Sex education (including non-abstinence) may not work at all, and if it does work it works only in a very weak and limited way.
Eating cholesterol doesn't cause high blood cholesterol. Eating saturated fat probably doesn't cause higher blood cholesterol. High blood cholesterol levels are protective against cancer and the mortality gain here probably outweighs any mortality loss from cardiovascular disease. The entire science of cholesterol is confused and terrible and practically every statement you have ever heard that includes the word "cholesterol" is very likely a lie. (link to a readable blog post with some of this, but you can also find it all in big-name medical journals)
The (good!) effect of drinking alcohol on life expectancy is super strong. Drinking wine a few times a week is correlated with up to four years gain in lifespan (effect mostly found in the middle-aged, might not be such a good idea in young), and people who are smart and understand that correlation isn't always causation have amassed some decent evidence that at least some of this might be causal.
Labeling the amount of calories in food (for example on McDonald's restaurant menus) totally fails to c...
I'm a fifth year med student from Finland, a long time lurker, and you provoked me to post the first time. Thank you for that, I'm a terrible procrastinator. I'm a also big fan of many of your submissions. The alcohol fact seems right and the other two I can't comment on, so I'll focus on cholesterol. In this case I'm surprised of seeing no criticism.
If the information you present about cholesterol is true, I am highly surprised too, and I hope you're right because otherwise the information is potentially very deadly. The effect, whatever the direction, is amplified by you being a high status member of this community. If there were no other comments on this, I wouldn't bother either.
I would like to see the sources that REALLY changed your mind, and the link you provide doesn't seem to contain any good sources at a glance. The post that Kresser links to has sources that are ancient. I looked up on Chris Kresser, and he is a licenced acupuncturist trained in some version of chinese medicine. This doesn't exactly make me trust him as a source of medical information.
From what I've read, in big-name medical journals you can find that the case about cholesterol is hardly settled for good...
Yes, I understand your indignation and I should not have been as quick to spurt that out without more information. I've tried to justify everything I've said above with data from Framingham and the Cochrane Collaboration, but I hope you'll forgive me if I have to lapse into a few sources from less hallowed publications once in a while.
"Eating cholesterol doesn't cause high blood cholesterol."
Since only citing things from Framingham or Cochrane is a hard constraint to keep I am forced to commit the minor sin of citing a work not published in a peer-reviewed journal and refer you to the Framingham Diet Study, a subpart of the Framingham Heart Study whose methodology was published appropriately but whose results for some reason weren't. A guy who tracked down the results reports on them here and finds that
"With one exception there was no discernible association between reported diet intake and serum cholesterol level in the Framingham Diet Study Group. The one exception was a weak negative association between caloric intake and serum cholesterol level in men. [As to] coronary heart disease–was it related prospectively to diet. No relationship was found."
If you...
That was fast. This is why I love you and the rest of the community.
Before I say anything else, let me remind everyone of something. Atherosclerosis is a systemic disease. When we're talking about arterial disease, mortality is not the only endpoint we're interested in. Most of the time a cardiovascular event will not kill you, it will leave you disabled. It's also a hell of a painful way to die. A stroke very rarely kills you, but most of the time leaves you less functional. Microinfarctions in the brain will cause dementia, but you might not die of it. Atherosclerosis in the leg will first make you lose sensation and function in the leg, and later you might lose the whole leg. That will probably not be lethal either. It would of course be intellectually dishonest to say that these events are not correlated with mortality, however.
...Since only citing things from Framingham or Cochrane is a hard constraint to keep I am forced to commit the minor sin of citing a work not published in a peer-reviewed journal and refer you to the Framingham Diet Study, a subpart of the Framingham Heart Study whose methodology was published appropriately but whose results for some reason weren't. A guy
I have almost no sense of smell and was a competitive athlete when I was younger so, "food is fuel" has been a pretty easy philosophy to follow. I forget about this sometimes. Mind projection fallacy ftw.
EDIT: Also, you can change your tastebuds if you just don't eat something for a while. I know that skim milk tasted a lot worse when I tried it again after switching to whole milk. Also, the easiest will power hack is to not need to use your will power. Don't leave snacks within your line of vision. Hide them at the very least. Better yet, don't buy them.
Huh. I wonder if this is at least somewhat down to sex-linked biology.
I'm trans, and my sense of smell changed significantly with hormone therapy. Before, I wouldn't have necessarily said that "most smells" I noticed were unpleasant, but it was definitely true that if I noticed an aroma at all from anything other than food, it was somewhat likely to be so. A lot of things I'd later learn I could smell, just faded into the background and weren't noticed as such.
Fast forward to years of living with a different hormone regimen. Everything smells, in the same sense that everything I can see has color. Most things do not smell bad, either -- they're just there, noticeable, conveying information. It's as stimulating as texture and as distinctive as color, and no more likely to be unpleasant than either of those things. Most smells are if anything pleasant, simply because they're non-icky sensory information with some emotional effects. I love to smell packages and objects that I've ordered from other countries, because the air inside contains some of the scents of the place where they came from -- and whenever I've travelled to a place I had received a package from, the signature was unmistakable. When my partner is travelling for business, I even sometimes sleep cuddling the shirt she wore just before she left, because it smells like her.
