and my concern as an educator – particularly one active in the field of critical reasoning – is that with 50 000 Twitter followers, and as an engaging and hard-working media personality who has garnered as many accolades as just about anyone you can think of in South African science, he has a powerful influence on how people perceive scientific activity.

One of the virtuous traits I mentioned a moment ago was a willingness to be wrong. Defenders of Noakes might immediately retort that of course he’s willing to be wrong – after all, he famously changed his mind on carbohydrates! And while this is a notable change of mind, it doesn’t (and shouldn’t) reassure anyone that it’s representative of a general disposition. As you’d know, it’s a single data point, and we don’t find a pattern in a single data point.

More to the point, perhaps, is that his own language regarding that change of mind comes with significant warning flags regarding his commitment to sound reasoning. Take this example:

At a public discussion with his erstwhile supervisor, Lionel Opie, in May 2014, Noakes told the audience “I’ve said one thing, and now I’m saying the exact opposite. And they can’t both be wrong. And that’s key.”

While a statement like that plays well to a crowd – and in this case, did result in some appreciative chuckles – it’s nonsense as far as logic is concerned.

He’s presenting his change of mind as evidence that he’s right now. And there are two immediate problems here – one is that the argument only gains traction if you agree with him that he was wrong before. If you think he was right then, then you’d think that he’s just strayed into error now.

The second way in which the logic is fundamentally flawed is that he’s suggesting that the audience embrace the logical fallacy of the false dilemma. What I mean is that the truth might actually be undiscovered, and exist somewhere in the middle – it’s not the case that one of the two extremes he’s suggested at various points have to be correct. We have other options, and he’s misrepresenting the choices available to us in leaving them out.

We should all – maybe A-rated scientists, teachers, and public figures in particular – have a concern for good scientific thinking and clear reasoning in expressing the conclusions we’d like to see adopted. Science does not work in absolute truths – it’s an inductive process, whereby we chisel away at falsehoods to arrive at a clearer understanding of what’s most likely to be true. The example above recommends absolutism, despite that being manifestly incompatible with the messy world of empirical data.

At various points in today’s talk, I’ll be showing you examples of statements like these, made by Prof Noakes on public media. There are many more such examples, but it would be tedious to belabor the point through repetition.

But I mention this to offset concerns you might have that I’m indulging in cherry-picking here – the pattern is unmistakeable in itself, and more to the point, many of the examples I’ll show you are examples of Noakes responding to critics accusing him of over-simplifying. In other words, even after applying the principle of charity and seeking clarification from him, his responses validate the concerns I’ll be highlighting.

A taxonomy of trouble

For ease of reference, I’ve loosely categorized the issues into 5 groups:

  • Indiscriminate use of sources
  • Ad hominem & double-standards
  • Exaggeration and immunity to error
  • Salesmanship over science
  • Errors in scientific reasoning

INDISCRIMINATE USE OF SOURCES

Chemicals that may cause diabetes – Noakes links to Natural News.

This is the site that argues that Microsoft are developing eugenics vaccines. And that HIV doesn’t cause Aids. And Icke? The world is controlled by reptiles from outer space, who live in underground tunnels and take on human form (Thatcher, Bush)

Next they say it has been discovered before. Lastly they say they always believed it. Louis Agassiz.” – Noakes links to evolution-denier.

This from a series of tweets explaining how his conclusions will be vindicated in the end. But if you’re going to suggest that there are better and worse ways of proceeding in science, perhaps better examples than Agassiz could be chosen. He is, after all, an evolution-denier, and a proponent of scientific racism – does one want to cite him as an authority on the scientific method?

“@natachab Weston Price http://amzn.to/15c8xRz believed superior nutrition of trad societies protected against TB. Need LCHF HIV/TB trial” – and to a “holistic dentist”.

Weston Price – “holistic dentist” whose treatments included homeopathy. The site carries numerous articles arguing that vaccines cause autism. Current board member Joseph Mercola has received at least three FDA warnings for making misleading and/or unsubstantiated claims regarding the products he sells.

AD HOMINEM & DOUBLE STANDARDS

Starting on a sound note…
. @katjanechild Only you know what motivates you, Katherine. My advice: Play the ball, not the man and you will go far.”

Obese dietician from British Dietetics Assoc tells us on BBC News that @DrAseemMalhotra article is wrong. Will believe her when she loses wt

I do not understand why you pay any attention to Dr Witt, who has absolutely no qualifications in this field and is a few years out of medical school.”

