SGU Episode 898: Difference between revisions
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=== Multivitamins for Memory <small>(28:17)</small> === | === Multivitamins for Memory <small>(28:17)</small> === | ||
* [link_URL Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial]<ref>[url_from_news_item_show_notes Alzheimer's Association: Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial]</ref> | * [link_URL Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial]<ref>[url_from_news_item_show_notes Alzheimer's Association: Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial]</ref> | ||
[28:17.100 --> 28:23.640] On the live stream this last Friday, somebody asked us about the recent study on multivitamins | |||
[28:23.640 --> 28:27.880] and memory, which I hadn't done a deep dive on yet, and I said I would do it for the show | |||
[28:27.880 --> 28:28.880] this week. | |||
[28:28.880 --> 28:29.880] So here I am. | |||
[28:29.880 --> 28:35.120] So the study is effects of cocoa extract and a multivitamin on cognitive function, a randomized | |||
[28:35.120 --> 28:36.780] clinical trial. | |||
[28:36.780 --> 28:44.520] This essentially was studying both a multivitamin and cocoa extract individually and together | |||
[28:44.520 --> 28:45.680] versus placebo. | |||
[28:45.680 --> 28:51.600] So there were four, you know, four groups in this trial was randomized and placebo controlled | |||
[28:51.600 --> 28:52.780] and blinded. | |||
[28:52.780 --> 28:58.080] And then they followed older subjects over three years. | |||
[28:58.080 --> 29:02.540] It was a telephone evaluation, but you could do that because it was essentially just a | |||
[29:02.540 --> 29:04.560] verbal mental status exam. | |||
[29:04.560 --> 29:09.640] You know, they asked them to do verbal tasks, naming tasks, trail making, whatever. | |||
[29:09.640 --> 29:13.960] Then they were these were standardized cognitive evaluations that you could be that can be | |||
[29:13.960 --> 29:14.960] scored. | |||
[29:14.960 --> 29:17.920] And then you can attach a number to it. | |||
[29:17.920 --> 29:23.960] And the bottom line is that what they found is over those three years that taking a multivitamin | |||
[29:23.960 --> 29:31.280] every day was associated with a greater improvement in performance on these cognitive tests than | |||
[29:31.280 --> 29:34.780] was placebo or the cocoa extract. | |||
[29:34.780 --> 29:39.800] The cocoa extract had zero effect, so there was no apparent benefit to that. | |||
[29:39.800 --> 29:40.800] Now I say a greater. | |||
[29:40.800 --> 29:44.520] Yeah, I say a greater increase because everyone improved, right? | |||
[29:44.520 --> 29:47.040] I mean, every group improved. | |||
[29:47.040 --> 29:49.600] And that's a well-known phenomenon. | |||
[29:49.600 --> 29:53.480] Whenever you do a study like this, it's a practice effect, right? | |||
[29:53.480 --> 29:56.640] The second time you do the set of standardized tests, you're going to be done. | |||
[29:56.640 --> 29:57.640] You're going to do better. | |||
[29:57.640 --> 29:59.600] The third time, you're going to do better. | |||
[29:59.600 --> 30:01.040] And then it kind of plateaus. | |||
[30:01.040 --> 30:04.600] So you can do this one of two ways. | |||
[30:04.600 --> 30:11.840] You can give the test to your subjects until they plateau and then that's their baseline, | |||
[30:11.840 --> 30:13.000] right? | |||
[30:13.000 --> 30:18.520] Or you just have to compare it against the placebo and then you see who improves more, | |||
[30:18.520 --> 30:19.520] right? | |||
[30:19.520 --> 30:21.000] Is there a difference or not? | |||
[30:21.000 --> 30:22.000] So that's what they chose to do. | |||
[30:22.000 --> 30:29.920] They did not establish, they didn't do a practice series to get them to their plateau first. | |||
[30:29.920 --> 30:33.480] So a few things to put this into perspective. | |||
[30:33.480 --> 30:36.720] First of all, this is not the first study to look at the effects, the correlation between | |||
[30:36.720 --> 30:42.560] taking a multivitamin and cognitive function in older patients or in patients in general | |||
[30:42.560 --> 30:43.560] subjects. | |||
[30:43.560 --> 30:48.320] There's been, you know, decades of research into this with pretty mixed results. | |||
[30:48.320 --> 30:52.200] Like there's no consistent effect here, no huge effect here. | |||
[30:52.200 --> 30:55.920] And the general interpretation of all the research has been, yeah, there's just no, | |||
[30:55.920 --> 31:00.120] nothing that you can point to that's clearly demonstrated. | |||
[31:00.120 --> 31:05.760] The reason the results are mixed is probably because there isn't a huge effect here. | |||
[31:05.760 --> 31:10.440] But you know, the researchers took all the previous research into consideration. | |||
[31:10.440 --> 31:14.920] They wanted to do a larger study with, that's more, that's with a longer follow-up. | |||
[31:14.920 --> 31:18.920] Most studies were only like six months or a year, so they did three years and et cetera. | |||
[31:18.920 --> 31:23.360] Basically just do a bigger, better, longer study to see if they could squeeze out a statistically | |||
[31:23.360 --> 31:25.560] significant effect that way. | |||
[31:25.560 --> 31:26.560] And they did. | |||
[31:26.560 --> 31:27.560] So what does that mean? | |||
[31:27.560 --> 31:31.760] So we need to, again, statistical significance, as I've said many, many times on this show, | |||
[31:31.760 --> 31:37.440] is not the only thing to look at when evaluating the clinical significance of a study of a | |||
[31:37.440 --> 31:38.980] medical trial. | |||
[31:38.980 --> 31:44.180] So you have to also look at the clinical significance of the difference, right? | |||
[31:44.180 --> 31:47.560] So what, how much of an effect size is there here? | |||
