|Contents||Chapter 2. Morals >|
Chapter 1. Body
“I am just going outside and may be some time.” It was March 1912 and with these words Lawrence Oates hobbled out of the tent to die. All four explorers knew that Oates was the slowest in their party. A few days earlier, he had tried to talk them into leaving him behind on the Antarctic ice sheet, but they refused. Now he lost himself in the blizzard. No one would ever find him, covered by his shroud of snow. The others would have to press on to the next supply dump without him. Perhaps they would make it. He never would.
Why was Oates the slowest in the party? They were all suffering from frostbite, exposure and malnutrition, but Oates was the worst. Why? We will never know for sure, but the smart money would be on his old war-wound re-opening due to scurvy. Ten years before, during the Boer War, Oates had been seriously wounded in the thigh — so seriously that when he recovered, one of his legs was an inch shorter than the other. One of the classic symptoms of scurvy is that it causes old wounds to first become painful and then to re-open. note 1
Scurvy was always a menace to polar expeditions. In 1875 the Nares expedition had to be abandoned due to scurvy. Robert Scott, the leader of this South Pole expedition, had seen first-hand the dreadful deaths of scurvy victims: joints black, arms and legs swollen like balloons. In the end, said Scott, “death is a merciful release.” So he took expert medical advice. He had hoped that with careful precautions, this time they would be free from the disease. But to no avail. Just like all his previous expeditions, scurvy struck anyway.
Looking back on the story, the puzzle to us now is why Scott did not know the cure for scurvy. These days, even school children could tell you about James Lind and how he discovered around 1750 that lime juice was the cure. They could tell you that sailors in the Royal Navy were issued a daily lime juice ration and were called ‘limeys’ because of this. How could Scott in 1912 not know the cure?
Robert Scott was no fool. He knew about lime juice and lemon juice. He knew the story of James Lind just as well as the school children. Yes, in 1799 a lemon juice ration had been made regulation issue on Royal Navy ships. But by 1912, it didn’t seem to work. note 2
In 1875 the Nares expedition set out to reach the North Pole by way of Greenland. Half of the sledging party fell ill with scurvy. Even sailors who stayed on board ship fell ill with scurvy. The regulation lemon juice was no help in preventing or curing it. The expedition had to be abandoned. Parliament and the Admiralty each held a separate enquiry into this embarrassing fiasco. The only clear lesson to be drawn was that lemon juice did not reliably prevent scurvy.
If it didn’t work now, had it ever worked? By the start of the twentieth century, there was no reliable cure for scurvy. It continued to plague polar expeditions, but it also struck elsewhere. Sometimes it even killed middle-class babies at home in England. So what was the cause? And what was the cure?
In the last decades of the nineteenth century the greatest advance in medicine was the germ theory of disease. It turned out that most diseases were caused by tiny microbes invisible to the naked eye. In 1912 the accepted explanation for scurvy, championed by the formidable professor of pathology Sir Almroth Wright, was that it too was caused by microbes. Scurvy was an “acid intoxication” caused by “ptomaine poisoning” due to eating badly preserved meat or fish. As Scott explained in 1905:
I understand now that Scurvy is believed to be ptomaine poisoning caused by the virus of the bacterium of decay in the meat. And in plain language, as long as man continues to assimilate the poison, he is bound to become worse.
And the cure? Fresh vegetables might help because they were alkaline. Fresh meat might also help, because it was free of “ptomaines.” Damp, cold, and over-exertion would contribute to the disease. This was the best medical advice of the day, the advice that Robert Scott took when planning his expeditions.
Sledging across the polar ice-sheet, fresh vegetables were in short supply, and in any case wouldn’t cure the disease, only hold it at bay. The only cure would be to stop eating the poison. The best way to avoid that in polar regions would be to eat fresh meat — seals in the Antarctic — or to be utterly scrupulous about the quality of the tinned meat. Which Scott was.
Scott did his best to follow expert medical advice but unfortunately for him and his men, it was wrong. Despite Lawrence Oates’ noble sacrifice, Robert Scott, Edward Wilson and Henry Bowers died around the end of March 1912, trapped by a blizzard only 12 miles from the next food dump, but too weak to continue. They had made some progress after Oates left them, but not enough. They died from many things, including bad luck and bad judgement, but without scurvy they would probably have made it.