So, yeah. If smell is like a pain sensor at a distance to you, possibly you don't have a very strong sense of smell.
The positive effect doesn't rely on drinking the level of alcohol that would normal cause someone to be considered "inebriated".
I checked this book out of the library recently, and most of the information in it pretty much fits into my models even if the specifics are news to me. I was quite surprised though, to find that Warren Buffett in particular directs his holdings to a lot of deliberate competition stifling and price gouging on captive customers. I had gotten used to thinking of him as the Big Good of the investment world, and I was surprised to realize that even if he puts his own personal fortune to benevolent uses, he doesn't have any particular qualms about deliberately concentrating wealth rather than producing it, in order to maximize profits. That didn't reflect the traditional capitalist values I imagined him to hold.
The divorce rate in India is 1.1%, and people in arranged marriages report greater love for partners than people in love marriages.
Some suggest that it has something to do with previous findings that being given more choices makes you less satisfied about the choice that you ultimately make.
I have been miscalibrating how much people at my workplace like or dislike me. I've gotten it wrong in both directions recently.
I was surprised by news of the Toyota labs replication of the Mitsubishi Low Energy Nuclear Transmutation experiment. Nuclear physics is nowhere near my field of expertise, but I am surprised and confused that phenomena similar to LENR are possible and are not being exploited left, right and centre.
The thing that first comes to mind is recently realizing that even I was infected by a dangerous memeplex directly decended from christianity.
I've always been an atheist and wondered what it was like to realize that there is no god, or what it's like to strongly believe some obviously false thing just because it's what people you grew up with believed. I remember thinking "well, I'm right on the big things like god and psychic powers and such, I guess epistemic rationality is a solved problem"
Now I'm like "holy crap, I (we) really suck at this, and could be way better".
NOt sure if this is what you're looking for.
Not saying which it is is pretty obnoxious, but I'll have to assume you've been bitten by the moldbug
I feel like there's an Edgar Allen Poe parody just waiting to happen here.
"Dis i' real bad, mistah. He bin bitten ba de moole-bug."
Even simple "obvious" insights often don't occur to us. But they become clear in hindsight or after being pointed out by others.
Humans don't have general intelligence. This became clear after watching a video of John Tooby, Evolutionary speaking humans have evolved subsystems for solving specific problems like navigating the social landscape. But we don't have general intelligence. This explains a lot.
Disclaimer: this post contains personal informations and (very mild) generalizations about gender behaviour. If you think you cannot handle it properly, please avoid it.
Unfortunately, the most surprising information I had recently has been my February break-up: this girl I was dating and was madly in love with exhibited all behaviours of being in love with me too... There were some problems that prevented us getting together, but I thought they weren't so determining. It turned out I was deadly wrong: she started dating a guy that was nearer to her home an...
Gender is much more biologically determined and less socially constructed than I had previously thought. http://whyevolutionistrue.wordpress.com/2011/01/31/evolutionary-psychology-gender-construction/
What has surprised me the most recently is reading this THINK document about the huge effects that self-improvement can have on one's ability to change the world for the better.
I was also surprised to learn that 25% of the philosophers that responded to Brian Leiter's 'Philosophers, Eating, Ethics' poll said they were vegetarian and an additional 8% said they were vegan. In other words, a whopping one third of respondents reported being either vegans or vegetarians. The proportion of vegetarians in this sample is about eight times larger than that of the ...
Having some predictions on record helps answering this kind of question. The following are from my GJP forecasts:
I think I've only ever had one bad experience speaking to a customer service representative. (They transferred me from the correct department to one which couldn't help me, and it took another two transfers to get back to where I started.) But every time I talk to one, I'm surprised by how helpful they are.
Why does being surprised imply being miscalibrated? I should be surprised that a 100-sided dice rolled a 100 even if it genuinely is fair. If I weren't surprised by that event, I would say that I was miscalibrated. Of course this means that I should expect to be surprised every now and then, but what's wrong with that?
That was fast. This is why I love you and the rest of the community.
Before I say anything else, let me remind everyone of something. Atherosclerosis is a systemic disease. When we're talking about arterial disease, mortality is not the only endpoint we're interested in. Most of the time a cardiovascular event will not kill you, it will leave you disabled. It's also a hell of a painful way to die. A stroke very rarely kills you, but most of the time leaves you less functional. Microinfarctions in the brain will cause dementia, but you might not die of it. Atherosclerosis in the leg will first make you lose sensation and function in the leg, and later you might lose the whole leg. That will probably not be lethal either. It would of course be intellectually dishonest to say that these events are not correlated with mortality, however.