[31:47.560 --> 31:52.940] And the bottom line is that the overall effect size was fairly small, right? | |||
[31:52.940 --> 31:59.120] It was less than the amount that everybody improved just from the study effect, right? | |||
[31:59.120 --> 32:01.200] Just from the practice effect. | |||
[32:01.200 --> 32:04.700] So it was pretty small, but it was statistically significant. | |||
[32:04.700 --> 32:07.520] And then the other question is, well, what could be going on here? | |||
[32:07.520 --> 32:12.200] So first of all, this could be a spurious effect and as the researchers acknowledge, | |||
[32:12.200 --> 32:18.480] we need to do this study with more individuals and with a more diverse population and we | |||
[32:18.480 --> 32:21.600] need to gather more data to see like, is this real? | |||
[32:21.600 --> 32:25.500] And if so, what are the, what's the probable mechanism? | |||
[32:25.500 --> 32:33.520] For me, the big glaring omission in this test was that they did not test vitamin levels | |||
[32:33.520 --> 32:41.660] before doing the study, because let's say older patients, older people do tend to have | |||
[32:41.660 --> 32:45.380] lower vitamin B12 levels, for example, cause that's a hard vitamin to absorb. | |||
[32:45.380 --> 32:48.040] You need a special molecule to bind to it. | |||
[32:48.040 --> 32:53.400] It's called intrinsic factor and then sort of usher it over, you know, the gastric membrane. | |||
[32:53.400 --> 32:58.000] So it doesn't just get passively absorbed and you know, that, that can decrease as we | |||
[32:58.000 --> 33:02.480] age and people could become B12 deficient as we get older. | |||
[33:02.480 --> 33:05.600] Pretty much I check it in every single patient that I have, cause it's just that one of, | |||
[33:05.600 --> 33:10.120] it's a basic neurology lab that we do because it affects neurological functioning. | |||
[33:10.120 --> 33:16.960] And you know, it's, it's a pretty high incidence of B12, either insufficiency or deficiency | |||
[33:16.960 --> 33:23.620] in the population being studied here and you know, multivitamins typically contain B12. | |||
[33:23.620 --> 33:32.200] So how do they know they're not just treating undiagnosed B12 deficiency in this population, | |||
[33:32.200 --> 33:35.920] which has a measure, which is, has a known benefit to cognition, right? | |||
[33:35.920 --> 33:40.760] As a known benefit in terms of dementia, you know, B12 deficiency contributes to dementia | |||
[33:40.760 --> 33:44.320] and can cause it by itself if it's bad enough for long enough. | |||
[33:44.320 --> 33:47.920] But so anyway, that seemed like a pretty big omission to me. | |||
[33:47.920 --> 33:51.760] And I think that definitely a follow-up study would do that because that might, you know, | |||
[33:51.760 --> 33:57.240] treating otherwise undiagnosed deficiency could be the entire explanation here, could | |||
[33:57.240 --> 33:58.240] be the entire effect. | |||
[33:58.240 --> 34:02.760] For the vitamin industry, isn't that also kind of their argument? | |||
[34:02.760 --> 34:07.280] The there's an important difference though, between targeted supplementation and routine | |||
[34:07.280 --> 34:10.040] multivitamin supplementation. | |||
[34:10.040 --> 34:16.180] And there is known harm, at least, you know, correlations between routine multivitamin | |||
[34:16.180 --> 34:20.600] use and, and other, you know, health, negative health outcomes like heart disease. | |||
[34:20.600 --> 34:21.600] Right. | |||
[34:21.600 --> 34:22.880] Cause you're taking too much of something. | |||
[34:22.880 --> 34:23.880] Yeah. | |||
[34:23.880 --> 34:27.800] And I'll tell you just from again, having tested vitamin levels on hundreds and hundreds | |||
[34:27.800 --> 34:33.360] of patients of all ages, but certainly many of them older, um, you know, we diagnose levels | |||
[34:33.360 --> 34:38.100] that are, that are too high as frequently as we diagnose levels that are too low. | |||
[34:38.100 --> 34:42.200] And so often I'm telling my patients, stop this, stop that, and add this, you know what | |||
[34:42.200 --> 34:43.200] I mean? | |||
[34:43.200 --> 34:44.840] Like I'm, I have to direct their supplementation. | |||
[34:44.840 --> 34:48.560] They're taking too much of certain things and not enough of other things. | |||
[34:48.560 --> 34:49.560] That's very, very common. | |||
[34:49.560 --> 34:56.840] So just, you know, a blanket multivitamin without any pre-testing of vitamin levels, | |||
[34:56.840 --> 34:58.160] I don't think is the right approach. | |||
[34:58.160 --> 35:02.280] I don't think the evidence supports that, but the, you know, the, the, the, all the | |||
[35:02.280 --> 35:05.780] other evidence, if you look at it in its totality, it does support, there's a lot of instances | |||
[35:05.780 --> 35:11.560] where targeted supplementation is proven to be effective and is, is good, you know, medical | |||
[35:11.560 --> 35:16.520] management, but routine multivitamin supplementation really isn't. | |||
[35:16.520 --> 35:21.000] And this study does not really answer that question because they didn't test vitamin | |||
[35:21.000 --> 35:22.000] levels. | |||
[35:22.000 --> 35:26.720] So, um, they didn't make the key distinction in my part, in my, in my opinion. | |||
[35:26.720 --> 35:31.480] And of course a good scientific study should, but I guess for the devil's advocate thing | |||
[35:31.480 --> 35:36.640] that I'm asking, just trying to kind of channel the people who take multivitamins regularly | |||
[35:36.640 --> 35:43.280] is, is there a, is there a benefit to a certain percent of the population who you know are | |||
[35:43.280 --> 35:48.120] not going to be going in for this routine testing, who you know are very likely not | |||
[35:48.120 --> 35:54.880] on top of their levels, a just in case multivitamin, it just, does the good outweigh the harm? | |||