On Anthony Dalby, a more recent critic: “Noakes said the doctor who said that happened to weigh 120kg.”

[email protected] @Briganto @livinlowcarbman @youmustbenuts That happens when the truth is not on your side. Yet to meet an obnoxious LCHF advocate

Prescription? A mirror.

OVERSTATING THE CASE/IMMUNITY TO ERROR

If you don’t eat carbohydrates, you don’t have to worry about cancer” – @ProfTimNoakes . Moerse gevaarlike stelling!!!

Noakes responds: “@RugbyPrinses Where and when did I say that? Or did someone else say I said that?Do you honestly think I would make such absolute statement?

Franschhoek: “If you’re insulin resistant, you do not have to get any disease whatsoever. If you eat a high-fat diet all your life, you will not develop diabetes, you will not get cancer, you will not get dementia. That I can guarantee you” – that’s where, and when (audio).

“Sweden becomes first nation to reject high fat dogma!” Noakes was making this claim in 2013, when the SBU report wasn’t even available in English, RT’ing AuthorityNutrition & Diet Doctor.

The authors of the (independent) body eventually had to step in and tell people to stop saying this. Report just on obesity, not necessarily generalisable, and:

Two mis-interpretations have, in our opinion occurred in the wake of the publication of the SBU report. One is that low carb high fat is by far better. Yes, during the first 6 months you lose weight faster on low carbohydrate diets. But after one and two years that diet has no advantage than other diets for obesity.

After having this pointed out to her, Teicholz blocks me and others. I couldn’t point it out to Noakes, because contrary voices also get blocked from being heard on his timeline. Contrary to what I think the ideal approach – of seeking out ways in which you could improve your arguments – motivated reasoning can involve simply shutting out dissent.

Then, addiction, where I fear that the LCHF movement is doing great harm to public understanding of the difference between compulsive and destructive behavior, and lifestyle choices which can be better or worse but are not intrinsically problematic.

From Real Meal Revolution:

The final blow to the gut: because carbohydrates are nutrient-deficient and often packaged with salt and sugar, you feel the need to eat more of them, thereby putting yourself into a near-perpetual cycle of weight gain.
Unless, of course, you break the addiction…

There’s plenty of “addiction” talk on his Twitter feed, as well as a partnership with Harmony Clinic in Hout Bay, that offers in and outpatient treatment for sugar addiction. Well, Harmony Clinic now liquidated, so perhaps not anymore.

The problem is – there’s no compelling evidence for sugar addiction, yet, and the case is being overstated in the service of promoting Banting.

What should we then say about so-called “addictive” foodstuffs? The first thing to remember is the point Paracelsus made in the 15th century – “the dose makes the poison”.

While there might be no safe number of cigarettes to smoke, there will be a dosage of carbohydrates, or sugar, that’s unproblematic in all but the most rare of cases.

Let’s look more closely at sugar addiction, and addiction in general. Two papers are typically cited as evidence for sugar being addictive. But what they mostly reveal is that science journalists no longer read or understand the journals, and that the public – and some professionals – are far too trusting when it comes to the sensational headlines that convey elements of those studies to us.

First, the Avena study, published in Neuroscience & Biobehavioral Reviews in 2007:

“we suggest that sugar, as common as it is, nonetheless meets the criteria for a substance of abuse and may be “addictive” for some individuals when consumed in a “binge-like” manner.”

Pause there – who might be inclined to consume in a “binge-like” fashion? Perhaps someone with a pre-existing impulse control disorder, who happens to latch on to sugar – the reverse inference from the bingeing to the sugar might get the causal direction entirely back-to-front. We’ll get back to the neurochemistry later, but also, notice the scare-quotes – the author is hedging her bets, with the text only weakly supportive of any claim to sugar addiction.

One is perhaps reminded of a line from Lewis Carrol’s “Through the looking glass”, where Humpty Dumpty said: “When I use a word, it means just what I choose it to mean—neither more nor less.”

Then, there’s Johnson & Kenny’s paper in Nature Neuroscience (2010) on junk food and addiction, also conducted on rats.

“Notably, it is unclear whether deficits in rewards processing are constitutive and precede obesity, or whether excessive consumption of palatable food can drive reward dysfunction and thereby contribute to diet-induced obesity.”

