“Think and Eat Yourself Smart”: a pre-review

Update: Read my full review of “Think and Eat Yourself Smart” here.

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They say, “Never judge a book by its cover.”  What about judging it by its marketing?

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist.  She’s also a wannabe nutritionist.  Her latest book is “Think and Eat Yourself Smart”, due for official release at the end of April.

I haven’t read her book yet so I’m not really sure what she’s going to say.  It might be a well reasoned and soundly researched discussion about healthy eating, except there are some conflicting ideas that are appearing in Dr Leaf’s own marketing of the book, so I’m not holding out much promise.

For example, yesterday Dr Leaf suggested that “the mindset behind the meal – the thinking behind the meal – plays a dominant role in the process of human food related health issues, approximately 80 percent.”

This is bogus science.  It doesn’t matter if I’m convinced that eating a half gallon tub of ice cream is nutritious or not, it’s going to have the same nutritional effect on my body (namely, none).  It’s not 80 percent healthy because I believe it’s healthy.

Dr Leaf has made this assertion based on other bogus science – “How does thinking affect eating, and how does eating affect thinking? Research shows that 75 to 98% of current mental, physical, emotional and behavioural illnesses and issues come from our thought life; only 2 to 25% come from a combination of genetics and what enters our bodies through food, Medication, pollution, chemicals, and so on.”

Dr Leaf’s assertion that “75 to 98% of current mental, physical, emotional and behavioural illnesses and issues come from our thought life” is a favourite factoid of hers that forms the basis of most of her teaching.  Except that it’s wrong.  It has no basis in fact.  I’ve discussed this at length in several blogs and in my book (see here for a more detailed explanation of Dr Leaf’s 98% myth).

It’s unclear just how much of her book Dr Leaf has based on this false assumption, but the fact that it’s there in the first place sets a bad precedent for the rest of the book.

Only time will tell, of course.  I’d like to be proven wrong, but unfortunately, Dr Leafs latest book seems to be plagued with the same poor science as her other tomes.

Watch this space …

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Is sunshine healthy again?

  • New study claims avoiding the sun is as dangerous as smoking
  • Study found women in Sweden who had greatest sun exposure had lowest risk of dying from heart disease/stroke and death overall
  • But study failed to consider exercise as possible cause of improved health in cohort
  • UV exposure clearly linked to cancer risk
  • Safe sun exposure for most people still a few minutes of sunlight to face, arms and hands in the morning and evening

I live in Queensland.  Queensland is the Sunshine State, so named because we boast about having the most hours of sunshine than any other state in Australia (we actually don’t have the most sunshine in Australia, but we like to remain pleasantly deluded).

We’re blessed with temperatures that vary from pleasantly warm to oppressive and humid, but with an outdoor climate and a coastline that boasts some of the world’s most beautiful beaches, traditionally, Queenslanders have enjoyed lots of time in the sun.

In the 1960’s and 70’s, it was fashionable, and even considered healthy, to have a deep brown tan, even if that meant burning yourself to a lobster-red colour in order to achieve it.  Then in the 1980’s, we had a rethink because of the large number of skin cancers that were appearing.  I remember being at school in the 1980’s and being indoctrinated with the “Slip Slop Slap” mantra, “Slip on a shirt, slop on some sunscreen, and slap on a hat”.

Now, in the mid twenty-teens, the trend in sun avoidance behaviour has almost led us back to the Victorian era of full body swimsuits, enormous hats and constant shade seeking.  Tan’s are considered unhealthy, and if you get burnt enough to peel, everyone tells you that you’re going to die of melanoma.

If the trend continues, the next generation will be anaemic zombies whose only light exposure will be from LED devices.  Actually, come to think of it, that IS the current generation …

Given our carcinophobic sun-avoidance, I was surprised to see an article come across my social media feed entitled, “Avoiding sun as dangerous as smoking”.