The truth was just around the corner. Even while the Antarctic snow fell on the bodies of the explorers, back in London, Casimir Funk had a new explanation for scurvy. Funk, working at the Lister Institute, said that scurvy was actually a deficiency disease, caused by a lack of chemicals that he called vitamines. Other diseases like beriberi and rickets, he said, had similar causes. Funk’s explanation turned out to be correct.
In retrospect, the crucial breakthrough had actually come in 1907 with the discovery in Oslo by Axel Holst and Theodor Frölich of an animal other than humans and monkeys which also suffers from scurvy: the guinea-pig. Amazingly, no other animals in the world suffer from the disease, only humans, monkeys and guinea-pigs. Clearly, guinea-pigs are far more convenient lab animals than the alternatives. Holst and Frölich had accidentally found how to induce scurvy by feeding the guinea-pigs a particular restricted diet. Soon they demonstrated that raw cabbage, apples or lemon juice would cure the scurvy. But progress in science is often slow and uncertain. With the weight of Sir Almroth Wright and most of the medical establishment behind it, the “acid intoxication” and “ptomaine” theory still held sway when Scott left for the Antarctic.
It wasn’t until 1918 that Harriette Chick and Ruth Skelton at the Lister Institute solved the puzzle of the disastrous 1875 Nares expedition. They showed that guinea-pigs with scurvy could be cured with fresh lemon juice, but fresh lime juice had a much weaker effect and preserved lime juice was totally ineffective. They also tested Royal Navy ‘lime juice’ and found it to be almost useless. The problem was the preservation process: boiling to concentrate the juice destroyed the active ingredient and the copper vessels used commercially made the destruction even more complete.
A few months later, in 1919, Alice Smith, also at the Lister Institute, finished an exhaustive search though the Admiralty archives. She discovered how the Royal Navy had found and then lost the cure for scurvy. It’s a curious and instructive tale whose finer details have been fleshed out further by other historians. As the school children said, the story does start with James Lind around 1750. Sort of.
James Lind was apprenticed to a surgeon at age fifteen and later joined the Navy as a surgeon’s mate. In those days before anaesthetics, surgery was a brutal affair. A ship’s carpenter maintained the wooden fabric of the ship and a ship’s surgeon maintained the sailors who provided the muscle power. In the smoke of battle, with splinters flying, the tools they used were remarkably similar. On the more usual quiet days, the ship’s surgeon attempted to treat various chronic ailments. The most frequent and serious was scurvy. note 3
Despite the confusion amongst learned men of medicine, ship’s surgeons had known about scurvy for centuries and passed down the knowledge of how to treat it to their surgeon’s mates. The secret was fresh vegetables, but citrus fruit was especially effective.
In 1747, while Lind was surgeon on HMS Salisbury, he tried a number of popular remedies for scurvy including fresh oranges and lemons. The oranges and lemons cured the seamen in a few days and they became fit for duty. Nothing else worked. The experiment was not very thorough by modern standards and it’s not clear that it really happened in the way that he described, but the conclusion was clear. The next year Lind left the Navy to study medicine at the University of Edinburgh. He took his MD by thesis, but curiously what he wrote about was not scurvy, but venereal diseases. He published his famous Treatise on Scurvy a few years later.
By 1758 Lind had rejoined the Navy and was chief physician at the Royal Naval Hospital Haslar. In his first two years there, the hospital had about about 6000 admissions and of these about 1 in 5 was for scurvy. Presumably he cured these with fresh oranges and lemons. However, this is not the remedy that he recommended in his Treatise on Scurvy. After describing his experiment, he instead recommended preserved lemon juice, made by almost boiling it to concentrate it. This would have been more convenient to take to sea because it would not spoil. The disadvantage, of course, was that lemon cordial made like this would never have worked in practice because the heat would have destroyed the vitamin C, especially if it was heated in copper vessels.