[35:54.880 --> 35:58.520] So again, if you look at, you can't answer that question from looking at this study, | |||
[35:58.520 --> 36:02.280] but because it's only looking at a certain number of things, but if you look at the totality | |||
[36:02.280 --> 36:06.800] of the research into multivitamins, there seems to be a net negative, if anything, you | |||
[36:06.800 --> 36:10.680] know, correlation with, with just taking a routine multivitamin. | |||
[36:10.680 --> 36:13.580] Here's here's one reason why that could be a bad thing. | |||
[36:13.580 --> 36:18.400] If you're in your sixties, you know, let's say like for seventies, the target population | |||
[36:18.400 --> 36:22.220] in this study, you should be seeing your primary care doctor at least once a year. | |||
[36:22.220 --> 36:26.000] So if you take a multivitamin and go, I don't have to see my primary care doctor, I'm taking | |||
[36:26.000 --> 36:29.720] a multivitamin, that's, I'm covered, you know, that actually can have an unintended | |||
[36:29.720 --> 36:31.520] negative consequence. | |||
[36:31.520 --> 36:35.160] But it's hard to know how that all shakes out, you know, because there's, there's multiple | |||
[36:35.160 --> 36:38.880] possible unintended consequences here. | |||
[36:38.880 --> 36:42.600] But the thing is you should be seeing your primary care doctor at least annually. | |||
[36:42.600 --> 36:47.540] And if you do, I guarantee you that they're checking your B12 level and other, and other | |||
[36:47.540 --> 36:48.680] vitamin levels as well. | |||
[36:48.680 --> 36:51.600] And if you certainly, if you have any neurological symptoms, you're going to get pretty much | |||
[36:51.600 --> 36:56.080] a full metabolic screen, you know, nutritional screen, you should anyway. | |||
[36:56.080 --> 37:01.560] And then you'll be able to take personalized, you know, targeted supplementation. | |||
[37:01.560 --> 37:08.000] And so, you know, there, there may be negative unintended consequences here that are not | |||
[37:08.000 --> 37:11.680] being picked up by this study, which is mainly concerned with cognitive function. | |||
[37:11.680 --> 37:12.680] Yeah. | |||
[37:12.680 --> 37:15.720] And by the way, there's another consideration here and I'll use a personal anecdote. | |||
[37:15.720 --> 37:21.400] I, you know, did have B12 testing when I was struggling, have been struggling with some, | |||
[37:21.400 --> 37:28.960] some specific symptoms and my physician recommended, and same thing actually with iron. | |||
[37:28.960 --> 37:34.440] So I was iron deficient and B12 deficient and sure, I could have like done targeted | |||
[37:34.440 --> 37:38.480] supplementation by going down the vitamin aisle, but these are like not FDA approved | |||
[37:38.480 --> 37:40.120] and I don't really know what's in them. | |||
[37:40.120 --> 37:43.260] And you know, this is, they're not regulated very well. | |||
[37:43.260 --> 37:46.820] And ultimately I had some issues with absorption, like with like gut problems from trying to | |||
[37:46.820 --> 37:48.240] take a oral iron. | |||
[37:48.240 --> 37:54.640] So whatever I was able to do B12 injections and I ended up having to get iron infusion. | |||
[37:54.640 --> 37:59.400] So now I'm getting prescription medication that I know is FDA approved. | |||
[37:59.400 --> 38:02.880] I know it's made in a lab, it's clean, it's been tested. | |||
[38:02.880 --> 38:05.640] And the same is true of many oral vitamins as well. | |||
[38:05.640 --> 38:12.920] And, and I write prescriptions for vitamins to my patients so they know exactly what they're | |||
[38:12.920 --> 38:15.120] getting and what dose and everything. | |||
[38:15.120 --> 38:16.280] And that's the other thing. | |||
[38:16.280 --> 38:21.840] If I'm prescribing B12 supplements to a patient who has B12 deficiency, who's whatever in | |||
[38:21.840 --> 38:26.400] their sixties or seventies, I then have to check followup levels because they may not | |||
[38:26.400 --> 38:27.760] be absorbing the B12. | |||
[38:27.760 --> 38:28.760] It may not work. | |||
[38:28.760 --> 38:29.760] You know, oral B12 may not. | |||
[38:29.760 --> 38:30.760] That's what happened to me. | |||
[38:30.760 --> 38:31.760] Yeah. | |||
[38:31.760 --> 38:32.760] And then you have, then you have to get the injections. | |||
[38:32.760 --> 38:35.200] You have to bypass the gut and do the injections. | |||
[38:35.200 --> 38:42.160] So again, just taking a multivitamin may not be addressing the actual, the actual problem. | |||
[38:42.160 --> 38:46.720] And if people are doing that, instead of getting their levels checked, that could have a net | |||
[38:46.720 --> 38:47.720] negative level. | |||
[38:47.720 --> 38:51.520] So you have to compare it to, you know, like best practices also. | |||
[38:51.520 --> 38:52.520] Yeah. | |||
[38:52.520 --> 38:56.920] It still could be true that, you know, there's an intention to treat analysis here, although | |||
[38:56.920 --> 39:00.360] I will say that there was about a 10% dropout, which they didn't count. | |||
[39:00.360 --> 39:03.680] And you know, that was probably enough people to affect the outcome of the study because | |||
[39:03.680 --> 39:06.520] the effect sizes were not that huge. | |||
[39:06.520 --> 39:10.040] And you have to wonder why that, you know, there was that dropout and what did, what, | |||
[39:10.040 --> 39:11.440] what was going on with those individuals. | |||
[39:11.440 --> 39:12.440] Right. | |||
[39:12.440 --> 39:13.440] Did that bias the outcome? | |||
[39:13.440 --> 39:14.440] Yeah. | |||
[39:14.440 --> 39:15.440] Right. | |||
[39:15.440 --> 39:16.440] Exactly. | |||
[39:16.440 --> 39:17.520] You know, that's, that's why you have to disclose the dropout rate. | |||
[39:17.520 --> 39:19.800] But in any case, yeah, I mean, the thing is, yeah, sure. | |||
