The Arrow #182

Hello everyone.

Greetings from Montecito, “where the cotton’s high, and the corn’s a growin’, and there ain’t no fields to plow.” (Strangely enough, there are a lot of fields to plow in Montecito.)

Let me know via a poll response where that last line in quotes came from, and I’ll be able to guess your age.

Speaking of poll responses, let’s get to them.

Poll Responses

Pleasure

First let’s take one that doesn’t have anything directly to do with health and/or nutrition.

Great story about your family’s movie schtick. We were a military family always traveling to new duty stations & to return home for visits… we played “movie trivia” with the kids on the road. Someone would come up with a line from a movie & the others must name the movie, the character & scene. These phrases all became a short-hand for us in conversation. We could pass meaning between us with no one else knowing what we were talking about. Real glue for our relationships that continues to this day & with their spouses & families included.

I love this response, because our family is the same way. We have all these hidden meanings in phrases from movies, books, music, and TV shows we all use and no one (other than family) has a clue as to what we’re talking about.

I love the arts in general. Clever people come up with clever things to make us all be appreciative of talent and experience pleasure. And, to me, pleasure is a nutrient, so it fits in nicely with the purpose of this newsletter.

The video of the week is an hilarious excerpt from one of our family’s all-time favorite flicks. The entire movie contains a bounty of Eades family quotes.

PUFA and Obesity

This poll respondent asks a question I’m asked over and over again.

So. Eggs, bacon and chicken thighs? It's possible to source these things so that they're low PUFA, but do you ('cause they kinda pricey)? Since your 'Alternate Theory of Obesity' presentation was the one that sent me down the omega-6/linoleic acid rabbit hole 3+ years ago, I am very careful about these things (to my great advantage, I might add, so THANK YOU).

Here is a slide from that presentation.

In this slide, from that very talk, I’m showing the various sources of fats added to the American diet. As you can see, vegetable oils and shortening surpassed the amount of fat we get from beef in about 2006 to 2007. It’s gotten worse since.

The bottom sort-of-flat lines show other sources of added fat: lard, beef tallow, butter, margarine, etc. Their contribution is minuscule as compared to vegetable oils and shortenings. The same goes for PUFA from poultry and pork. Even though poultry is the meat with the largest US consumption, the overall contribution to total LA just isn’t that much.

There just isn’t a lot of linoleic acid (LA) there.

I prefer pork and poultry that has a lower PUFA value simply because the animals are better raised and taste better. But I eat regular old store-bought chicken and pork all the time.

If you look at the difference between LA content of pasture-raised chicken as compared to grain-raised chicken, you can see there is what appears to be a pretty good difference. A 100-gram portion is a standard measure. It calculates to about 3.5 ounces. A typical chicken thigh with bone included weighs almost 4.5 ounces, so getting rid of the bone, which you doubtless don’t eat, means the amount of edible weight of a chicken thigh comes in circa 3.5 ounces. So think of the following graphs as representing the edible portion of a chicken thigh, skin included.

As you can clearly see, there is a fair amount more LA in a grain-fed chicken thigh than in one from a grass-fed bird.

But if you notice the Y-axis of the graph, you can see that the magnitude of the LA contained in either one is pretty tiny. Just to give you a comparison, I made a graph of the LA content of these same two chicken thighs as compared to the LA in a similar amount of walnuts.

People will pay a lot of money for pasture-raised chickens to avoid LA and think nothing of throwing back a handful of walnuts (or, really, almost any other nut other than Macadamia nuts), which contains over 20 times the LA of grain-fed chicken.

I guess the take-home message is that you can do a lot to decrease your LA consumption, but avoiding store-bought chicken or pork isn’t going to contribute as much as getting rid of a whole lot of other high-LA foods we seldom think about.

If you want to spend the extra money for taste, or for the better life for the animals, go for it. Both worthy reasons. But I don’t think it’s worth it just to reduce LA intake by a smidgen.

The Plight of the Elderly

The poll response below was one of many in reference to the section on constipation last week.

I don't understand why many functional medicine doctors say you must have 2 bowel movements a day! My father (94) has terrible bowel problems. The GI Dr tells him to eat more fiber. My dad gave himself prolapse from YEARS of constipation (my analysis). He refuses to drink enough water and could use more protein & fat in his diet. But like so many of his generation believe, saturated fat and lots of red meat will destroy your heart. [My bold]

I find the bolded part of the above to be extremely sad. My generation and those after have learned to be suspicious of the medical community and authority figures in general. Not so with the so-called greatest generation. They were and are true believers.