Now, the fact that a particular remedy for scurvy did not work in practice had not previously stopped the Admiralty. Against the advice of ships surgeons, they chose “elixir of vitriol” for the Anson circumnavigation of 1740. Anson set out with 8 ships and 1854 men. When he returned four years later he had only one ship and 188 men. Over half of the dead were killed by scurvy. But in Lind’s case it was probably his almost painful shyness that stopped his remedy being adopted. This, coupled with his humble origins, was no match for the bold, upper-class higher echelons of the Admiralty. To find the true origins for the cure to scurvy in the Royal Navy we need to look elsewhere: to the almost unknown Thomas Trotter and Gilbert Blane.
Thomas Trotter was a poor boy made good: the son of a baker, he became a surgeon’s mate in his late teens. By 1783, aged 23, he was certified competent by the Liverpool Infirmary so that he could get a job as surgeon on a slave ship. (A career choice which clearly makes him unsuitable as a modern-day hero.) To encourage a greater interest in the health of the human cargo, the poorly paid ship’s surgeon on a slave ship was usually given two slaves on the coast of Africa. If they survived he could cash them in as a bonus when they got to America.
Perhaps Trotter had been told how to cure scurvy by other ship’s surgeons, or perhaps he had heard of Lind’s ideas. Perhaps he had even read about the Pacific voyages of James Cook who had recently been awarded the Copley Medal by the Royal Society for his remarkable achievement of completely preventing any deaths from scurvy amongst his crew. However he acquired his knowledge, Trotter put it to use and experimented on the slaves. He found that sour, unripe fruit worked better than ripe fruit and he perfected a way of preserving lemon juice by straining it and bottling the juice with a covering layer of olive oil. This was still effective against scurvy over a year later off the coast of Africa.
Trotter used his profits to go on and study medicine at Edinburgh where he wrote his own monograph on scurvy. A few years after getting his his MD he joined the Royal Navy. He became second in command of the Haslar naval hospital and physician of the Channel Fleet. Trying to repeat his local success against scurvy more widely, he campaigned for the general use of of lemon juice on board ships, but little changed until Gilbert Blane arrived on the scene.
Gilbert Blane was altogether more refined, a gentleman’s physician with excellent connections in society. Later in life he became personal physician to the Prince Regent and was given a knighthood. Blane was notoriously icey in his bedside manner, earning himself the nickname “Chilblaine.” (To a modern eye, Blane looks a lot like someone with mild autism.)
Ten years older than Trotter, in 1780 Blane was in the West Indies as personal physician to Lord Rodney, admiral in command of the West Indies fleet. Blane persuaded the admiral to order the West Indies fleet to start keeping systematic records of cases of scurvy. He found that 1 in 7 sailors died of scurvy, versus less than 1 in 200 through enemy action. He then started campaigning, on purely economic grounds, for better food for sailors, particularly citrus fruit. He also experimented with preserving lemon juice by adding a small quantity of alcohol. By 1782, the death rate in the West Indies fleet was reduced to 1 in 20.
These ad-hoc arrangements, depending on the judgement of particular admirals, persisted until 1795. By then Blane was back in London with a thriving private practice amongst high society. One of his patients was the First Lord of the Admiralty who appointed Blane to the Navy’s Sick and Hurt Commission. And so it was in 1795, when the Navy Victualling Board turned down yet another of Thomas Trotter’s memoranda on the advantages of lemon juice, that Trotter finally found a sympathetic ear on Blane’s Commission. In August 1795 the Admiralty approved the issue of lemon juice to the fleet at Portsmouth and by 1799 to all Royal Navy ships everywhere in the world. They had found the cure.
Scurvy more or less disappeared from the fleet. At the end of the Napoleonic wars, the death rate had fallen from 1 in 7 to 1 in 150 — a nuisance rather than a scourge. As a consequence, the Royal Navy could afford to wait off the coast of Europe literally for years, blockading the ships of Napoleon’s empire, like a vast pirate fleet waiting patiently on the horizon. Over the course of the Napoleonic wars, lemon juice probably doubled the effective strength of the Royal Navy. Historians have speculated that if this improvement had come just a few decades earlier, perhaps Britain would not have lost her North American colonies.