Since only citing things from Framingham or Cochrane is a hard constraint to keep I am forced to commit the minor sin of citing a work not published in a peer-reviewed journal and refer you to the Framingham Diet Study, a subpart of the Framingham Heart Study whose methodology was published appropriately but whose results for some reason weren't. A guy who tracked down the results reports on them here and finds that....
I'm sorry. I'm not trying to be extra difficult, but where is the original source? Is it authentic? (Edit: Here, unfortunately not accessible, thank you Yvain)
If you'll allow me to step out of Framingham and Cochrane for a moment I can also link to a review on egg consumption and LDL which found that in most of the population there's no relationship.
Permission granted ;) I accept that the effect of dietary intake varies between individuals. Even this review recognizes that there are "hyperresponders" to dietary cholesterol. I also think that for a motivated individual measuring their response to diet would be optimal compared to just blindly switching. Measuring lipid profiles and other risk factors is cheap. I'm not sure how to measure subtypes of LDL, however, and to be honest I know nothing about their clinical relevance.
You may also be interested in a Cochrane review that finds no effect reducing dietary fat consumption on cardiovascular events, cardiovascular mortality or total mortality, and finds that changing the type of fat slightly decreases cardiovascular events (look how close that confidence interval gets to 1!), but not cardiovascular mortality or total mortality.
As I said, mortality is not the only interesting endpoint. Also the CI upper bound for CVD is not over 1, not matter how hard we want to push it. The other review does support your conclusions. It doesn't however support increasing dietary saturated fat or changing nutritional guidelines in any other way.
The only lipid-lowering drugs that seem to be consistently awesome are, of course, the statins, but they seem to work equally well in high and low cholesterol populations leading some to think they also have non-cholesterol-related effects.
That statins work equally well in high and low cholesterol populations is to me the most interesting claim that you make. Can you provide a source for it? It is commonly accepted that they have benefits on top of them affecting lipids, but that the effect is completely isolated is contrary to my knowledge. The reason for the bonus effect is also a mystery. The other drugs you mention have common annoying side effects that mostly reduce compliance, and I wouldn't be surprised if some of the side effects increased mortality. In Finland they are also usually prescribed by a specialist and are never a first line treatment.
I also just think LDL is a lousy biomarker. A majority of heart attack patients have LDL levels considered normal; this is especially impressive considering the high results of high cholesterol even in the general population.
We have guidelines to measure lipid profiles after 48 hours of an ischemic vascular event. Within this time period, the LDL levels plummet, but then they rise again. Since this is a very recent guideline, it might explain the finding you present. Then again, it also might not. If I skimmed correctly there was no mention of the timing of the measurements. Look below for Edit2 for a better explanation.
Framingham found that mortality increased with increasing cholesterol in people younger than 50. In people older than 50 (ie 90% of heart attack victims) it found no relationship (other sources say low cholesterol led to higher mortality in these age groups, but I can't access the paper to check.)
Atherosclerosis is mostly a nonreversible progressive disease that can start as early as in late adolescence, so it makes sense that hypercholesterolemia before age 50 is most important for its development. All it takes for a plague to rupture after tens of years of accumulation is that the endothelium covering it fails, it doesn't necessarily have to grow anymore. (Edit: see additional explanations in the next comment) I'm definately more critical about these issues in older age groups and probably should read more about them. We're taught that statins are useful even in people over 75, but maybe this has nothing to do with cholesterol. If you can tell me what the other source is, I can look it up. I might have access ;) Edit: Apparently neither of us do.
Only standard labs are readily available to me in clinical practice. We have a mostly public health care system, and nonstandard labs are usually ridiculously pricey. Of course LDL is hardly the only measurement we take, and is combined with all the other risk factors when assessing total arterial disease risk.
I hope I have provided a POV of how background knowledge can change the way we interpret study findings, and how much easier it makes sceptiscism about them. I apologize that I don't have english sources ready at hand for the claims I make, and I know that you will not take them on authority. It is impossible to me to keep record of most of my sources, and most of them are in finnish language.
I will check out the book you recommend, I'm chillin' after all. I think there are far too few rationalists in medicine. The education methods are authoritative and many times frustratingly ineffective. Unfortunately I don't know how to change it (yet), and will do my best with what I have.
Another neat summary of Cochrane's pitfalls, despite the medical communities truth is nicely explained here: http://blog.tripdatabase.com/2013/04/a-critique-of-cochrane-collaboration.html
Information that surprises you is interesting as it exposes where you have been miscalibrated, and allows you to correct for that.
I suspect the users of LessWrong have fairly similar beliefs, so it is probable that information that has surprised you would surprise others here, so it would be useful for them if you shared them.
Example: In a discussion with a friend recently I realised I had massively miscalibrated on the percentage of the UK population who shared my beliefs on certain subjects, in general the population was far more conservative than I had expected.
In retrospect I was assuming my own personal experience was more representative than it was, even when attempting to correct for that.