My father was of that generation, and once during a conversation not long before he died, I made the point that the government shouldn’t be trusted uncritically. I don’t remember the subject of the convo, but I do well remember his response to my argument. He said, and I quote, “You seem to think the government is out to get us. I don’t believe that at all.”

There in a couple of sentences is the generational difference.

People of that generation are scared to death of red meat and any kind of saturated fat. Said fear has been foisted on them by our leaders in Washington, who started the nutritional guidelines promoting a low-fat diet about 50 years ago without so much as a smidgen of data showing that diet was optimal. Since that time, we’ve seen both diabetes and obesity skyrocket, yet it’s difficult to get the ideologues responsible for reformulating the guidelines to make significant changes. Especially since there is so much money involved.

But the old timers, such as my dad and the poll respondent’s dad, still believe in the wisdom of Uncle Sam (I was at least able to persuade my dad he didn’t have to avoid red meat). And it is making their later years a nightmare in many cases.

These are the folks with sarcopenia who would profit greatly by more protein in their diets. But the absolute best sources of good quality protein are meat and eggs, which they eschew because of their government-promoted fear of cholesterol and saturated fat. Many of them take statins, because that’s what their ignorant doctors tell them to do despite the fact that statins have never been shown to reduce all-cause mortality in the elderly. In fact, most studies show that higher cholesterol in the aged correlates with greater longevity. There is no doubt that in many people statins cause a loss of memory, and the elderly are fighting memory loss in general under the best of circumstances.

I don’t want to dwell on this because it is too sad. To me, at least. But you get the picture.

More BM Commentary

Here are a couple more. Without my commentary on them. I just thought they might be of interest.

I can confirm everything you say with regards to bowel movements on low carb and carnivore. I take our Labrador for his morning walk, 5 miles almost every day, so am very well acquainted with his various excretions. We feed him a raw food diet and the contrast with the other local dogs who are fed on the "veterinarian recommended" kibble diet that's in vogue at the moment is stark. I can tell how balanced his diet is quite easily. There's not a huge amount produced but if what comes out is dry and powdery and we need to reduce the amount of bone he's eating. Looser than usual and we need to bring the bone content up. Whatever he does produce, if left, will dry out quickly and leave behind the "white dog poo" that was everywhere in the 70s (at least here in the UK) and is often cited in "whatever happened to..." reminiscence memes on social media. In contrast, the local dogs leave behind huge piles of paste like movements that stick around forever. We get a lot of pushback for not following the "recommended" route but there's no way on earth you can persuade me that a big bag of meat-flavoured kibble is better for him than natural raw meat, bone and organs. Have you ever seen a nature documentary where a pack of wolves hunt down and massacre a herd of wild biscuits? No. Didn't think so.

I wasn’t alone in having bowel-obsessed parents (grandmother, in my case).

I'm 79 and very interested in bowel movements. I burst out laughing when I got to your enema experience. My parents were devotees of this treatment and if I broke my leg, they would have certainly given me an enema before taking me to the hospital.

Richard Bernstein, M.D.

One poll respondent wanted to dock me a star for failing to remember and to report that Dr. Bernstein’s birthday was June 17.

Thanks doc, and a belated Happy Birthday. I would have given you the fifth star but for your failure to give a shoutout (and an intro to those who don't know him) to Dr. Bernstein, who turned 90 on June 17. For those interested, there's an hour long video of celebration on Dr. Bernstein's Diabetes University on You Tube. The video is one-minute messages from some of the many diabetics (almost all T1) whose lives were dramatically changed by his work. Someday he may get what he deserves from the world.

Mea culpa. But I didn’t know June 17 was Dr. Bernstein’s birthday. Dr. Bernstein, Dick, as he known by his friends, and I (and MD) have a long history. I had no clue he even existed till I got a call from him out of the blue telling me he was the head of the NY Medical Literary Society. He was calling to tell me that the society had given MD and me the Medical Book of the Year award for Protein Power back in 1996 (I think—it could have been 1997). We went to NYC to receive the award and commemorative plaque (which is in storage, or I would put up a photo of it).

We ended up setting Dr. Bernstein up with our literary agent, who sold his book Dr. Bernstein’s Diabetic Solution to its publisher. We provided him with a cover blurb on his first edition. You can barely see it, but I’ve circled it below.

For those of you who don’t know who Dr. Bernstein is, he is a giant in the field of diabetes medicine. If he doesn’t know it, it isn’t worth knowing. His book is the most comprehensive book out there on the treatment of diabetes, both type I and type II. His is a phenomenal story.