[39:19.800 --> 39:24.040] Some people in the study were probably helped by taking, by taking a multivitamin. | |||
[39:24.040 --> 39:25.040] That's true. | |||
[39:25.040 --> 39:30.280] But you know, we definitely, my concern is that because there's already a huge cultural | |||
[39:30.280 --> 39:35.760] impetus to just take a multivitamin just in case, that if people get the bottom line message | |||
[39:35.760 --> 39:39.560] from this, that taking the multivitamin is good and that's all they have to worry about, | |||
[39:39.560 --> 39:41.800] that could have a net negative effect. | |||
[39:41.800 --> 39:45.640] And that we really do want to get the message out that, you know, vitamins are a medical | |||
[39:45.640 --> 39:46.640] intervention. | |||
[39:46.640 --> 39:50.200] You know, you do need to have your levels checked, especially when you get older, especially | |||
[39:50.200 --> 39:55.800] if you have certain medical concerns or symptoms and things need to be done in an evidence | |||
[39:55.800 --> 39:58.120] based way, not just shooting from the hip. | |||
[39:58.120 --> 39:59.120] Take a multivitamin. | |||
[39:59.120 --> 40:00.120] Don't worry about it. | |||
[40:00.120 --> 40:01.120] Right. | |||
[40:01.120 --> 40:04.080] Like you wouldn't take an, well, maybe aspirin is different, but I wouldn't take like a | |||
[40:04.080 --> 40:08.280] full dose of ibuprofen every day just in case I'm going to get a headache. | |||
[40:08.280 --> 40:12.040] That's dangerous. | |||
[40:12.040 --> 40:16.480] The dose ranges are pretty broad for vitamins, but you know, but we do see vitamin toxicity | |||
[40:16.480 --> 40:17.480] does happen. | |||
[40:17.480 --> 40:18.480] Yeah. | |||
[40:18.480 --> 40:20.320] Because you don't know what else, you don't know what else they're, they're having their | |||
[40:20.320 --> 40:23.000] regular diet, what else they're consuming. | |||
[40:23.000 --> 40:26.080] And sometimes when people are really doing it, like for these health, they're taking | |||
[40:26.080 --> 40:30.640] like thousands, the plural percent of like the recommended daily intake. | |||
[40:30.640 --> 40:32.840] Well, the other thing is, yeah, they might be taking too much. | |||
[40:32.840 --> 40:33.840] They don't know what dose to take. | |||
[40:33.840 --> 40:35.240] The other thing, or they might be taking too little. | |||
[40:35.240 --> 40:36.760] That's the other thing. | |||
[40:36.760 --> 40:42.480] There are, like I've had patients who've had like, you know, vitamin B6 levels that are | |||
[40:42.480 --> 40:47.800] 10 times the upper limit of normal, like really super high levels. | |||
[40:47.800 --> 40:51.720] And they tell me that they don't know that they're not supplementing. | |||
[40:51.720 --> 40:57.120] The thing is there's so much embedded supplementation in, you know, food. | |||
[40:57.120 --> 40:58.600] Oh, like fortified foods. | |||
[40:58.600 --> 41:03.480] Fortified, like are you drinking vitamin water or whatever, the cereal, whatever, that they're, | |||
[41:03.480 --> 41:08.360] they're might be getting too much of certain vitamins without specifically taking a multivitamin | |||
[41:08.360 --> 41:10.560] or specifically supplementing. | |||
[41:10.560 --> 41:14.040] So again, it's why it's good to sort of have a conversation with them about like what they're | |||
[41:14.040 --> 41:17.840] eating and what they're not eating and then, and what their levels are and, and again, | |||
[41:17.840 --> 41:23.080] try to give them some specific personalized advice about their diet as well as, you know, | |||
[41:23.080 --> 41:26.000] what may or may not need to be supplemented. | |||
[41:26.000 --> 41:28.320] That's the direction I definitely would like to see things go. | |||
[41:28.320 --> 41:31.640] And that's, you know, I think neurology is there for the things that we are concerned | |||
[41:31.640 --> 41:36.440] about because, you know, actual deficiencies in the, in these vitamins can cause neurological | |||
[41:36.440 --> 41:40.680] symptoms and dementia being a big one, you know, so, you know, we're kind of already | |||
[41:40.680 --> 41:41.840] all over that. | |||
[41:41.840 --> 41:49.400] But anyway, it's and again, this is one study embedded in a very, you know, decades of research | |||
[41:49.400 --> 41:51.960] showing results kind of all over the place. | |||
[41:51.960 --> 41:56.840] So we can't, you know, look at this as if this is conclusive, you know, we definitely, | |||
[41:56.840 --> 42:01.480] I would definitely like to see, you know, better controlled, more thorough, larger studies | |||
[42:01.480 --> 42:05.280] with more diverse population and, you know, see, and see if there's a consistent effect | |||
[42:05.280 --> 42:06.280] here. | |||
=== Refreezing the Poles <small>(42:07)</small> === | === Refreezing the Poles <small>(42:07)</small> === | ||
Revision as of 21:57, 28 October 2022
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| SGU Episode 898 |
|---|
| September 24th 2022 |
 |
2012 Arctic sea ice minimum. Outline shows average minimum 1979-2010.[1] |
| Skeptical Rogues |
| S: Steven Novella |
B: Bob Novella |
C: Cara Santa Maria |
J: Jay Novella |
E: Evan Bernstein |
| Guest |
DA: David Almeda (sp?), SGU Patron |
| Quote of the Week |
In the field of thinking, the whole history of science – from geocentrism to the Copernican revolution, from the false absolutes of Aristotle's physics to the relativity of Galileo's principle of inertia and to Einstein's theory of relativity – shows that it has taken centuries to liberate us from the systematic errors, from the illusions caused by the immediate point of view as opposed to "decentered" systematic thinking. |
– Jean Piaget, Swiss psychologist |
| Links |
| Download Podcast |
| Show Notes |
| Forum Discussion |
Introduction, Guest Rogue
Voice-over: You're listening to the Skeptics' Guide to the Universe, your escape to reality.