Oh my goodness, was this another thing we’ve been get wrong all these years?  Should I start promoting tans again?  Should I be in my backyard in my underwear trying to get one myself?

As it turns out, I can keep my clothes on, much to the relief of my neighbours.

The study in question is a 20 year follow up of nearly 30,000 women in Sweden [1].  They measured their sun exposure habits at entry to the study, and throughout the two decades of follow up, and they found a nice linear relationship between their sun exposure and their overall mortality.

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The authors stated that, “Nonsmokers who avoided sun exposure had a life expectancy similar to smokers in the highest sun exposure group, indicating that avoidance of sun exposure is a risk factor for death of a similar magnitude as smoking.”

This is sometimes where reading medical literature can be confusing.  I can imagine some people thinking, “Well, that means if I want to spend all day on the beach, I can protect myself by taking up smoking.”  So let’s take a step back here before we swap our sunblock for a packet of ciggies.  We have to be careful in how we apply this information from this study.

For a start, this research was done on women living in Sweden, where the climate is slightly different from living in the tropics.  There isn’t much sun in Sweden, and when it does come out, it’s not very intense.  That’s a big different from living in climates like Queensland where standing in the sun for an hour does to us what my microwave does to my leftovers.

We know that UV radiation is bad for us.  Tanning beds increase the risk of melanoma [2] and sunscreen decreases it [3].  When the current study broke down their numbers, the all-cause mortality related to sun-exposure was lower, but the cancer risk was higher.

Despite the risk of cancer increasing with sun-exposure, the cardiovascular causes of death were much lower, but this may be nothing to do with sun-exposure at all, but may be all to do with exercise, something the study failed to account for as an independent variable.  Time outside is usually going to be active time – exercising, gardening, walking, etc., and it may simply have been that those women who had the most sun exposure also did the most exercise or were the most active, which is common sense.

So the article isn’t able to prove that the health benefits which they ascribe to sunlight aren’t from something else.  Their cohort of subjects also doesn’t allow for a broad application of the results given their lack of UV intensity in their climate compared to other parts of the world.

I don’t think this study is enough to reverse the current wisdom about sun exposure.  It’s ok to have a few minutes of exposure to sunlight on your face, arms and hands most of the year, although some people in areas of higher latitudes (closer to the poles than the Equator) may need some more sun exposure in winter.  Look at information from a cancer council in your area for locally appropriate information.

So, keep your pants on, and the rest of your clothes for that matter.  We don’t need to expose ourselves and get a tan to live a longer life.

References

[1]        Lindqvist PG, Epstein E, Nielsen K, Landin-Olsson M, Ingvar C, Olsson H. Avoidance of sun exposure as a risk factor for major causes of death: a competing risk analysis of the Melanoma in Southern Sweden cohort. Journal of internal medicine 2016 Mar 16.
[2]        Boniol M, Autier P, Boyle P, Gandini S. Cutaneous melanoma attributable to sunbed use: systematic review and meta-analysis. Bmj 2012;345:e4757.
[3]        Green AC, Williams GM, Logan V, Strutton GM. Reduced melanoma after regular sunscreen use: randomized trial follow-up. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2011 Jan 20;29(3):257-63.

Dr Caroline Leaf – Increasing the stigma of mental illness again

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Let me tell you a story.

A couple of years ago, one of my patients was an elderly gentleman in his late seventies.  He was living in a nursing home at the time, but because of his history of psychosis, he remained on a treatment order – a requirement by law that if he was to remain outside of a mental facility, he had to have regular anti-psychotic medication every few weeks.

This man was on a treatment order because his disease caused him to have delusions.  He misinterpreted what was going on around him, and would not consider that he could be wrong.  In his particular case, he was convinced that his next-door neighbour was a paedophile, and he was planning to ambush his neighbour and castrate him.  Luckily the police had taken my patient into custody before he got the opportunity.  With treatment, my patient had clear thoughts, although needed close supervision.  Without his medication, he became confused and violent.