He developed type I diabetes when he was about 12 years old. He has been on insulin since then and has doubtless lived longer than anyone else ever with type I diabetes. He was educated as an engineer and worked as an engineer up into his late 30s/early 40s. His wife was a physician and one day she came home and told him about a new machine they had gotten in the emergency room that could perform rapid tests for blood glucose.

To digress just a bit, those machines were incredibly important because prior to their development, it took a while to get a blood sugar measurement back from the lab. As someone who has worked many, many shifts in an ER, I can tell you a lot of people show up unconscious via ambulance. More often than not, whoever comes in with them—a co-worker, a friend, whomever—is clueless as to why they passed out.

A common cause is insulin shock. Those who have type I diabetes give themselves insulin shots to regulate their blood sugar. But if they are brittle diabetics, they have a lot of difficulty. They can easily give themselves too much. And when they do, their blood sugar drops precipitously and they pass out.

If you’re a doc working in an ER, and someone gets brought in unconscious without any history of trauma, that’s the first thing you should think of. Strangely, diabetic ketoacidosis (DKA) can also cause loss of consciousness, so you don’t really know. If someone with DKA comes in, you can usually smell the ketones on their breathe, but not always.

So if you get an unconscious patient, the first thing you do is think insulin shock, start an IV, and give them a dose of glucose. If they’re in insulin shock, it will bring them to almost immediately. If not, then you know something else is going on.

So a machine that gives instantaneous glucose readings in the ER is a godsend.

Anyway, Dick’s wife told him about this new glucose measuring machine, so he had to have one. At the time these machines were about the size of a copier and cost about $600, which would be about $2,400 now, but he bought one. Then he began meticulously measuring everything he ate and compared it to his blood sugar change. He created a huge database of what all kinds of foods did to his blood sugar. He wrote it all up in a self-published (I think) book called Diabetes: The Gluco-Graf Method for Normalizing Blood Sugar.

After publication of this book, he wanted to get a scientific paper published describing his methodology. He wrote it up and presented it to a handful of journals, all of which rejected it because he wasn’t a doctor. Or a Ph.D in some kind of medical science.

So he said, Screw it, I’m going to medical school, which he did at an advanced age for a medical student. When he got out and finished his post-grad training, he went into practice treating people with diabetes. And has done so ever since.

MD and I have spent a fair amount of time with him and can tell you he is an amazing person. He is open minded to the nth degree. If someone tells him about an herb or a supplement that may work for diabetic patients, he is all over it searching out info and even trying it himself. If it works, he recommends it to his patients.

We have had dinner with him multiple times, and it is an amazing experience. He tests everything he eats by chewing a bit of it, putting it on a strip, getting a reading, then injecting himself with insulin. He has the entire process down to an art. He does it so quickly, you don’t even really notice his doing it, though he’s sitting right next to you at the table. What totally shocked me the first time I saw him do it was his injecting himself with insulin right through his dress shirt and undershirt. He figured out his dose, loaded his syringe almost without my noticing, then, Bam, right through his shirt. The whole process took a few seconds.

He injects himself with tiny doses of insulin to cover the food he eats, which is virtually always low carb. He has come up with his law of small numbers. Anytime anyone doses themselves with anything, including insulin, there is both measurement error and a variable response. Let’s say there is a 20-30 percent measurement error or response differential. If you are taking large doses of insulin, then you’ve got a 20-30 percent variation in effect, which can be large. And cause insulin shock or not enough blood sugar lowering. If you’re only giving yourself 8 units of insulin instead of 100, then that 20-30 percent variation isn’t that much.

Dr. Bernstein is a small guy, but he is very fit. He works out all the time doing strength training. He follows a low-carb diet. And he still has all his marbles at age 90. As a Type 1 diabetic. So he must be doing something right.

I hope this short bio makes up for my missing his birthday. He’s an incredible person and doctor, and I’m proud he’s my friend.

Waist-to-Hip Ratio

Received this from a curious respondent. Don’t remember getting it from before. I guess I’ll have to reduce my statin dose. (Just kidding.)

I guess my poll question on the excellent Arrow 180 was lost: concerning waist-hip ratio, you allow a higher ratio than the graphic for women (0.85 v. 0.8) and a lower one for men (0.9 v 0.95). What’s your reasoning there??

These numbers are not set in stone. I’m a little more strict on men than on women simply because men are more prone to develop heart disease than women. Therefore I would like to see my male patients with a little lower WTH ratio than my female patients. I would like to see the females a little lower as well, but I don’t ride herd on that as hard since they live longer and have fewer issues.

I wonder in these days of woke what the guidelines are for our trans brothers and sisters in the new DEI order. So far, I haven’t seen any guidelines. Has anyone else?