As in the Avena study, we don’t know whether an impulse control disorder is simply being expressed – rather than discovered as an effect, resulting from the junk food – in this experiment.

Yes, if you grow to like something (or find it rewarding), you’ll seek it out. This does not mean the thing is innately addictive. In fact, Hebebrand’s recently published paper in Neuroscience & Biobehavioral Reviews concludes that if anything, “eating addiction” rather than “food addiction” best captures what’s going on when people compulsively over-eat. The food is an expression, not a cause of the impulse control disorder.

We can easily engage in a battle of link-sharing – but the point is that the truth is complex, and not settled by individual studies. In this case, there’s one clear issue with using these studies as definitive, and this is that both of these studies use brain imaging to support their conclusions.

As Sally Satel (who works as a psychiatrist in a methadone clinic) puts it, brain scanning is “a perfect storm of seduction”. The technology promises great revelations and great objectivity. More to the point of my presentation today, it offers the possibility of eliminating your responsibility for what’s wrong with you – we can say, “it wasn’t me, it was my brain!”

This image is interesting is that it neatly summarises why you can’t reach firm conclusions from fMRI data. This fish is in fact dead, yet the scanner showed signs of brain activity.

fMRI data are suggestive, and weakly so at that, in that they reflect neural correlates of various stimuli, and nothing of the perceived and subjective mental responses to those stimuli.

In slightly more detail: Increased blood flow and a boost in oxygen are treated as proxies for increased activation of neurons, and from there we induce to what those neurons are doing. We compare that data to a baseline, and subtract the one from the other, averaging out over the many data points of all participants in a study, with software filtering out background noise, and creating the seductive images.

But our experimental conditions are imperfect – think of the difficulties of creating appropriate baseline tests, for one – and large sample sizes cost a lot of money. Add to that the fact that our brains can process the same stimuli in different regions – no one specific area can reliably be said to perform the same task for all of us – and it should be clear that it’s far too soon to reach definitive conclusions from fMRI data.

The philosophical problem is one of reverse inference – we reason backward from neural activation to subjective experience. But if identified brain structures rarely perform single tasks, one-to-one mapping between activation in a region and a mental state is very speculative.

To avoid the false positive of the fish brain activity above, we need to use multiple comparison fMRI, which comes at far greater expense in terms of cost and time. But headlines don’t have space for subtleties, and furthermore, novel and exciting claims get the public’s attention. If your fMRI scans can be said to show that sugar is more addictive than cocaine, you’re guaranteed some prime media attention, and who can blame you for trying to capitalize on that? Well, perhaps nobody can blame you if you’re trying to sell newspapers. And perhaps we can blame you, or be rather concerned, if you’re presenting yourself as a responsible scientist.

We can’t tell – yet – whether fMRI scans indicate an impulse that is irresistible, or one that simply hasn’t been resisted. But it’s easier to make choices when you believe that there’s a choice to make, rather than a forced one, such that an “addiction” narrative might support. Diminished expectations of agency lead to diminished agency – if you’re not aware of your choices, it’s more difficult to make choices. So, it’s politically useful to say that carbs are addictive – but that isn’t equivalent to it being true.

But at least we have a following. The great failing in science is not to be wrong – it is to be irrelevant.” – Noakes

SALESMANSHIP OVER SCIENCE & SENSITIVITY

Robin Williams was a vegan.Vegetarians are twice as likely to suffer mental illness.Humans are designed to eat meat.” @ProfTimNoakes RT’ed, the day of Williams’ suicide.

Response when challenged:
“@theviscountess @HermanBeukes Was Mr Williams informed about association between meat-free diet and mental health? http://1.usa.gov/1t2janN”

Then when people point out how poor that paper is, he appeals to the association, even though when anyone cites associational data in favour of low fat, he rejects it.

Dr Bill Wilson wonders if the Carbohydrate Associated Reversible Brain (CARB) disorder played a role in Newtown tragedy http://bit.ly/URArgp”… Where a 20-year old fatally shot 20 kids, and gun control might be a more interesting conversation.

ERRORS IN SCIENTIFIC REASONING

What does the future hold for a pastry chef?
@PastryKeegan The public will decide. In era of social media, public will eventually discover what works for each, independent of “experts

Why are “experts” being trivialized here? Experts do exist, and the public are often misinformed. If experts disagree with you, then you defeat them in the battleground of expertise – peer reviewed journals. An army of laypeople doesn’t make the scientific case.