According to a post on the blog Mad in America and promoted by Dr Caroline Leaf, my patient’s diagnosis was spurious, and he was denied his basic human rights by being forced to take medications.

Dr Caroline Leaf is a communication pathologist and self-titled cognitive neuroscientist.  She is also a self-declared expert in mental health, despite not having any professional training in medicine, psychiatry, psychology or even cognitive neuroscience for that matter.

Indeed, if she had any experience or expertise in mental health, she would have recognised the basic factual errors and logical fallacies that riddled the post she quoted from.

Take the quote that Dr Leaf posted on social media.  The full quote from the Mad in America post is:

“Despite the fact that no one in history, not even the omnipotent American Psychiatric Association – which produces and profits mightily from the ‘Bible’ of mental disorders — has come up with a halfway good definition of “mental illness,” and despite the fact that the process of creating and applying the labels of mental illness is unscientific, any of those labels can be used to deprive the person so labeled of their human rights. This is terrifying. It ought to terrify those who are so labeled and those who are not, because deprivation of human rights on totally arbitrary grounds is inhumane and immoral.”

This is the same tired, emotionally laden and misleading rhetoric that’s so often barked in fervent paroxysms through the foaming lips of those opposed to modern psychiatric practice:

  1. There is no good definition of ‘mental illness’
  2. The American Psychiatric Association is just a profit-driven cabal
  3. The DSM5 (which the author alludes to as the ‘Bible’ of mental disorders) is unscientific
  4. Psychiatric diagnoses are unscientific
  5. Any psychiatric diagnosis can be used as a trigger to force people into unwanted treatments or incarceration
  6. Therefore psychiatric diagnosis and treatment is against basic humans rights and is inhumane and immoral.

Inhumane and immoral hey?  Tell that to my patients neighbour who almost became a eunuch except for that “inhumane and immoral treatment” of my former patient.

Caplan claims just don’t stand up to any rational scrutiny.

  1. There are lots of good definitions of mental illness … modern psychiatry critics just don’t like them. But take the definition used by the CDC, “Mental illness is defined as … ‘health conditions that are characterized by alterations in thinking, mood, or behavior (or some combination thereof) associated with distress and/or impaired functioning.’” There’s nothing wrong with this definition. It describes mental illness and helps differentiate mental illness from variations of mood, thought and behaviour that are part of the everyday human experience.
  1. The American Psychiatric Association isn’t the only group to have created a classification of psychiatric illnesses. The World Health Organisation publishes the International Classification of Diseases, or the ICD, which is also used for psychiatric diagnosis. Is the WHO an evil profit-driven junta too?
  1. The DSM, the ICD, and any other system of diagnosis, are simply different classification systems. Over the last century, clinicians have noted clusters of symptoms and have tried to classify them into common groups. How is that unscientific?  It’s no different to scientists looking at the different characteristics of various animals and creating a taxonomy, to provide a common system and language for clinicians and researchers across disciplines and across countries.The DSM system isn’t perfect, but what system ever is?  As knowledge of neuroscience grows, the classifications are reviewed and tightened in an ongoing process of improvement.  If those who oppose the DSM want to come up with something better, they’re welcome to put something forward.
  1. The old saying goes that medicine is an art and a science. Human beings, as nuanced as we are, often don’t fit into diagnostic criteria as easily as we would like. That doesn’t invalidate the diagnostic criteria or make the process unscientific as critics of modern psychiatry would have us believe, just like an unusual and hard-to-classify form of cancer doesn’t invalidate the other cancer classifications that are well defined.  Psychiatry, by it’s nature, relies on verbal report from patients rather than a clean-cut blood test or piece of tissue under a microscope, so at this stage in history, it seems imprecise.  That doesn’t make it any less scientific.
  1. The allegation that any psychiatric diagnosis can any be used to deprive the person so labeled of their human rights is utter nonsense. It’s a giant scarecrow – it seems really scary, but on closer inspection, it’s just a tarted-up mound of straw.People are never forced into treatments unless they really are “dangerous to themselves and/or others”.  This rule can’t be invoked willy-nilly.  There are multiple checks and balances, and a whole school of civil rights lawyers expectantly circling, ready for the whiff of blood in the water (http://www.mhrt.qld.gov.au/?page_id=2 is an example of the process in my home state, but each jurisdiction has their own version).