Dr. Seyfried’s Paper

Received this from a disappointed reader.

Was disappointed that you didn't discuss Thomas Seyfried's new paper.

Well, this reader is going to be disappointed again. I didn’t know the paper existed till my friend Bob Kaplan did an analysis of it for the Broken Science Initiative. I figured I would see if I could add anything to what he said, but then when I sat down to do it, I realized I didn’t have the actual paper. It was behind a paywall. So I emailed Bob, and he sent me a copy.

After I went through it, I realized I didn’t have anything to add. You can read Bob’s discussion here. I stuck the paper in my Dropbox, so you can read it here.

Okay, let’s move on.

If you enjoy The Arrow and get something out of it, buy me a coffee. That’s what it costs per week to be a premium subscriber. Thanks in advance.

ChatGPT, Niacin, and Me

When it first came out, I played around with ChatGPT a bit, but I never really got deeply involved in it. I didn’t really have anything I thought I could use AI for, so I didn’t spend a lot of time with it. I signed up for an online course, but haven’t gone back to it since I went through the first few lessons. These were mainly about the varied uses of ChatGPT, none of which I really needed. So, I pretty much abandoned it.

Our grandson Ben came out to stay with us and visit Thomas Aquinas, a Great Books school, to which he has been accepted for admittance this coming fall. The college is in the mountains near Santa Paula, CA located about 50 miles from us here in Montecito. We spent most of a day there, and I can tell you that without a doubt it is the most beautiful college campus I’ve ever been on. Absolutely stunning in its architecture and natural surroundings.

While here, Ben told me that some students he knows used ChatGPT to write their essays for school. He said only the smart ones could get away with it, because the essays were much better than the ones the not-so-smart ones could write on their own, so they were always outed. He asked me if I had ever used it. I told him about my brief experience. He said it was great for research.

I have been working on a project for the last few weeks here and there on a theory that too much niacin might be a factor in the obesity epidemic. I didn’t come up with this theory myself. I’ve read about it sporadically from various sources over the past couple of years. But just lately started to really dive into it.

Problem is, there isn’t a lot of scientific literature on it. There are plenty of papers showing niacin causes insulin resistance and elevated glucose levels, which themselves are drivers of obesity, but not a lot of papers on niacin and obesity. I’ve read old papers from back in the 1930s that describe how feeding children niacin made them eat more and gain more weight than children who didn’t take niacin supplementation. Both groups in these studies had plenty of good food to eat, so these weren’t starving children who finally got some nourishment. These were well-fed kids to begin with, who did not suffer from pellagra.

Pellagra, a niacin-deficiency disease, was a major problem in the American South a century ago when corn was the staple. There is niacin in corn, but it’s bound tightly; the grain has to be nixtamalized by cooking in lime ash water to release it. The indigenous people of the desert Southwest soaked their corn in lime ash water to make hominy or posole. Poor southerners didn’t know this, so pellagra was a common disorder in the South.

Sometime in the 1940s (I’m not absolutely positive about this date as I haven’t dug into all the federal and state regs yet), the government, in its infinite wisdom, decided to require the enrichment of flour with niacin to prevent pellagra. Since at that time bread was a staple, the enrichment of the flour it was made from provided plenty of niacin. And the enrichment pretty much got rid of pellagra.

In the mid-1970s (again, I’m note sure of the exact date) the dose of niacin was bumped up in the enrichment regulations. Not long after that, the obesity epidemic kicked off.

My intent is not to attribute the entirety of the obesity epidemic to niacin in enriched flour, but it could well be a factor. Especially when you consider that most snack foods contain some measure of flour, all of which is enriched with niacin. Couple that with the giant increase in the consumption of snack foods since the late 1970s/early 1980s, and it raises suspicion.

It’s not only flour products that contain niacin. Meat of all kinds is a great source of niacin along with eggs, dairy products, nuts, legumes and seeds. Consuming a diet with animal protein, eggs, and dairy with provide all the niacin one needs.

People meeting their niacin needs with an array of the above foods don’t need extra niacin. But if they eat also snack foods, breakfast cereals, or any kind of baked goods and other products made with enriched flour (virtually all of them), they get a lot more niacin than they need.

And, unfortunately, it isn’t just flour-filled foods that load us up on excess niacin. Everyone food-manufacturing-wise gets in on the act. We live in a world where people down vitamins by the handful, so if a particular food can be “fortified” or “enriched” with vitamins (including niacin, which is also called vitamin B3), you can count on big food to include them. They are dirt cheap and provide a halo of healthfulness. If a junk food can be advertised as containing 100 percent of the RDA of vitamins, then all the better.