Why is journo Gary Taubes pushing for scientific studies into #LCHF diets (http://blogs.scientificamerican.com/cross-check/2014/10/07/gary-why-we-get-fat-taubes-speaks-out-on-diet-studies-including-his-own/ …) while @ProfTimNoakes focuses on populism?

[email protected] Because change will only come when public understands truth expressed in @garytaubes book. New science will not change that”

“New science” will not change the truth? And again, a scientist calling for less science?

September 2014, Australia

So, I watched it. Here’s one rather interesting bit (the text below is copied from a previous post):

And you must never trust consensus guidelines, because they are anti-science. Science is not about consensus, it’s about disproof, disbelief and skepticism. It’s not about consensus. When you’ve got consensus, you’ve got trouble.

This conflates two very different stories into one, to serve the rhetorical purpose of granting credence to the underdog-story. The two stories are first, that yes, dogma is antithetical to science. The second is that if a preponderance of evidence points in a consistent direction, consensus guidelines could be well-justified, and it would only be irrational or inattentive people who would not believe in that consensus.

In the second story, you’d have been rational to believe in the consensus account even if it later turns out to be false. The point is that denying a well-justified consensus doesn’t make you a better scientist – it makes you a conspiracy theorist, or simply wrong about the facts.

In other words, consensus guidelines that emerge out of honest engagement with the evidence, and that are open to correction, are not anti-science at all. They are the product of good science, and their later overturning (if that happens) in favour of a new consensus is also the product of good science.

You don’t measure or identify good science from its conclusions – because we don’t know that those will survive future data – but by method, and by openness to correction in light of evidence. The first kind of story mentioned above, involving dogma, is of course an example of bad science. That doesn’t mean that consensus is by definition bad.

Science is indeed about “disproof, disbelief and skepticism” – but all of these serve to challenge any existing view and replace it with a better one. They are tools, or methods, for reaching a better consensus, not for rejecting consensus in general.

The simplest way of putting the point is this: Noakes would like it to be the case that medical practitioners and educational programmes see the light, and teach the same message he professes. In other words, he’d like his own views to be the basis of a new consensus, because he believes that the existing consensus is wrong.

When you’ve got dogma, you’ve got trouble. And when you’ve got consensus, you might have dogma. But you might also have a bunch of responsible people agreeing that yes, that’s what the data imply, and until we learn something to overturn our view, the evidence leads us – as rational, responsible scientists – to a certain consensus.

In short, while the quote above can play as a sexy soundbite for undercutting received wisdom, it’s another instance of Noakes playing scorched earth with understanding of the scientific method.

He might say that the public health concerns are too significant to care about niceties like the ones I’ve been talking about today. To that, there are two immediate responses. First, sloppy thinking should arguably never be encouraged. For someone who is regarded as an inspiration by many budding scientists, and who is one of South Africa’s most decorated scientists, one might even argue that he has a moral obligation to encourage sound scientific thinking.

The second response is that even if this were true – that we should misrepresent the strength and consensus behind a certain dietary position, in order to save lives – we should be able to debate how far we’re allowed to take the misrepresentation.

But this would require agreeing that misrepresentation occurs, and Noakes insists that it’s others who are being obtuse rather than himself. More disturbing, perhaps, is that those who do disagree are ignored or blocked, or characterized as shills, or victims of “groupthink”.

In conclusion, two tweets that show the best and worst of Prof Noakes:

[email protected] @umduzu @JSDKirby @davegreenway Many of my most vocal critics think science is easy and definitive. It is nuanced and complex

Yes, it certainly is, and I wish he’d take his own counsel on these matters.

Overlooked: If I am wrong, all that suffers is my reputation. If diet-heart is wrong, billions suffer. Scary responsibility.

This is the worst, obviously, in that the consequences of him being wrong could be far more acute. The logic here is entirely circular, in that his conception of being “wrong” simply ignores all the harms that competing views say could result from a high-fat diet.

He’s assuming he’s right, even while speculating about the consequences if he were wrong.

Even Noakes’ supporters should expect more of him, for two reasons:

  1. The scientific method deserves better.
  2. If he’s right, he’s impairing the credibility his viewpoint garners. The same dietary advice could be given without the “aid” of examples like these, and that might well get the revolution taken seriously in a far more widespread fashion.