But then what happened? When the war was over, the world settled down to a relatively peaceful existence with the Royal Navy the undisputed master of the world’s oceans. Sailors continued to be issued lemon juice, but at some point something changed without anyone noticing.
Writing in 1919, Alice Smith at the Lister Institute uncovered the tragic twist in the story from the Admiralty archives. She found that in 1845 the Governor of Bermuda made a proposal to use the juice of limes from British colonies in the West Indies instead of buying lemons from Europe. It would be more patriotic. So, with the scent of Admiralty money in their nostrils, entrepreneurs set up huge lime plantations in the West Indies. By 1860 the deal was done and the Navy was supplied solely with West Indies limes, which they assumed were equivalent to lemons. After 1869 this lime juice was bottled in Liverpool.
But as Chick and Skelton had discovered in 1918, even without further damaging preservation, West Indies limes after their voyage to England had only a quarter the effect of fresh lemons. Without realising what they had done the Admiralty had lost the cure for scurvy and set the stage for disaster on polar expeditions.
By now you are probably saying to yourself: this is quite interesting, but what has it got to do with tyrants or hackers? Well, hackers are experts at finding and applying the hidden rules, experts at how things really work. If you want to do that yourself, there are some vital lessons in this story.
Firstly, there’s the lesson that an authority like Almroth Wright is always happy to give you advice, with an air of confidence that makes it hard to resist. But they are not always correct. Robert Scott listened to the best advice medical authorities could give, and it turned out to be completely wrong. The authorities were full of opinions, but didn’t really justify them. They expected to be believed, and they were believed, because of their authority, not because they had evidence to prove their case. Clearly, we need to be able to sort out truth from nonsense for ourselves and come to our own conclusions. How can we do this? In the next few chapters I will show you how to evaluate evidence for yourself and how to see when the conclusions are not justified by the facts.
Secondly, there’s the lesson that the history you were taught in school is not always the history that actually happened. Sometimes the difference between the accepted story and what actually happened is breathtaking. The true story of the cure for scurvy is just one example.
Thirdly, if you are going to be an effective hacker you need to be as healthy as possible. Your body is where your mind lives so you need to look after it. You’ll also want to look after your family and help your friends. But over the last few decades the advice that we have been given by authorities on nutrition has been even worse than Almroth Wright’s ideas on scurvy. There are curious echoes from the past of opportunities wasted, of cures found and lost. I want to explore this topic in the remainder of this chapter and give you my best idea of what you can do for yourself. Of course you’ll still have to make your own mind up, but by the time you’ve finished the first few chapters of this book you should be well equipped to do that.
So, where to start? Nowadays, we know all about the vitamins, don’t we? In 1928 Albert Szent-Gyögyi isolated pure crystalline vitamin-C, which he named ascorbic acid. Only when it was proved to cure scurvy in guinea-pigs, was Almroth Wright finally convinced that his “acid-intoxication” theory was wrong. Szent-Gyögyi won the Nobel prize for medicine in 1937. The minimum intake of vitamin-C needed to prevent scurvy is rather small, but how much more is the best amount to take? What is the right amount to be healthy? In 1970, Szent-Gyögyi wrote:
As to ascorbic acid, right from the beginning, I felt that the medical profession misled the public. If you don’t take ascorbic acid with your food you get scurvy, so the medical profession said that if you don’t get scurvy you are all right. I think this is a very grave error. Scurvy is not the first sign of the deficiency but a premortal syndrome, and for full health you need much more, very much more. I am taking, myself, about 1g a day. This does not mean that this is really the optimum dose because we do not know what full health really means and how much ascorbic acid you need for it. What I can tell you is that one can take any amount of ascorbic acid without the least danger. note 4
Today, in 2011, the U.S. recommended daily allowance for vitamin C remains close to the scurvy-prevention level of 90mg per day. We still don’t know how much people need to be in the best of health, as opposed to merely being not sick. The situation is made more confusing by the clear fact that different people need different daily amounts of vitamin C to achieve a particular level of health. Even taking Gilbert Blane’s statistics from the eighteenth century, the fact that 1 in 7 sailors died of scurvy meant that 6 in 7 didn’t. The ones who died were presumably the ones with the greatest need for vitamin C, and clearly this need varies widely. note 5
The medical establishment appears to have resolved this difficulty by turning its back on the problem. The Almroth Wrights of our own age seem to have a keen interest in treatments for diseases which involve new drugs, but have cultivated an active disinterest in nutrition. Research programmes on drugs are large and well-funded. Even when drug trials show only slight benefits, they are used to support vast prescriptions by doctors. In contrast, research programmes on nutritional supplements are mostly small and underfunded. Even when these trials show large, clear benefits, the results are questioned: more research is always necessary before any changes can be recommended.