It’s not just junk foods, either. It’s all kinds of stuff. Last weekend I was out playing golf, and one of my golfing buddies suggested I try an electrolyte mixture in my bottled water. He gave me a couple of packets of the product shown below.

As you can see from the red line I put under it, this little packet contains, among other things, 24.9 mg of niacin, which is 160% of the RDA. If I consumed this packet, which I didn’t, and if I ate a typical diet with plenty of added flour-based products, which I don’t, and took a vitamin pill or two per day, (which I don’t) along with the meat, eggs, and dairy I eat, God only knows how much niacin I would get in a day.

This is what’s happening to the entire population of the Westernized world. People are ODing daily on a vitamin they don’t need (aside from just a little) that causes insulin resistance and elevated blood sugar.

Take a look at the RDA as shown on the NIH site:

And now look at the tolerable upper limits, which are defined on the site as the “maximum daily intake unlikely to cause adverse health effects.”

As you can see, the amount in that one little packet used to mix in water to provide electrolytes ends up almost reaching the tolerable upper intake level of 35 mg for me. If I were to drink two of those, I would be well over the limit. Just one little packet along with some kind of snack food and three meals including some kind of meat would throw me way, way over the tolerable upper intake level.

Most of the snack food crap people get contains the RDA of niacin in each item. So breakfast cereal and toast in the morning, a snack or two or three throughout the day, a hamburger (the bun is made with enriched flour) and a meat patty, then dinner with a dinner roll (enriched flour again), meat, vegetables, and finally a piece of cake, say, (made with enriched flour), and you’re getting a shit load of niacin. Way, way more than the tolerable upper intake level. And if you throw in a vitamin pill to boot, your niacin will really be over the moon.

Serendipitously, just as I was typing the words above, I got a ding that I had a new email. I checked and discovered it was a JAMA Network Open email notifying me of papers that had just been published. Here is one that caught my eye for obvious reasons.

I took a break from writing and read it. The study included almost 400,000 subjects and looked at multivitamin intake and mortality. Here is the conclusion:

Conclusion and relevance: In this cohort study of US adults, MV [multivitamin] use was not associated with a mortality benefit. Still, many US adults report using MV to maintain or improve health.

You may be surprised to learn that this is not the first study to show this. There have been many before this one. Vitamins are suffused with the health halo effect, so people figure that if some are good more are better.

I had a friend who was a nutritionist and took plenty of vitamins. Once after a talk he gave, someone in the audience told him all those vitamins ended up doing nothing but giving him very expensive urine. He replied that he wanted expensive urine and expensive everything else, so that’s why he took them. Sadly, he ended up dying in his 40s of colon cancer. I have no clue as to whether his enormous vitamin/supplement intake had anything to do with his early death, but it is ironic.

The long and short of it is that vitamins have a real Goldilocks effect. You certainly don’t want too little, but you also don’t want too much. Problem is, most people think the more the merrier, but that isn’t the case. A little aspirin is good. A lot can kill you, just like it did many, many people in the 1918 flu pandemic. Maybe it’s the same with niacin.

And I’d be remiss not to note that this stance on vitamin supplementation is a real philosophical departure from what we (MD and I) learned and thought twenty or thirty years ago.

Back to ChatGPT

Given that prelude, let’s look at what I found on ChatGPT. With grandson Ben at my side, I decided to see if I could get it to make a run through the medical literature and find studies demonstrating niacin’s effect, or lack thereof, on obesity. I made my query.

Now granted, this is not a long explicit query, but it asks the right question.

“Has excess niacin been shown to promote obesity?”

ChatGPT cranks out an answer in just a few seconds. I was stunned to see how comprehensive it was.

Excess niacin intake has been implicated in promoting obesity and metabolic disorders in several studies. Here’s a summary of the evidence:

Mechanisms

Increased Adiposity: Excess niacin can lead to increased fat deposition. High doses of niacin stimulate the production of insulin, which promotes fat storage in adipose tissues .

Insulin Resistance: Long-term high niacin consumption can contribute to insulin resistance, a condition where cells become less responsive to insulin, often leading to obesity and type 2 diabetes .

Lipid Dysregulation: Niacin influences lipid metabolism by affecting the balance between fat breakdown and fat storage. While it is often used to manage cholesterol levels, excessive amounts may disrupt this balance, leading to increased body fat .

Inflammation: Niacin can cause flushing, a sign of inflammation, and chronic inflammation is associated with metabolic disturbances that contribute to obesity .