[00:12.880 --> 00:17.560] Today is Tuesday, September 20th, 2022, and this is your host, Stephen Novella.
[00:17.560 --> 00:18.960] Joining me this week are Bob Novella.
[00:18.960 --> 00:19.960] Hey, everybody.
[00:19.960 --> 00:20.960] Kara Santamaria.
[00:20.960 --> 00:21.960] Howdy.
[00:21.960 --> 00:22.960] Jay Novella.
[00:22.960 --> 00:23.960] Hey, guys.
[00:23.960 --> 00:24.960] Evan Bernstein.
[00:24.960 --> 00:26.760] Good evening, everyone.
[00:26.760 --> 00:30.400] And we have a guest rogue this week, David Almeida.
[00:30.400 --> 00:32.120] David, welcome to the Skeptics' Guide.
[00:32.120 --> 00:33.120] Hi, guys.
[00:33.120 --> 00:34.120] Thank you for having me.
[00:34.120 --> 00:40.440] So, David, you are a patron of the SGU, and you've been a loyal supporter for a while,
[00:40.440 --> 00:45.200] so we invited you on the show to join us and have some fun.
[00:45.200 --> 00:46.200] Tell us what you do.
[00:46.200 --> 00:47.840] Give us a little bit about your background.
[00:47.840 --> 00:48.840] I'm an electrician.
[00:48.840 --> 00:52.640] That doesn't sound very exciting relative to what you guys are all doing.
[00:52.640 --> 00:55.080] No, electricians are cool, man.
[00:55.080 --> 00:56.080] Yeah, they're shocking.
[00:56.080 --> 00:58.120] Oh, it starts.
[00:58.120 --> 01:05.640] I actually heard about your show kind of because of work, because when I was starting out as
[01:05.640 --> 01:09.920] an apprentice, pretty much all the work I did was really boring and repetitive, and
[01:09.920 --> 01:13.520] so I was kind of losing my mind a little bit.
[01:13.520 --> 01:17.080] And a friend of mine was at my house helping me work on the house, and he was playing your
[01:17.080 --> 01:20.400] guys' podcast, and I had no idea what a podcast even was.
[01:20.400 --> 01:22.200] This was like 2012, I think.
[01:22.200 --> 01:24.400] I thought he was like listening to NPR or something.
[01:24.400 --> 01:26.320] You were late to the game.
[01:26.320 --> 01:27.320] Yeah, I know.
[01:27.320 --> 01:28.320] I know.
[01:28.320 --> 01:32.320] And so anyways, he was listening to your show, and I asked him what it was, and he told me,
[01:32.320 --> 01:35.400] and then I ended up going back and listening to your whole back catalog while I was doing
[01:35.400 --> 01:41.320] horrible, very repetitive work, and it got me through that for the first couple years
[01:41.320 --> 01:42.320] of my apprenticeship.
[01:42.320 --> 01:43.320] Yeah, we hear that a lot.
[01:43.320 --> 01:49.520] It's good for when you're exercising, doing mind-numbing repetitive tasks, riding a bike
[01:49.520 --> 01:50.520] or whatever.
[01:50.520 --> 01:51.520] It's good.
[01:51.520 --> 01:53.840] You're not just going to sit there staring off into space listening to the SGU.
[01:53.840 --> 01:58.520] I guess some people might do that, but it's always good for when you're doing something
[01:58.520 --> 01:59.520] else.
[01:59.520 --> 02:00.520] Well, great.
[02:00.520 --> 02:01.520] Thanks for joining us on the show.
[02:01.520 --> 02:02.520] It should be a lot of fun.
News Items
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2022 Ig Nobels (2:08)
[02:02.520 --> 02:05.640] You're going to have a news item to talk about a little bit later, but first we're just going
[02:05.640 --> 02:07.960] to dive right into some news items.
[02:07.960 --> 02:12.760] Jay, you're going to start us off by talking about this year's Ig Nobel Prizes.
[02:12.760 --> 02:14.160] Yeah, this was interesting.
[02:14.160 --> 02:22.840] This year, I didn't find anything about people getting razzed so much as I found stuff that
[02:22.840 --> 02:26.520] was basically legitimate, just weird, if you know what I mean.
[02:26.520 --> 02:28.200] Yeah, but that's kind of the Ig Nobles.
[02:28.200 --> 02:29.200] They're legit, but weird.
[02:29.200 --> 02:32.880] They're not fake science or bad science.
[02:32.880 --> 02:37.880] The Ig Nobel Prize is an honor about achievements that first make people laugh and then make
[02:37.880 --> 02:39.720] them think.
[02:39.720 --> 02:44.720] That's kind of their tagline, and it was started in 1991.
[02:44.720 --> 02:47.600] Here's a list of the 2022 winners.
[02:47.600 --> 02:48.600] Check this one out.
[02:48.600 --> 02:53.520] The first one here, the Art History Prize, they call it a multidisciplinary approach
[02:53.520 --> 02:57.600] to ritual enema scenes on ancient Maya pottery.
[02:57.600 --> 03:01.960] Whoa, I want to see those.
[03:01.960 --> 03:04.560] Talk about an insane premise.
[03:04.560 --> 03:11.680] Back in the 6-900 CE timeframe, the Mayans depicted people getting enemas on their pottery,
[03:11.680 --> 03:13.640] which that's crazy.
[03:13.640 --> 03:18.520] This is because they administered enemas back then for medicinal purposes.
[03:18.520 --> 03:20.200] So it was part of their culture.