For example, let’s look at the study conducted in 2002 by Bernard Gesch, a physiologist at Oxford University and Director of Natural Justice, a charity which sponsors research into the effect of nutrition on violent and anti-social behaviour. Gesch’s team conducted a randomised, placebo-controlled double-blind trial, the “gold-standard” of clinical trials, on 231 of the inmates at Aylesbury Young Offenders Institution. Half of the prisoners took a daily dose of 28 vitamins, minerals and fatty acids; the other half took a placebo. The levels of the vitamins and minerals were only the small “recommended daily allowance” so it’s unlikely that anyone could tell who was getting the placebos. The staff giving out the pills certainly didn’t know. After 9 months, the result was a surprising 37% reduction in serious or violent offences compared to the “control” prisoners taking the placebo. And these offences were not for trivial rule-breaking, but “governor reports,” serious enough to lose a prisoner the chance of parole. note 6
Gesch’s explanation is that some of the prisoners were suffering from “subclinical malnutrition,” and though they didn’t show signs of any deficiency disease, the food supplements presumably helped to correct this. The idea that prisoners have a right to adequate nutrition is not contentious. We have nothing but revulsion for the Japanese who in world war two gave polished rice to their prisoners in the full knowledge that it would cause the deficiency disease beriberi. Surely, a decision to withhold adequate nutrition from modern-day prisoners is different only in degree, not in essence?
But what do we find? Prevarication, repeated calls for more investigation and pooh-poohing the methodology of the trial (which was in fact impeccable). The supplements were criticised because they only solve part of the problem: most of the previous violence still happens. But so what? Some people were helped, presumably those with the greatest need for the supplement, the ones who were most malnourished. People vary. The supplements were criticised because they change how people think. As though helping people think better by preventing malnutrition is equivalent to mind control. It isn’t. The supplements were criticised because we don’t know exactly how they work. The critics say they will support the supplements when they know exactly what it is in the supplements that could make a difference.
Modern scientists like Bernard Gesch must feel a lot like Thomas Trotter, writing fruitless memoranda to the admiralty year after year, trying to get them to adopt lemon juice. Without the cool clarity of Gilbert Blane in a position to say yes, that might never happen. Don’t mistake institutional inertia for prudence.
This still leaves us with the question of whether it is worthwhile for you to take vitamins or other food supplements, and if so how much? Personally, I think that taking about 1g of vitamin C a day seems prudent, also around 1000mg of omega-3 fatty acids and 1000 I.U. (25μg) of vitamin D3. (Vitamin D has different variants and D3 is most effective.) It’s probably not necessary to take other vitamins or minerals if you are eating a varied diet. If you do think you need them, be careful that you don’t take too large a dose of vitamin A by accident. Almost every multi-vitamin pill seems to contain the RDA of vitamin A, which is ironic since vitamin A is practically the only vitamin which it’s easy to get an overdose of. Read the labels carefully and do your own research.