Caplan rightly pointed out that those with mental illness were less likely to be the perpetrators of violence and more likely to be the victims, but that doesn’t negate the need for protection of the community from those with mental illness who have shown violent intent and no capacity to control their behaviour.

If you want to find a group that really are suffering from inhumane and immoral deprivations of their human rights, then that would be Christians.  Around the globe, millions of Christians are oppressed, imprisoned, tortured, raped, and murdered every year.

Time and space preclude a full analysis of Caplan’s post, but what’s really important is that both the American Psychiatric Association and the U.S. Department of Health and Human Services’s Office of Civil Rights, an independent ombudsman, dismissed formal appeals by Caplan relating to her hysterical claims of inhumane forced psychiatric treatment.  Dr Leaf conveniently left that out of her social media post.

Instead, Dr Leaf chose to publish one of the most alarming quotes from an article heavy on scaremongering, from a disaffected author on an extremist blog.  If Dr Leaf was a real expert on mental health instead of being a self-declared one, she would have easily seen how nonsensical Caplan’s post was.

By posting this quote on social media today, it’s highly likely that Dr Leaf has caused harm to thousands of vulnerable Christians by unnecessarily increasing the stigma and fear of a mental health diagnosis.  This, in turn, is likely to lead to these same vulnerable Christians missing out on (drug and non-drug) treatment which would help them rise to their true potential in God and in life, leaving them trapped and suffering in their mental destitution.

Dr Leaf has a track record of misinformation when it comes to mental health.  Christians suffering mental illness need more support, not more stigma.  It’s time Dr Leaf stepped aside, and stopped making things worse.

Lies in the name of God are still lies

Let’s be honest, we all lie, and we lie a lot.

It’s ok, we’re all friends here.  You can admit it – lying is a regular part of everyday social cohesion.  We don’t call it lying, we call it tact, but it’s still lying.

Like when we automatically say to the mother of a newborn baby, “Oh, your baby’s adorable”.  Sure, most of them are, but there are some newborns that, shall we say, need to grow into their features.

Or when a patient walks in and asks, “Hey, have you lost some weight?!”  No, I’ve actually gained five kilos, but thanks for your flattery.

Even some of the most brutally honest people still figure out they have to lie at some point.  My children, for example.  They have absolutely no diplomacy filter between their brains and their mouths, “Aw, Dad … you stink”, or “Dad, you’re really fat.  You need to exercise.”  But when their butt’s on the line, things change, “I only ate one biscuit …”, or, “He started it …”.

Adults are no better.  Sometimes when things are important enough to us, we bend the truth to fit our world-view.  It’s often subconscious, though confirmation bias of our opinions can also be overt.

Sometimes we’re right, sometimes we’re wrong, and sometimes there is no right or wrong, but our beliefs shape our interpretation of the world, and the language and actions that stem from them.  And most of the time, it doesn’t really matter.
“Chocolate is the nicest flavour of ice-cream”.
“Beer is better than cider.”
“The Broncos shouldn’t have lost the NRL Grand Final.”
“Holden’s are better than Ford’s at Bathurst.”
“Donald Trump is a great guy.” **

Hey, if you think Donald Trump is a great guy, then you’re welcome to your opinion.  It ultimately makes no difference, if you like Trump, or I like vanilla ice-cream, or if you’re a ‘Ford guy’.

Though what about when someone in the public sphere lies, or allows their opinion to shape their version of truth?  Is ‘a little white lie’ ever truly acceptable?