Research Findings

Animal Studies:

Rats: Studies have shown that high doses of niacin in rats lead to weight gain and increased fat mass .

Mice: Similar results have been observed in mice, where excessive niacin intake led to obesity and insulin resistance .

Human Studies:

Observational Studies: Some observational studies suggest a correlation between high niacin intake from diet or supplements and higher body mass index (BMI) .

Clinical Trials: Long-term high-dose niacin therapy in humans has been associated with weight gain in some cases, though the evidence is not universally conclusive .

Recommendations

Moderation: While niacin is essential for health, it's crucial to avoid excessive intake, especially through supplements, to mitigate the risk of obesity and related metabolic disorders .

Individual Variation: The effects of niacin can vary between individuals, and factors like genetics, existing health conditions, and overall diet play significant roles .

References

: Study showing the impact of high niacin on adiposity in animal models.

: Research linking niacin to metabolic changes and obesity.

: Reviews of clinical and observational studies on niacin's role in obesity.

In summary, while niacin is vital for many body functions, excessive intake can contribute to obesity and other metabolic issues. Moderation and careful management of niacin intake are recommended to avoid potential adverse effects. [Bold in the original]

I then asked for the specific references the above relied upon. I figured I would get the same ones I had already found plus some I hadn’t come across.

A few seconds later, ChatCPT spits out this:

Wow thinks I. I’ve died and gone to heaven. Why am I just now learning this? It’s going to be a phenomenal tool!

The red line under the last line is mine, but the rest is exactly how it came out of ChatGPT. I was surprised that there was no mention of any of the papers I had found on my own, which are all cross-quoted in the literature. But I was delighted to find all these other articles, the existence of which I was totally unaware. In fact, I was kind of bummed that I hadn’t been able to turn even a single one of these up in any of my own literature searches.

I immediately clicked on the link to the first one, and got this response.

I didn’t think much about it because journals occasionally change links to articles. I looked the article up on PubMed under the first author’s name and date. Nada. Then I went to the journal’s website and tried to look it up via the “49(5), 327-333,” which is the volume, issue, and page number.

I found that volume 49 was from 1995, not 2010 as the ChatGPT citation had listed it. I searched the journal by title and author and found no results. I then put the title in PubMed and discovered there was no such article listed. For completeness sake, I searched PubMed for all the publications of each of the authors listed in the citation. I found no articles even approximating the title or subject of the one in the citation.

I then went through the other citations in the ChatGPT printout and discovered they were all non-existent. They were made up.

I couldn’t believe it, but there it was.

Ben suggested we tell ChatGPT that the citations were bogus and have it retry.

We did exactly that, and got a response saying basically, sorry, we’ll try again.

We got another printout with another long list of citations, all of which don’t exist. They were all variations of the first go through with minimal changes.

Ben then queried them saying “The first citation is made up.”

We got this response: “I apologize for the mistake. Here are the corrected references with accurate URLs:”

What followed was yet another listing of mostly the same citations for non-existent articles. Three times was enough.

I realized ChatGPT would not be my go-to source for citations on any subject. It took me vastly more time to determine these citations were bogus than it would to have run a dozen literature searches on PubMed using different search terms.

I suddenly felt the pain of Trump’s former lawyer Michael Cohen when he got caught doing the same thing with legal citations. Apparently, he was trying to help out his own lawyer in one of the many lawsuits he (Cohen) was involved in by using ChatGPT to come up with citations for a legal point he was trying to make. His lawyer assumed Cohen had done the legwork and found legitimate citations to support their case, so he submitted them to the court and the opposing attorneys. Of course, the opposing attorneys looked them up, discovered the same thing I did with the medical citations—that they were imaginary—and reported it to the court. The judge was not happy.

Cohen used Google Bard, a different AI machine than ChatGPT. I suspect they are all the same and wouldn’t use any of them.

What I find interesting about the whole experience is that the summary ChatGPT came up with was right on the mark. The search engine (or whatever the technical term is for whatever AI uses to come up with answers) must have come across articles from which it extracted the info to create the summary. Why didn’t it simply cite those articles correctly instead of creating fake ones out of thin air?

Maybe if I knew more about how AI works, I would know this answer. But based on my almost non-existent knowledge of how AI works, I’m mystified.

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How About a Little Pareidolia?

I came across a fascinating article in The Guardian a few days I about the genetics of memory. I love reading The Guardian about anything but political issues. It is a far left newspaper, so nothing they write about politics is even handed, but usually their non-political articles are terrific. The one we’ll be discussing is one of those.