[03:20.200 --> 03:24.200] And the researchers think it's likely that the Mayans also gave enemas that had drugs
[03:24.200 --> 03:28.000] in them to make people get high during rituals, which is-
[03:28.000 --> 03:29.000] That works, by the way.
[03:29.000 --> 03:30.000] Yeah.
[03:30.000 --> 03:33.000] So one of the lead researchers tried it.
[03:33.000 --> 03:39.960] He gave himself an alcohol enema situation, and they were giving him breathalyzer, and
[03:39.960 --> 03:43.340] lo and behold, he absorbed alcohol through his rectum.
[03:43.340 --> 03:46.120] He didn't need to do that to know that that happens.
[03:46.120 --> 03:47.120] This is science.
[03:47.120 --> 03:48.120] We already know that that happens.
[03:48.120 --> 03:49.120] What's the problem, Kara?
[03:49.120 --> 03:50.120] Science?
[03:50.120 --> 03:51.120] Hello?
[03:51.120 --> 03:52.120] Lit review.
[03:52.120 --> 03:53.120] Lit review.
[03:53.120 --> 04:01.160] The guy also tested DMT, but apparently the dose was probably not high enough for him
[04:01.160 --> 04:03.280] to feel anything because he didn't feel anything.
[04:03.280 --> 04:04.840] So I think that's pretty interesting.
[04:04.840 --> 04:09.760] I mean, that's very, very provocative, just to think that the Mayans, I didn't know they
[04:09.760 --> 04:11.160] did that, and then it was like a thing.
[04:11.160 --> 04:13.480] I was like, whatever.
[04:13.480 --> 04:16.080] Next one, Applied Cardiology Prize.
[04:16.080 --> 04:18.940] This one I find to be really cool.
[04:18.940 --> 04:24.700] So the researchers, they were seeking and finding evidence that when new romantic partners
[04:24.700 --> 04:29.880] meet for the first time and feel attracted to each other, their heart rates synchronize.
[04:29.880 --> 04:31.840] That was the premise of their research.
[04:31.840 --> 04:35.640] So the researchers wanted to find out if there is something physiological behind the gut
[04:35.640 --> 04:42.240] feeling that people can and do feel when they have met the quote unquote right person.
[04:42.240 --> 04:44.560] I don't know about you guys, but I've felt this.
[04:44.560 --> 04:49.440] I felt an inexplicable physiological thing.
[04:49.440 --> 04:53.440] I just didn't realize that something profound was happening.
[04:53.440 --> 04:55.960] So let me give you a quick idea of what they did.
[04:55.960 --> 04:58.080] They had 140 test subjects.
[04:58.080 --> 05:03.060] They monitored test subjects as they met other test subjects one on one.
[05:03.060 --> 05:09.280] If the pair got a gut feeling about the other person, the researchers predicted that they
[05:09.280 --> 05:15.660] would have motor movements, you know, act certain types of activity with their eyes,
[05:15.660 --> 05:18.440] heart rate, skin conductance.
[05:18.440 --> 05:22.020] These types of things would synchronize or they would pair each other or mirror each
[05:22.020 --> 05:23.020] other.
[05:23.020 --> 05:27.820] So 17 percent of the test subjects had what they considered to be successful pairing with
[05:27.820 --> 05:28.820] another subject.
[05:28.820 --> 05:33.760] And they found that couples heart rates and skin conductance correlated to a mutual attraction
[05:33.760 --> 05:35.060] with each other.
[05:35.060 --> 05:41.680] So there is some type of thing happening physiologically when two people, you know, get that feeling
[05:41.680 --> 05:44.520] when they're, you know, there's an initial attraction.
[05:44.520 --> 05:50.040] And it doesn't surprise me because, you know, as mammals, attraction is, you know, it's
[05:50.040 --> 05:51.480] a huge thing.
[05:51.480 --> 05:55.800] It's really it's not only important, but it, you know, your body is reacting to it.
[05:55.800 --> 06:00.180] There are things that happen when you feel that your body is is changing in a way.
[06:00.180 --> 06:01.180] Very cool.
[06:01.180 --> 06:04.960] The next one, I think a lot of people will get a kick out of the it's the literature
[06:04.960 --> 06:11.400] prize and they are analyzing what makes legal documents unnecessarily difficult to understand.
[06:11.400 --> 06:14.280] The basic idea here was there's two camps.
[06:14.280 --> 06:21.040] There's a camp that thinks that legal documents need to be as complicated as they are because
[06:21.040 --> 06:26.180] there's technical concepts and they need to be precise and they use they use this type
[06:26.180 --> 06:28.720] of language to help get that precision.
[06:28.720 --> 06:33.880] And there are other experts that think that laws are actually built upon, you know, mundane
[06:33.880 --> 06:38.360] concepts like cause consent and having best interests.
[06:38.360 --> 06:42.100] And what the researchers wanted to do was they wanted to test the two positions against
[06:42.100 --> 06:43.100] each other.
[06:43.100 --> 06:47.600] And essentially what they found, which is which is not going to surprise anyone, that
[06:47.600 --> 06:53.840] legal documents are at their core, essentially difficult to understand, which is what they
[06:53.840 --> 06:55.320] basically started with that premise.
[06:55.320 --> 07:00.640] But they proved it and they found out exactly what parts of the of the actual legal documents
[07:00.640 --> 07:02.080] were difficult to understand.
[07:02.080 --> 07:07.380] And they called it something called center embedding, which is when lawyers use legal
[07:07.380 --> 07:11.920] jargon within what they call convoluted syntax.
[07:11.920 --> 07:16.420] So in essence, I think what they're saying here is that that legal documents are difficult
[07:16.420 --> 07:21.800] essentially by design, that it's deliberate, which I find interesting and frustrating.
[07:21.800 --> 07:26.680] If you've ever had to read any type of legal documentation, it's kind of annoying how difficult
[07:26.680 --> 07:27.680] it is.