For example, is it justifiable if news reporters lie about themselves or their motives to get to the truth of a story?  For example, in an article written as an ethical primer for journalism students at Indiana University, Henry McNulty recalled an expose he was part of in which reporters posed as couples trying to get into the local real estate market.  The investigation exposed some inherent racial prejudice amongst the realtors, and eventually lead to the state governor ordering a formal investigation into real estate discrimination.

While he noted that the investigation had noble goals and positive outcomes for the community, he also concluded that the end should never justify the means.
“Credibility is our most important asset.  And if we deceive people in order to do our job, we’ve compromised that credibility before a word is written”, he said.

In recent times, the Safe School’s program has come under intense scrutiny.  For those not familiar with it, the Safe Schools program was touted by its supporters as an evidence-based anti-bullying program for mid-late primary school students, although its primary agenda appears to be in promoting the Lesbian-Gay-Bisexual-Transgender (LGBT) lifestyle and ideology.  Or as one commentator put it, “In reality, the debate is between those who support the right to childhood and children’s bodily dignity, the right to an education that educates, not indoctrinates, versus those who believe Marxist activism constitutes sound school curriculum.”

A post came up on my Facebook feed in the last couple of days, titled, “Gender Ideology Harms Children”.  It was published by the American College of Pediatricians, which sounds like an official body, except that the American Academy of Pediatrics is the peak body of paediatricians in America. Then the style of language of the statement was inconsistent with that used by most peak bodies – this statement by the American College of Pediatricians was very strongly partisan.  I couldn’t help but wonder who the American College of Pediatricians actually were.

As it turns out, the American College of Pediatricians are a group that promote a very conservative agenda under the guise of official medical and scientific opinion.

In their core values, they state that their college:
“A: Recognizes that there are absolutes and scientific truths that transcend relative social considerations of the day.
B: Recognizes that good medical science cannot exist in a moral vacuum and pledges to promote such science.”

I’m all for good science, but one has to wonder if they’re going about it the right way, because while they declare their pledge to scientific truth, their next core value is essentially an opinion:
“C: Recognizes the fundamental mother-father family unit, within the context of marriage, to be the optimal setting for the development and nurturing of children and pledges to promote this unit.”

As much as I agree with and share most of their values, their pledge to opinion-based science is somewhat duplicitous, because opinion-based science isn’t absolute truth, it’s still a version of truth relative to their values and presumptions.

The irony hasn’t escaped some of the colleges critics, who have highlighted some of the factual errors and bad science that inevitably occurs when one tries to fit scientific findings into a set of values rather than drawing conclusions from the science.

In fairness, I’m not saying that the LGBT community is faultless either.  I’m sure that an in-depth study of their sources would find some over-zealous misinterpretations of scientific data as well.

My point is that we tend to look for information that suits our own pre-conceived notions, and the Christian community can get itself into trouble by doing this.  Christian lobby groups and church leaders need to be wary selectively accepting ‘scientific’ information that conforms to their world-view.  They need to, in all diligence, ensure that the data they cite really does support their position, not cherry-pick or over-extrapolate.  Otherwise they’re no better than the moral relativists on the other side of the political spectrum, or journalists who would justify mistruth to achieve a higher goal, or my eleven-year-old denying his biscuit binge.

One critic of the American College of Pediatricians wrote something very incisive in the title of his blog, “Lies in the name of God are still lies.”

It’s a fair call.  Misleading with the best of intentions is still misleading.  We may have the best of intentions, and feel justified in picking the science that conforms to our world-view.

Even so, God called us to speak the truth, because Jesus was the way, truth and life, and it’s the truth that sets us free.  And our credibility is our witness.  If we deceive people in order to do our job, we’ve compromised that witness before a word is written.

That’s the honest truth.

** The opinions expressed here do not necessarily represent those of the authors, and are for illustrative purposes only … except the bit about the Broncos … but the rest is just illustrative. 

Let boys be non-stigmatised boys

Boys will be boys ...