Vitamin D seems to reduce cancer and has other health benefits — for example it can reduce both viral infections and depression. Even though your body manufactures vitamin D, you almost certainly don’t have enough of it. If you have white skin and stand out in the summer sunshine, 15 minutes of full-body exposure a day will generate enough vitamin D to keep you healthy. (You’ll need to stay out longer if you have darker pigmented skin.) But who does that? In northern countries in winter the sunlight is too weak, and even in summer, we are told to keep out of direct sunshine and to put on sun-screen, to protect us from skin cancer. note 7
This is especially unfortunate since skin cancer forms a small fraction of cancers. It is relatively easy to spot and fairly straightforward to treat. It’s probably too early to say for sure, but when the verdict is finally in, we may find that the advice on sun-screen has accidentally killed several people for every prevented case of skin cancer. The story of vitamin D has echoes of the “ptomaine” poisoning theory of scurvy. Are elevated levels of cancer in northern countries due to poisonous pollutants contaminating the environment? Perhaps, but Reinhold Vieth at the University of Toronto thinks we may be “looking for a bogeyman that doesn’t exist” and that “it’s more likely a lack of vitamin D.” So don’t get sun-burnt, but do enjoy the sunshine. It’s good for you. note 8
Omega-3 is helpful because it counteracts an imbalance in the fatty acids in our modern diet. In the past we had roughly equal proportions of omega-6 and omega-3 fatty acids. The Japanese, with a high-fish diet, still have roughly equal levels of omega-6 and omega-3. Nowadays in the West we have vastly more omega-6 in our diet, mostly from long shelf-life processed foods. The Western ratio between omega-6 and omega-3 is more than 10 to 1. This imbalance makes a difference because it changes the chemical properties of the cells in our brains. It changes the way we think. note 9
For example, researcher Joseph Hibbeln found that people with low levels of omega-3 in their spinal fluid also had low levels of serotonin. Since low serotonin is found in people with depression, some kinds of depression may be caused or made worse by low omega-3. Studies using omega-3 supplements to treat depression have had some success. It certainly won’t do you any harm to try restore your omega-3 levels to the balance we used to have, by taking a supplement and trying to eat more foods like fish and olive oil that are naturally high in omega-3.
(But if you are on an SSRI medicine for depression, don’t stop taking it! SSRIs take several weeks to achieve their effects, and have severe withdrawal symptoms. You need to proceed carefully. But it would be better if you didn’t need to resort to such drastic drugs in the first place. Many of them are not much better than placebos, except for the side effects, which are real enough. Not all depressions are the same, and many instances of depression may actually be a normal and productive response to severe difficulties, not a disease. We’ll return to this alternative explanation for depression in a later chapter.)
After micro-nutrients like vitamins, let’s now turn our attention to macro-nutrients — in other words, to food. Clearly you need to have enough food, so that your body has the energy it needs, and you need to have clean water to drink. If you don’t have these, then what I have to say in this chapter must seem conceited and irrelevant. In that case, I can only hope that some of my advice in later chapters might still be useful to you in the long run.
For most people in the rich part of the world, the main problem is not quantity of food but quality. It’s important to eat a variety of food, and to try to avoid processed food, which is not designed to be good for you, but rather to be profitable and have a long shelf-life. Above all, avoid “low-fat” foods, sugar and pure “white” carbohydrates. In the 1960s and ’70s the rate of obesity in the USA was about 1 in 8. From the 1980s to the present day it has risen steadily, to the current figure of over 1 in 4. (The worst states in the USA have figures around 1 in 3. No single state is as good as the 1970s national average.) Something changed around 1980. What was it? The clearest culprit is the “low-fat” diet promoted by the US Congress and then the National Institutes of Health. note 10
In 1950 Ancel Keys at the University of Minnesota proposed a theory that eating fat raises cholesterol and causes heart disease. The evidence was equivocal, so the US government spent several hundred million dollars over the following decades on five studies that tried to prove a link between eating fat, poor health in general and heart disease in particular. They failed — no clear link was found. Not to be discouraged, they spent more money on a sixth study which tried to show that a drug to lower cholesterol would reduce heart disease. This study succeeded. But we can see that’s not the same thing, is it? If a drug reduces heart disease and lowers cholesterol, that doesn’t mean it reduces heart disease because it lowers cholesterol. Think, for example about aspirin. We know that aspirin reduces heart disease and we know that aspirin reduces headaches. But no-one is silly enough to claim that aspirin reduces heart disease because it reduces headaches.