Most of us don’t believe the experiences of our parents or grandparents can be passed along in our genetic inheritance, but some psychological studies may show they can.

I’ve always believed this. Not so much that the lived experiences of my parents or grandparents would somehow be coded in my genes, but I have always believed the lived experiences of our ancient ancestors bleed through.

Pareidolia is the phenomenon by which we visualize concrete objects in abstract patterns. Seeing faces or horses or whatever in clouds, for example. We see something that looks semi-sort-of-kind-of-familiar in a cloud or other abstract form, and our brains fill in the off parts and make whatever it is look like what our brains want it to look like. Then once we see it, we can’t unsee it.

Once I was on a driving trip, and I saw a big bush ahead of me on the highway. At first I thought it was a bear. It looked just like a bear until I got close enough to realize it was actually a bush. I had had this experience multiple times, seeing some inanimate object up ahead and identifying it in my mind as some sort of animal. Then getting closer and realizing it wasn’t.

It finally occurred to me that my brain was probably hard-wired to do that. I realized I had never seen a deer or cow or other animal on the road ahead and thought it was a bush. Then gotten closer and realized it was an animal. It was always the other way around.

If I’m out walking—even playing golf—and I see a crooked branch on the path ahead of me, my brain says snake. I’ve never seen a snake—and I’ve seen plenty—and thought, oh, that’s just a crooked branch.

The progression is always See an object > think it’s an animal > realize it’s a bush or something else. It never goes the other way. At least for me. And I assume that’s the case for most of us.

Our Paleolithic ancestors doubtless saw a helluva lot more bushes than they did animals off in the distance, yet their livelihood depended upon hunting. They would miss out if couldn’t identify prey in the distance, or even worse if they couldn’t identify predators.

Since I’ve never mistaken a bear for a bush, I’ve always figured that was hard-wired in my genes.

Now comes The Guardian article describing a fascinating study showing there is some validity to that. And it doesn’t have to be implanted by many thousands of generations.

Here’s the deal.

The study made use of mice’s love of cherries. Typically, when a waft of sweet cherry scent reaches a mouse’s nose, a signal is sent to the nucleus accumbens, causing this pleasure zone to light up and motivate the mouse to scurry around in search of the treat. The scientists exposed a group of mice first to a cherry-like smell and then immediately to a mild electric shock. The mice quickly learned to freeze in anticipation every time they smelled cherries. They had pups, and their pups were left to lead happy lives without electric shocks, though with no access to cherries. The pups grew up and had offspring of their own.

The researchers then took a look at the grandpups of these mice that had been negatively sensitized to the smell of cherries by zapping them with electricity. They discovered that if they presented the odor of cherries, these mice two generations down the family tree became apprehensive and fearful.

But how could this happen?

The team discovered that the DNA in the grandfather mouse’s sperm had changed shape. This in turn changed the way the neuronal circuit was laid down in his pups and their pups, rerouting some nerve cells from the nose away from the pleasure and reward circuits and connecting them to the amygdala, which is involved in fear. The gene for this olfactory receptor had been demethylated (chemically tagged), so that the circuits for detecting it were enhanced. Through a combination of these changes, the traumatic memories cascaded across generations to ensure the pups would acquire the hard-won wisdom that cherries might smell delicious, but were bad news.

But the researchers didn’t quit there.

[They] wanted to rule out the possibility that learning by imitation might have played a part. So they took some of the mice’s descendants and fostered them out. They also took the sperm from the original traumatised mice, used IVF to conceive more pups and raised them away from their biological parents. The fostered pups and those that had been conceived via IVF still had increased sensitivity and different neural circuitry for the perception of that particular scent. Just to clinch things, pups of mice that had not experienced the traumatic linking of cherries with shocks did not show these changes even if they were fostered by parents who had.

So it was indeed in the genes or in the epigenetics. So the researchers wanted to see if it could be reversed.

The most exciting thing of all occurred when the researchers set out to investigate whether this effect could be reversed so that the mice could heal and other descendants be spared this biological trauma. They took the grandparents and re-exposed them to the smell, this time without any accompanying shocks. After a certain amount of repetition of the pain-free experience, the mice stopped being afraid of the smell. Anatomically, their neural circuits reverted to their original format. Crucially, the traumatic memory was no longer passed on in the behaviour and brain structure of new generations.

The article goes on to discuss studies done on Holocaust survivors and their offspring, which indeed found genetic changes in cortisol. The entire article is well worth reading. My only caveat is that psychological studies are the kind that frequently cannot be repeated with the same outcome. So I’m always a bit suspicious of them.