[07:27.680 --> 07:30.860] You have to reread it over and over and over again and look things up and really like sink
[07:30.860 --> 07:32.000] into it to understand.
[07:32.000 --> 07:34.320] So I understand why they did the research.
[07:34.320 --> 07:37.500] I just don't see what the benefit is to the result of their research.
[07:37.500 --> 07:38.720] Maybe they have to iterate it.
[07:38.720 --> 07:41.920] The center embedding thing is actually pretty interesting.
[07:41.920 --> 07:48.120] I saw an example of it and it's like not like it's not what I thought it was going to be.
[07:48.120 --> 07:52.760] It gives an example of like a sentence like a man loves a woman and then a man that a
[07:52.760 --> 07:57.880] woman that a child knows loves a man that a woman that a child that a bird saw is giving
[07:57.880 --> 08:03.840] these examples of like how they do the legal jargon with all those like with all those
[08:03.840 --> 08:08.520] little like phrases within phrases.
[08:08.520 --> 08:12.120] And it's like grammatically correct, but it's like impossible to follow once you have like
[08:12.120 --> 08:13.440] more than one of those.
[08:13.440 --> 08:16.480] The longest one they had here was a man that a woman that a child that a bird that I heard
[08:16.480 --> 08:18.680] saw knows loves.
[08:18.680 --> 08:23.720] I don't know how that actually makes grammatical sense, but apparently it does.
[08:23.720 --> 08:26.960] It makes no sense to me even though I read it like five times in my head.
[08:26.960 --> 08:29.000] I don't know what that sentence means.
[08:29.000 --> 08:33.500] Have you guys seen I just started watching that show Maid.
[08:33.500 --> 08:35.000] Have you guys seen that show on Netflix?
[08:35.000 --> 08:36.000] It's so good.
[08:36.000 --> 08:37.840] Oh, highly recommend.
[08:37.840 --> 08:41.660] But they do this funny thing where like she has to go to a court hearing and they kind
[08:41.660 --> 08:45.600] of show what she hears instead of what is being said.
[08:45.600 --> 08:51.680] And so she's at this custody hearing and the judge is talking to one of the prosecutors
[08:51.680 --> 08:56.620] and like mid-sentence they start going, and then legal, legal, legal, legal, so that you
[08:56.620 --> 08:57.720] can legal, legal.
[08:57.720 --> 08:59.520] I'll legal, legal after you legal.
[08:59.520 --> 09:02.520] And she like looked so confused because it's all she hears.
[09:02.520 --> 09:06.680] And they do it on the forms too when she looks at the forms like the words move and they
[09:06.680 --> 09:08.960] start to just say like legal, legal, legal, legal.
[09:08.960 --> 09:13.360] It's a great representation of exactly what you're talking about.
[09:13.360 --> 09:14.360] Totally.
[09:14.360 --> 09:17.360] The Charlie Brown teacher.
[09:17.360 --> 09:18.360] Charlie Brown.
[09:18.360 --> 09:19.360] Yeah.
[09:19.360 --> 09:20.360] Totally.
[09:20.360 --> 09:22.080] Let me get through a few more really quick.
[09:22.080 --> 09:26.720] There was a biology prize where they studied whether and how constipation affects the mating
[09:26.720 --> 09:28.360] prospects of scorpions.
[09:28.360 --> 09:36.540] There was a medical prize for showing that when patients undergo some form of toxic chemotherapy,
[09:36.540 --> 09:41.720] they suffer fewer harmful side effects when ice cream replaces ice chips.
[09:41.720 --> 09:42.720] Okay.
[09:42.720 --> 09:43.720] Reasonable to me.
[09:43.720 --> 09:44.720] Reasonable.
[09:44.720 --> 09:45.720] Unactionable.
[09:45.720 --> 09:46.720] Yep, it is.
[09:46.720 --> 09:47.720] And it's legit.
[09:47.720 --> 09:48.720] It is actually legit.
[09:48.720 --> 09:53.080] The ice cream, giving chemo patients ice cream helped them a lot more deal with side effects
[09:53.080 --> 09:55.280] than ice chips.
[09:55.280 --> 09:59.300] Their engineering prize, they're trying to discover the most efficient way for people
[09:59.300 --> 10:04.400] to use their fingers when turning a knob, doorknob.
[10:04.400 --> 10:09.920] That's you know, so they study people turning doorknobs and figured it out.
[10:09.920 --> 10:14.040] Works for trying to understand how ducklings manage to swim in formation.
[10:14.040 --> 10:20.520] Now this is cool because we know that fish and birds have very few rules of interaction
[10:20.520 --> 10:26.640] in order to do profound feats of being able to stay in these giant groups.
[10:26.640 --> 10:27.640] They could swim near each other.
[10:27.640 --> 10:31.600] They can fly near each other and they don't really need to have a complicated algorithm
[10:31.600 --> 10:32.600] happening.
[10:32.600 --> 10:34.560] They just have to follow a few simple rules and it works.
[10:34.560 --> 10:36.240] And apparently ducks can do it too.
[10:36.240 --> 10:40.720] There was a peace prize and this one is for developing an algorithm to help gossipers
[10:40.720 --> 10:43.800] decide when to tell the truth and when to lie.
[10:43.800 --> 10:44.800] Very important.
[10:44.800 --> 10:45.800] Right?
[10:45.800 --> 10:47.200] That's just wacky as hell.
[10:47.200 --> 10:52.740] The economics prize for explaining mathematically why success most often goes not to the most
[10:52.740 --> 10:55.460] talented people but instead to the luckiest.
[10:55.460 --> 10:56.460] That one was interesting.
[10:56.460 --> 10:57.840] I recommend you read that.
[10:57.840 --> 11:04.400] And then this last one here is safety engineering prize for developing a moose crash test dummy.
[11:04.400 --> 11:05.400] That's smart actually.
[11:05.400 --> 11:06.400] Yeah.
[11:06.400 --> 11:09.480] So you know lots of people hit these animals with their cars.