“When I was a boy …”

Many a stirring yarn has been started with those exact words, as aging men relive their childhood adventures with sentimental grandiosity increasingly taking over from detail as each passing year blends in with the blur of distant memories.

Ps Greg Gibson wrote an article that caught my attention as it floated across my Facebook feed last night.  Gibson is a pastor in Knoxville, Tennessee.  His “when I was a boy” story recalled his happy times as an energetic child, a serene innocence punctuated by two years of Ritalin-induced misery.

His point: “I think we should let boys be boys, and non-medicated ones at that. Therefore, parents, if at all possible, don’t medicate your boys.”

I think I understand what he’s trying to say, that it’s ok to be an energetic child and to see the extra energy as a strength to harness, not a weakness to control.

That would be fine, except that in trying to normalise energetic behaviour, he also winds up demonising Ritalin.  It may not have been his intention, but whenever someone respected in the community says something negative about stimulant medication or ADHD, it reinforces the oppressive stigma attached to those who suffer from it.

Ps Gibson’s fundamental assumption, that normal but energetic children are being misdiagnosed as ADHD and therefore unnecessarily medicated, happens far less often than the opposite – children with ADHD are misdiagnosed as energetic children that just need to be taught how to control themselves.

Personally, I don’t know of any parent who ever wanted to medicate their child with Ritalin.  If anything, it’s the opposite, because if your child’s on Ritalin, then you must be a lazy parent, or given them too much sugar, or too much screen time, or not hugged them enough as babies, or didn’t practice vaginal seeding, or whatever other form of parent-guilt is being perpetrated by the media at the time. Parents will do everything they can in their power to avoid using Ritalin, because of a culture that blames and shames.

Unfortunately, this means that children who could be helped by Ritalin or other stimulant medication are left behind, because ADHD isn’t the mislabeling of normal energetic children who just need better structure, or better posture, or who learn differently.  ADHD is a real disability, a dysfunctional lack of planning and control that’s abnormal compared to other children, affecting their entire lives.

For example, these children find it hard to play with other kids because they can’t follow basic social rules like the rules of games, or waiting their turn.  These children find school difficult, because they can’t concentrate for long enough to focus on completing a multi-step task, or have a long enough attention span to make new memories for words or facts.

One of my patients, a little boy about seven years old, was brought in by his mother because a chiropractor wanted me to arrange a blood test on his behalf.  When I asked why, the mother said the little boy had dyslexia which the chiropractor was ‘treating’ (actually, this chiropractor was blaming a disease that didn’t exist, and wanted me to arrange a test that was resigned to the pages of history, but that’s another story).  When I talked to the mother about the child’s symptoms, it was pretty obvious that he had ADHD, amongst other things.  After seeing a developmental paediatrician to confirm the diagnosis, and taking Ritalin for just one week, his reading improved three whole reading levels, and after a month, he had not only caught up, but had passed a number of his class-mates.

This is a real life example of how ADHD can hold children back, and how stimulant medication can help.  While there are always exceptions to the rule, stimulant medications help more often than they hinder.  They’re sometimes the difference between a child meeting his full learning potential, or being unnecessarily held back, languishing at the bottom of his class as his peers go further ahead in leaps and bounds.

Our culture needs to move on.  We need to stop our social prejudices making life more difficult than it already is for children and their families who battle with ADHD.  We need to see that medications for ADHD can be the difference between a life of learning and a life unfairly held back.

Let’s change the tune.  Rather than saying, “Let boys be non-medicated boys”, how about we say, “Let boys be non-stigmatised boys.”  It’s only through the break-down of the stigma surrounding ADHD and stimulant medications, that all boys (and girls) can truly meet their full potential, whether they have ADHD or are just a bit more energetic.

If you want more information on ADHD and its treatments, this is a good place to start: http://www.rch.org.au/kidsinfo/fact_sheets/ADHD_an_overview/

If you are concerned that you or your child might have ADHD, talk to your local GP or paediatrician.