 

Categories
Headspace Science

On robots, AI, and the future of humanity

robotaiA few weeks back, Sarah Wild asked if I’d be interested in offering a comment or two on artificial intelligence for a piece she was working on (the article in question appears in this week’s Mail & Guardian).

While I knew that only a sentence or two would make it into the article, I ended up writing quite a few more than that, and offer them below for those interested in what I had to say.


 

What role to humans have to play in a world in which computers can do everything better than they can?

In the most extreme scenario, humans might have no role to play – but we should be wary of thinking that we’re somehow deserving of playing one in any event. While it’s common for people to think of themselves, and the species, as both special and deserving of special attention, there’s no real ground for that except our high regard for ourselves, which I think unfounded. We don’t “deserve” to exist, or to thrive as a species, no matter how much we might like to. If the planet as a whole, including all sentient beings, would be better off with us taking a back seat or not existing at all, those of a Utilitarian persuasion might not think that a bad thing at all.

In a less pessimistic (for some) scenario, we’re still a very long way away from a world in which humans are redundant. Computers are capable of impressive feats of recall, but are significantly inferior to us at adapting to unpredictable situations. They’re currently more of a tool for implementing our wishes than something that can initiate and carry out projects independently, so humans will – for the foreseeable future – still be necessary for telling computers what to do, and also for building computers that are able to do what we’d like them to do more efficiently.

Elon Musk has said that AI offer human kind’s “greatest existential crisis”. What do you make of this statement?

This strikes me as bizarrely technophobic. We’re already at a point – and have been for decades – where the average human has no idea how the technology around them operates, and where we routinely place our faith in incomprehensible processes, machines and technologies. (Cf. Arthur C. Clarke’s comment that sufficiently advanced technology is “indistinguishable from magic”.) If it’s a level of alienation from the world we live and work in that triggers this crisis, I’d think we’d be in crisis already.

There seems no reason to prefer this moral panic or fear-mongering to what seems an equally plausible alternative, namely that the sort of alienation Marx was concerned about might be alleviated through AI. If machines can perform all of our routine tasks far more quickly, efficiently and cheaply than we currently can, perhaps we can spend more time having conversations, walks and dinners, rediscovering play over work, or generating art.

It’s probably true that there will be an interregnum wherein class divides will accentuate, in that wealthier people and nations will be first to have access to the means for enjoying these advances, but as with all technologies, they become cheaper and more accessible as our research advances. Technophobia as displayed by Musk here runs contrary to that, in that the last thing we want to do is to disincentivise people from engaging with these technologies through making them fearful of progress.

A recent Financial Times articles paints an apocalyptic AI future. What do you think a future world – with self-driving cars, care-giver robots, Watson-driven healthcare, etc – looks like?

The key fears around an AI future tend to be driven by the concept of the singularity, popularised by Ray Kurzweil. One possibility sketched by those who take the singularity seriously is that if we invent a super-intelligent computer, it would be able to immediately create even more intelligent versions of itself – and then this concept, applied recursively, means that we’d soon end up with something unfathomably intelligent, that might or might not think us worth keeping around.

Again, I think this pessimistic. We’d be building in safeguards along the way (perhaps akin to Clarke’s laws of robotics), and we’d likely see frighteningly smart computers coming years or decades in advance, allowing us to anticipate, to some extent at least, what safeguards would be necessary. Given the current state of AI, we’re so far away from this possibility that I don’t think it worth panicking about now (despite Kurzweil’s claim that the singularity will occur in 30 or so years from now).

(Incidentally, Nick Bostrom is very worth reading on these things.)

A more general reason to not be as concerned as folk like Kurzweil are is that I’d think malice against humans (or other beings) requires not only intelligence, but also sentience, and more specifically the ability to perceive pains and pleasures. Even the most intelligent AI might not be a person in the sense of being sentient and having those feelings, which seems to me to make it vanishingly unlikely that it would perceive us as a threat, seeing as it would not perceive itself to be something under threat from us. (A dissenting view is here.)

But to address the question more directly: such a world could be far superior to the world we currently live in. We make many mistakes – in healthcare, certainly when driving, and it’s simply ego that typically stands in the way of handing these tasks over to more reliable agents. Confirmation bias is at play here, and also mistaking anecdotes for data, in that when you react instinctively to avoid driving over a squirrel, the agency you feel so acutely feels exceptional, and validates fears that the robot driver might make the wrong choice (perhaps, sacrificing the live of its passenger to save other lives). On aggregate, though, the decisions that a sufficiently advanced AI would make would save more lives, and we are each individually typically in the position of the aggregate, not the exceptional. I therefore would think it immoral to not opt for robot drivers, once the data shows that they do a better job than we do.