My suspicions of this one have been tempered by my own musings over the years on the bears-to-bushes phenomenon I’ve experienced so many times myself.

Oh, and just in case you think I’m brilliant because I knew the word pareidolia and you didn’t, I’m not. I just read it in another terrific article about speculation as to why Paleolithic cave painters painted what they did.

In this case, the researchers believed these ancient folks saw bumps and grooves and variations in the cave walls made prominent by the flickering flames of the fires or torches required to see. They used the word pareidolia to describe how these people would see animals or whatever in the irregularities of the cave walls and were inspired to paint them.

I think it’s BS, but I did learn a new word.

I suspect that our ancient ancestors with their large brains (same size as ours) appreciated beauty as much as we do. And some were clearly artistically inclined, so they made representations of what they lived with in the same way we take photos.

But what do I know? I didn’t even know pareidolia was a word.

The Big Debate

Okay, I haven’t written about politics in weeks, so you’ll have to indulge me on this one. I’ll try to keep in non-partisan.

Tonight there is a debate between Donald Trump and Joe Biden, which is a first. It’s not the first presidential debate—those have been going on since 1960. But it is the first to happen before the nominating conventions of both parties. And I’ve been obsessed with it.

After a lot of pondering and a little inside info, I think I’ve sussed out what’s going on.

At first Biden refused to debate. Probably for obvious reasons.

Then, suddenly, he proposes this debate before the convention. Not only does he propose the debate, he sets the rules. It’s to be broadcast by CNN and moderated by Jake Tapper, a never-Trumper if there ever was one. The mics of the non-speaking party are to be muted, so there can be no interruptions or arguments.

And Trump accepts with the rules as they are. Which did not surprise me.

What did surprise me is that Biden suggested it.

Here’s what I think is going on.

I have a friend in the know, and Biden has been hidden away at Camp David this past week prepping for the big event. It is no secret that CNN is an arm of the Democratic Party. That’s not a partisan thing to say—it’s the truth. Just watch it if you don’t believe it. Saying CNN is non-partisan is like saying FOX News in non-partisan. Jake Tapper hates Trump. He made that clear when he reported the news that Biden won the last election by saying “Our long national nightmare is over.”

I’m absolutely certain that Biden has been provided with all the questions he is going to be asked. And he has been memorizing all the answers his handlers have provided for him. It is their hope he will be able to spout them off when asked without Trump having a chance to interject and throw him off.

I’m assuming Trump has received no questions, so he’s going in blind. I’m sure he will be hit with all the topics his opponents know will push his buttons. He will be asked if he really still thinks the 202O election was stolen. He’ll be asked if he thinks Jan 6 was his fault, and if it was an insurrection. He’ll be asked if he’s going to pardon all those Jan 6 people languishing in prison. He’ll be asked if he plans on going after the FBI and the CIA in a retaliatory fashion. He’ll be asked about the fact that he’s been convicted of a felony.

All this will be done to stir him up and goad him into acting like Trump. What Team Biden wants most of all is to keep Trump away from anything having to do with Biden’s record, which is not the best. If they can keep Trump acting like Trump at one of his rallies, they will succeed.

In my view, the reason they’ve set this debate when they did is to see how Biden comes off. If despite all his prepping with the known questions, he wanders off script or loses his train of thought or mumbles out something incomprehensible as he’s given to doing, they’ll be able to replace him at the convention.

This is the only reason I can think of that this debate is set up the way it is. We’ll see soon enough if I’m on the mark. I’ll just be glad when it’s over, so I can quit trying to parse everyone’s rationale.

Odds and Ends

Newsletter Recommendations

I haven’t had time this week to try to uncover any newsletters. But there is always my beloved bride’s OutlanderMD, which you should read if a) you’re an Outlander fan, or b) if you want to learn about 18th century medical practices as contrasted with today’s.

Video of the Week

As promised, the VOTW this week is an hilarious scene from one of the Eades family’s favorite movies: Monty Python’s The Life of Brian.

If you haven’t seen the movie, here is the setup. Brian is born on the same day as the baby Jesus, and he keeps being confused with the Messiah. He’s part of an anti-Roman activist group that goes out at night and paints anti-Roman graffiti on all the buildings. He gets captured and brought before the local Roman leader Pontius Pilate, who in this movie version has an R to W speech impediment, which leads to many hysterical interactions. As this clip starts, he’s just been dragged into the presence of Pilate, played to perfection by Michael Palin, who can barely keep from laughing himself.

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That’s about it for this week. Keep in good cheer, and I’ll be back next Thursday.

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This newsletter is for informational and educational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and should never be relied upon for specific medical advice.

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