Brushing over this problem with their evidence, these scientists declared that they had proved what they were trying to prove all along: that eating fat is bad for your health and causes heart disease. This became the new health dogma, replacing the previous consensus that it was eating potatoes, pasta, white bread, sugar — pure carbohydrates — that made you fat. Companies swept in with new low-fat product ranges, and health-conscious consumers bought them eagerly. Unfortunately, we have to get our energy, our calories, from somewhere and fat is high in calories. If you take the fat out of food, you need to replace it with something else, so in practice, a low-fat diet is high in carbohydrates. An earlier generation would have expected this to make many people obese, and it has. This outcome has a tragic irony, since the only point of the low-fat diet was to reduce heart disease, but obese people suffer more from heart disease and have a host of other medical problems too.
The pendulum of scientific opinion is slowly swinging back the other way, since we now know why high-carbohydrate food tends to make everyone fat and drives the bodies of some people to obesity. It works like this. The cells of our bodies are capable of burning two kinds of fuel: fat and glucose. In prehistoric times, and in modern hunter-gatherer societies, carbohydrates were quite rare, and most of the time people’s bodies ran on fat. The fat cells in your body are like little batteries storing and releasing this fuel, and they are very dynamic, continually emptying and filling in response to your body’s minute-by-minute need for energy. When you are exerting yourself, on balance they are emptying. Afterwards when you feel hungry and eat a meal, on balance they are refilling.
Several hormones influence this emptying and filling, but the dramatic “master switch” hormone over-riding all the others is insulin. When you eat fat, this has no effect at all on your insulin. When you eat protein, your level of insulin increases slightly. But when you eat carbohydrate, your level of insulin surges. The purer and whiter the carbohydrate, the bigger the surge. All carbohydrates eventually get broken down into glucose, but refined white carbohydrates are easier to digest, so the glucose arrives in the your bloodstream in a more concentrated rush. A high concentration of glucose is something of a problem for the body, and if not quickly used or stored away can cause all kinds of damage.
The surge of insulin signals to all your body’s cells that they need to drop what they are doing and deal with this problem. Insulin’s main effect is to cause cells to switch from burning fat to burning glucose. But insulin also stops fat cells continually emptying and filling. In the presence of insulin, they only fill, they don’t empty. In the presence of insulin the fat cells also take up some of the glucose and use it to help them store even more fat.
So carbohydrate drives insulin and insulin drives fat accumulation. If you eat lots of carbohydrate, you will have generally high levels of insulin, your fat cells will fill more than they empty and the quantity of fat they store will gradually increase. That’s what happens on a microscopic scale. On a larger, human scale you will get visibly fatter over a period of years . And yet, while your body has high levels of insulin, your fat cells will not release this stored fuel. Even though you are visibly fat, you cannot access that stored fuel. This explains the otherwise baffling phenomenon of poor people who are obese and undernourished. Because they are poor, they can only afford to eat carbohydrate. The carbohydrate drives up their levels of insulin, and the high levels of insulin make them fat.
To make things worse, about 1 in 3 people are prone to become “insulin resistant.” In other words, when they eat the same amount of carbohydrate, their body produces more and more insulin. This is necessary because of a gradual change in their cells: over time they need more and more insulin before they will switch from fat-burning to glucose-burning. This insulin makes their fat cells fill and not empty, just as before, but the higher level of insulin means that their fat cells are locked in this state almost all the time.
What triggers insulin resistance in the first place? For those people who are susceptible, maybe a high-carbohydrate diet is enough by itself, but there is some evidence that the culprit could be fructose. (Common sugar is half glucose, half fructose. Fructose from maize is an ingredient in soft drinks and many processed foods.) note 11
Eventually people with insulin resistance will suffer from adult-onset diabetes when their body cannot ramp up its insulin production any further. It should be no surprise that on the high-carbohydrate low-fat diet recommended by health authorities in the USA, the obesity rate is now approaching 1 in 3. That’s everyone who is prone to insulin resistance.
The saddest part of this statistic is that all these people are made to feel guilty about being obese — the conventional view is that they have only themselves to blame. If only they were less greedy or less lazy, say the authorities, then these people would be fine. But really, the obese are for the most part no more guilty of sloth and gluttony than thinner people. Really, they are mostly just victims of a hormone disorder caused by excessive carbohydrate consumption.