(An older column about driverless cars, for more on this.)

What you do think is the most interesting piece of AI research underway at the moment?

On a broad interpretation of AI, I’d vote for transhumanism, without a doubt. We’ve been artificially enhancing ourselves for some time, whether through spectacles, doping in sport, Ritalin and so forth. But AI and better technology in general opens up the possibility for memory enhancement (one could perhaps even rewind your memories), or for modulating mood, strength and so forth. Perhaps these modifications will occur with the help of an AI implant, that modulates some of your characteristics in real-time, in response to your situation.

This would fundamentally change the nature of humans, in that we’d no longer be able to define ourselves as persons in the same way. Who you are – the philosophical conception of the person – has always been a topic of much debate, but this would detach those conversations from many of the factors we take for granted, namely that you are your attributes, such as the attribute of being a non-French speaker (with the right implant, everyone is a French speaker in the future).

It would also likely change the nature of trust, and relationships. Charlie Brooker’s “Black Mirror” TV series had a great episode (The Entire History of You) on this topic, suggesting that it would be catastrophic for human relationships – nobody would be able to lie about anything. It is this area (of human enhancement via AI/tech), rather than autonomous AI, that I think potentially far more worrisome.

But to answer your question more directly – neural network design is going to open up very exciting possibilities for problem-solving and planning. In everyday applications, we’re talking about Google Voice or Siri becoming the most effective PA imaginable. But in more important contexts, we might be fortunate to consult with robot physicians who save far more lives than is currently the case, perhaps with the help of nano-bots that repair cell damage from inside the body.

While many AI applications, such as driverless cars or Watson, offer societal benefits, robot caregivers arguably could damage ideas of collective responsibility for vulnerable people or erode filial responsibilities and make people less caring. Do you think that’s a valid concern? That as we outsource more of the jobs we don’t like, we lose our humanity?

Part – I’d say most – of what we currently value about human interaction has been driven by the ways in which we’ve been forced, by circumstance, ability, environment, to engage with people. In other words, I don’t think it’s necessarily the case that those relationships of feelings of commonality are connected to the ways in which we currently care for people. We need to avoid reifying these ideas into very particular forms. Speaking for myself, if I were living with a terminally-ill loved one, I can imagine my relationship with that person being enhanced by someone else performing various unpleasant tasks, which would mean that the time I spent with that person could be of a higher quality.

More generally, we’ve always outsourced jobs we don’t like to machines (or to poor people, of course) – I don’t see how this is a qualitatively different situation from the one we’re already in, rather than just another step on a continuum. Those who argue that these AI applications will cost us some humanity need to accept the burden of proof, and demonstrate that the new situations are incomparable to the old.

Joseph Conrad wrote, in Heart of Darkness, “I don’t like work — no man does — but I like what is in the work — the chance to find yourself. You own reality — for yourself not for others — what no other man can ever know. They can only see the mere show, and never can tell what it really means.” Do we impoverish our experience or fundamentally alter who we are by outsourcing less enjoyable work?

Much of what I said in response to the question above applies here also. We can’t restrict ourselves to one model of work, or certain sorts of activity, to find meaning – and never have. We’ve always adapted to different situations, and found whatever meaning we can in what it is that we’re engaged with. And optimistically, when we’re freed from running on various hamster-wheels, we might find forms of meaning that we never imagined existed.

Categories
Science

#Ebola: Support, don’t stigmatise

It’s irrational to not be afraid of dangerous things. We tend to avoid them for good reason – but in some cases, they are dangerous enough that we need to suppress our fears and engage with them, because the danger of not doing so is even more acute.

“We” is of course a gloss on something far more complex. It’s only some of “us” who do this, partly thanks to relative courage levels, and partly thanks to having or not having the requisite skills and knowledge.

But in the case of Ebola, clinicians, epidemiologists and other healthcare workers are not going to Sierra Leone and elsewhere because they want to expose themselves to a very scary risk. They are doing so in order to help eliminate this very scary risk – for themselves, for their families, for you.

Ebola is scary enough that engaging with it – no matter how terrifying it must be to do so – is the only way to eliminate it.

When people do engage with it – for all of our benefit – the last thing we should do is punish them for doing so. Panicking and pandering to fear through stigmatising them in quarantine – whether mandatory or socially imposed – does just that.

downloadWe know that asymptomatic people are not contagious. We know that mob mentalities based on fear are dangerous in cases like this (and more generally), in that we need people to be honest about where they have travelled to, and the risks they might have been exposed to – and if you know you’re going to be quarantined or shunned, you might simply lie instead.

We know that self-monitoring works. We know that we want to incentivise those who are willing and able to engage in this fight to do so, rather than to make them fear stigmatisation.

Pandering to fear is not the solution to Ebola. Watch the video below to see State troopers making sure that Kaci Hickox doesn’t leave her home, even though she’s not symptomatic, and has twice tested clear. CNN reports:

Having to defend herself and not being able to hug her friends, especially after four tough weeks in West Africa, is “painful (and) emotionally draining,” the nurse said. Hickox also said “it’s frustrating to hear nasty things,” saying her intentions going to Sierra Leone was to make “a difference in people’s lives” and her aim now that she’s back is not “to put anyone at risk in this community.”

Of course she wouldn’t want to put anyone at risk – she has a lover, she probably has a family. It would be shamefully insulting to treat her as if she’s putting you at risk, when she’s surely thought of who she might be putting at risk already, and wouldn’t be in public (rather than in voluntary quarantine or hospital) if she thought she was putting others at risk.

Here are some examples of over-reactions based on fear, and ignorance:

  • A North Carolina school district forced an assistant principal to stay home for 21 days because she visited South Africa
  • Several universities cancelled talks by people from Africa or those who had visited lately
  • A Congressional candidate called for a citywide “no touching” edict in Dallas

I’m currently in the USA, and am hearing far too many fearful conversations about the risks people perceive themselves as being exposed to. Americans can be somewhat paranoid, but the fear is most likely quite universal. It’s difficult, I know, but let’s not make our fears more likely to manifest themselves through panic and misinformation.

Categories
Science

Does #Banting compromise humour and understanding of metaphor?

This entry is part 16 of 30 in the series Noakes

It’s been an amusing few days for those of us who follow the social media commentary related to Prof. Tim Noakes and the Banting diet. Earlier this week, an investment strategist named Magnus Heystek posted an opinion piece titled “Is Noakes running a Ponzi scheme?“, in which Heystek uses the example of Ponzi schemes (where people get suckered into poor investments via a combination of wishful thinking and deception) to riff on the “collective delusions” that can accompany diets.

The analogy is clear, even if imperfect – in the Banting analogue, someone uncharitably disposed towards what they think of as a fad diet could argue that the flock isn’t seeing the evidence and argument objectively, but are instead being seduced by the charisma of a person or an offer into a poor investment (in their health) – just as is the case in the investment analogue.

The analogy is imperfect in the sense that – as I’ve argued in the past – Noakes seems entirely sincere, and second that he is using the proceeds of the “real” meal revolution to fund research into health, rather than for personal enrichment. But even if imperfect, it’s fair comment, and has certainly provoked debate (if not much thought).

Heystek is making a similar point to the one that I’ve repeatedly made here, which is that the evangelical fervour in support of the diet, and the casual dismissals of any opposition to it as simply uninformed, both offer little reassurance that people are thinking things through carefully, rather than being in the grip of a collective delusion (of sorts).

There’s also a sense of humour and perspective failure in the responses – from the earnest (and unfortunately snide) response of one of Noakes’s co-authors, Jonno Proudfoot, to the Twitter contingent who think Noakes should sue for defamation, the Banters need to realise that as strong as they think the evidence is for their point of view, it’s not heresy to think things aren’t as simple as all that.

By contrast, what Heystek is pointing to (and again, my main point in all these words about Noakes and Banting) is that we already know things are not simple, and that we therefore have reason to believe that evangelism is taking the place of reason when people claim they are simple.

It’s when reason is sacrificed that we encounter Noakes saying, on the one hand, that when you get personal, you’ve lost the argument; and on the other hand dismissing the arguments of critics on the grounds of their being overweight (as he’s done at least twice, with Catherine Collins and with Anthony Dalby).

His followers have learnt the lesson well, rushing to dismiss Heystek on the grounds that he, too, could lose a few kilograms (which is something Heystek himself points out in the column, but since when does the playground pay attention to details like that?).