To be healthy, you should also take a moderate amount of exercise. Health is mixed-up in our modern ideas with fitness — a “health club” is in fact an exercise club. Don’t over-do it though, and don’t do much more than you are used to. It will help you to be healthier and feel happier, but it won’t have any predictable effect on your weight. If you exercise more you might lose weight or you might gain weight. (When you exercise more you feel hungrier and eat more, and the composition of your body changes.)
You also need to make sure that you get enough sleep. Depression and anxiety are the biggest causes of insomnia and lack of sleep may in turn cause cellular damage to the brain. Sleep continues to be a mystery to science, although some progress has been made in recent years. In particular no one really knows what sleep does, so no one really knows precisely what happens when we don’t get enough. We can measure some of the effects though: if you don’t get enough sleep, your immune system will be worse, you’ll have a faster pulse rate and higher blood pressure and you’ll be more prone to develop insulin resistance. So, you’re more likely to become obese if you don’t get enough sleep. note 12
All animals, no matter how primitive, need sleep. Marine animals usually can’t go fully to sleep — they need to keep moving — but one half of their brain sleeps, then the other. Something really fundamental is going on here. The most plausible idea seems to be that sleep is necessary for cellular repair. Curiously, smaller animals sleep longer than larger animals. For example, mice sleep for 14 hours a day, elephants for only 4 hours. Researchers Van Savage and Geoff West looked at this data more closely and came to an interesting conclusion. When you adjust for metabolic rate, time spent asleep scales with the size of the animal, but it doesn’t scale with the size of the animal’s body. It scales with the size of its brain. So presumably sleep’s primary function is to repair your brain cells.
If you want to be an effective hacker, you need your brain to work well, and despite the stereotype of the computer hacker staying awake all night fuelled by sugar and caffeine, this is a pretty stupid habit unless there’s an emergency. Being awake for more than 24 hours causes an impairment similar to being legally drunk, over the limit for driving. (Though it’s even worse for the first 30 minutes after waking up, even from a good night’s sleep: during that first 30 minutes, performance is worse than after 3 days without sleep! Don’t ask someone for a decision just after you wake them up, not unless you want the wrong answer.) When you miss a night’s sleep there’s a payback: as an adult if you miss one night completely, you need at least three good nights to catch up. If you have only five hours for an extended period, not only will you be impaired while you are awake, it will take you weeks and weeks of good sleep afterwards to recover.
How much sleep do you need? Eight hours sleep is enough for most adults. (That’s eight hours actually asleep. We don’t count going to bed and reading or watching TV.) Six hours isn’t enough. Children and teenagers need more — ten hours or perhaps more. You might say, I don’t need that; my children don’t get that. Well … you do need it! And if your children are irritable, hyperactive and overweight, then they need more sleep too.
Troublesome people tend to get diagnosed as “sick,” particularly in the USA. Children who are hyperactive and irritable are likely to be given a diagnosis of ADHD and put on drugs like Ritalin, which are essentially just “speed” — they help you to stay awake longer and cope with less sleep, but they mask the real problem. It’s like buying ear-defenders because your car is making a squeaking noise. It helps you cope, but it doesn’t solve the problem.
After those major factors, there are a couple of others which will help your body or mind to work better. Despite the fact that tobacco helps you concentrate, it should be fairly obvious that you should not smoke. It’ll give you cancer and heart disease, cost you a lot of money and make you smell. You should have only a little alcohol. Apart from other effects, like helping you to fall over and get into fights, alcohol interferes with your ability to learn new things. If you learn something today and sleep on it, then without any more practice you will be better at it tomorrow, provided you get a full night’s sleep (six hours isn’t quite enough). If you learn something today and drink alcohol tonight, you will go to sleep more easily but it’s not the same sleep. Your REM sleep will be suppressed, and you won’t be any better tomorrow at what you learned today.
I think I’ve covered the major things that you can change right now to improve your health. If you turn to the notes for this chapter at the end of the book, you will find a few other ideas and some pointers to further reading. However, I think we have now reached a point where the next most important thing to understand is how to make up your own mind about things, and that is the topic of the next few chapters. note 13
|Contents||Chapter 2. Morals >|
Version: DRAFT Beta 3. Copyright © Stuart Wray, 29 December 2011.