This doesn’t mean that criticism of Noakes and Banting can’t itself sometimes be overly simplistic – nobody is immune to error. Heystek was pricking a bubble of pomposity, though, not making a scientific argument, and his column needs to be read in that context.

By contrast, this Sunday Times piece arguing that Noakes has made a u-turn on dairy is shamefully misleading (rather than simply mischievous), and really just an example of someone exploiting a popular trend to generate some traffic, with complete disregard for the evidence.

The ninth of the “10 Commandments for beginner Banting” – right there in the first edition of “Real Meal Revolution”, you are told “Control your dairy. Although dairy is good for you, it does contain carbs and can be a stumbling block for some. In your Banting beginning, perhaps avoid eating too much dairy.” (I’m leaving complexities regarding particular forms of dairy aside here – they aren’t relevant to this argument.)

Later on in the book, readers are told: “If you are not intolerant to dairy products and find they do not affect your weight loss or blood sugar levels, aim for high-fat dairy products, not skim or reduced fat, light or fat-free alternatives – they must be full-fat.”

In other words, the advice regarding dairy was always qualified advice. The authors made a mistake in compiling their green, red and orange lists of foods, though, in that greenlisted foods were described as follows: “GREEN is an all-you-can-eat list – you can choose anything you like without worrying about the carbohydrate content as all the foods will be between 0 to 5g/100g. It will be almost impossible to overdo your carbohydrate intake by sticking to this group of foods.”

That needed a “terms and conditions apply” in the case of dairy, especially because we can predict in advance that many people would go for the simple heuristic of the list (you don’t even need to read the book for the list – it’s freely available on the Real Meal Revolution website), but despite this error, there’s no evidence of any flip-flopping or change of mind for dairy, as purported by the Sunday Times.

The team simply realised that dairy being in the green list was causing people to consume more of it than was compatible with the weight-loss they were expecting, so they moved it to the orange list – in line with the qualifications above. To put it even more simply, the heuristic of the colour-coded lists wasn’t sending the right signal, so it was adapted.

And then, because people don’t pay sufficient attention to detail or relevant qualifications as they sometimes should, there was a freak-out regarding dairy suddenly being unsafe, and Noakes having “changed his mind” – so they moved it back to the green list, and re-iterated the relevant qualifications.

So, no drama there. Of course, that didn’t stop the chief lobbyist for the Banting cause (or, “science” “journalist”) Marika Sboros, from using this as an excuse to write a new piece of hyperbolic prose in defence of her hero (in which she of course links to all her old pieces, which continue being edited and added to yet carry the same permalinks as before, which seems a rather odd way to practice journalism. But I digress.).

patrick3In this new piece, much effort is directed at undermining the criticisms made by Patrick Holford in relation to Noakes. Now, contrary to how some Noakesians like to read me, I’ve never called Noakes a quack (I have said he can sound like one, though) – but I have no reservations in calling Holford a quack, and I also think he’s a mendacious one, in that he knows he’s a fraud.

There’s no need to waste time debunking Holford’s criticisms, if you are Noakes or a mouthpiece of Noakes, like Sboros. Doing so is like writing a column refuting the metaphysical views of George down at the pub, as Holford is irrelevant to science and scientific reasoning – except as an example of doing so badly.

It’s perhaps instructive, though, that even Noakes seems to think he needs to play in that market, or believes that he should – I suppose that once you become a populist, it comes with certain obligations, or at least expectations. The thing that should concern you, though, if you are a Noakes-supporter, is how defending oneself against populist criticisms can lead you to oversimplification – itself a characteristic of populism.

Sboros reports that Noakes said (it’s not an attributed quote, unfortunately) that “the clear evidence is that carbohydrate in the diet is linked to colon cancer”, in response to Dr Roger Leicester (via Holford) claiming that Banting is a risk-factor for colon cancer. Noakes also says – and I’m sure that you’ll all find this as persuasive as I do – that “that’s all unscientific twaddle”.

Except, that’s utter bullshit. It might turn out to be false – as might any hypothesis – but right now, we’ve got good evidence that high red-meat consumption is associated with increased risk of colorectal cancer. And yes, association/correlation isn’t causation, but it’s the best clue as to causation available to us in many cases – and a staple of much pro-Banting literature also (and as much as you might like to, you don’t get to cherry-pick).

Oh wait, you do get to cherry pick. Sorry, I forgot.