[11:09.480 --> 11:12.800] I heard you hesitate because you didn't know if you're supposed to say moose or mooses.
[11:12.800 --> 11:13.800] Meeses.
[11:13.800 --> 11:14.800] I don't know.
[11:14.800 --> 11:15.800] You were like hit these animals.
[11:15.800 --> 11:16.800] Animals.
[11:16.800 --> 11:17.800] Yeah.
[11:17.800 --> 11:18.800] I'm not going to.
[11:18.800 --> 11:19.800] What the heck?
[11:19.800 --> 11:20.800] What's the plural of moose?
[11:20.800 --> 11:21.800] Isn't it moose?
[11:21.800 --> 11:22.800] Yeah.
[11:22.800 --> 11:25.720] I think the plural of moose is moose.
[11:25.720 --> 11:27.640] I just add a K in when I don't know what to do.
[11:27.640 --> 11:29.520] Have I told you the story about the mongoose?
[11:29.520 --> 11:30.520] No.
[11:30.520 --> 11:31.520] What?
[11:31.520 --> 11:32.520] I heard.
[11:32.520 --> 11:33.520] I learned this.
[11:33.520 --> 11:43.760] I heard this in my film class where a director needed two mongoose for a scene and he couldn't
[11:43.760 --> 11:46.640] figure out what the plural of mongoose was.
[11:46.640 --> 11:49.780] You know the mongooses, mongies, whatever, he couldn't figure it out.
[11:49.780 --> 11:56.120] So he wrote in his message to the person who had to do this, I need you to get me one mongoose
[11:56.120 --> 11:59.600] and while you're at it get me another one.
[11:59.600 --> 12:04.160] Yeah, technically solves that problem.
[12:04.160 --> 12:05.160] All right.
[12:05.160 --> 12:06.160] Thanks Jay.
It's OK to Ask for Help (12:06)
[12:06.160 --> 12:08.520] Kara, is it okay to ask for help when you need it?
[12:08.520 --> 12:09.920] Is it okay?
[12:09.920 --> 12:13.400] Not only is it okay, it's great.
[12:13.400 --> 12:19.480] Let's dive into a cool study that was recently published in Psychological Science.
[12:19.480 --> 12:23.680] This study has a lot of moving parts so I'm not going to get into all of them but I have
[12:23.680 --> 12:29.520] to say just kind of at the top that I'm loving the thoroughness and I'm loving the clarity
[12:29.520 --> 12:32.320] of the writing of this research article.
[12:32.320 --> 12:37.040] I feel like it's a great example of good psychological science.
[12:37.040 --> 12:39.440] It's based on a really deep literature review.
[12:39.440 --> 12:44.120] A lot of people that we know and love like Dunning are cited who have co-written with
[12:44.120 --> 12:45.480] some of the authors.
[12:45.480 --> 12:56.720] This study basically is asking the question, why do people struggle to ask for help?
[12:56.720 --> 13:01.960] When people do ask for help, what is the outcome usually?
[13:01.960 --> 13:08.800] They did six, I think it was six or was it eight, I think it was six different individual
[13:08.800 --> 13:12.000] experiments within this larger study.
[13:12.000 --> 13:18.000] Their total and the number of people overall that were involved, that participated in the
[13:18.000 --> 13:21.780] study was like over 2,000.
[13:21.780 --> 13:25.180] They kind of looked at it from multiple perspectives.
[13:25.180 --> 13:30.340] They said, first we're going to ask people to imagine a scenario and tell us what they
[13:30.340 --> 13:34.640] think they would do or what they think the other person would feel or think.
[13:34.640 --> 13:39.200] Then we're going to ask them about experiences that they've actually had, like think back
[13:39.200 --> 13:43.220] to a time when you asked for help or when somebody asked you for help and then answer
[13:43.220 --> 13:44.400] all these questions.
[13:44.400 --> 13:50.280] Then they actually did a more real world kind of ecological study where they said, okay,
[13:50.280 --> 13:52.920] we're going to put a scenario in place.
[13:52.920 --> 13:59.120] Basically this scenario was in a public park, they asked people to basically go up to somebody
[13:59.120 --> 14:02.700] else and be like, hey, do you mind taking a picture for me?
[14:02.700 --> 14:10.200] They did a bunch of different really clean study designs where they took a portion of
[14:10.200 --> 14:14.280] the people and had them be the askers and a portion of the people and have them be the
[14:14.280 --> 14:17.920] non-askers and then a portion of the people and have them ask with a prompt, without a
[14:17.920 --> 14:18.920] prompt.
[14:18.920 --> 14:22.920] The study designs are pretty clean but they're kind of complex.
[14:22.920 --> 14:26.760] What do you guys think, I mean obviously you can't answer based on every single study,
[14:26.760 --> 14:31.360] but the main sort of takeaway of this was?
[14:31.360 --> 14:34.040] Asking for help is good and people are willing to give the help.
[14:34.040 --> 14:35.040] People like getting help.
[14:35.040 --> 14:36.040] Right.
[14:36.040 --> 14:37.040] Yeah.
[14:37.040 --> 14:40.440] So not only do people more often than not, and not even more often than not, like almost
[14:40.440 --> 14:46.200] all the time, especially in these low hanging fruit scenarios, do the thing that's asked
[14:46.200 --> 14:50.200] of them, but they actually feel good about it after.
[14:50.200 --> 14:54.240] They feel better having given help.
[14:54.240 --> 14:58.980] And so what they wanted to look at were some of these kind of cognitive biases basically.
[14:58.980 --> 15:04.560] They asked themselves, why are people so hesitant to ask for help?
[15:04.560 --> 15:13.120] And they believe it's because people miscalibrate their expectations about other people's prosociality,
[15:13.120 --> 15:17.640] that there's sort of a Western ideal that says people are only looking out for their
[15:17.640 --> 15:21.600] own interest and they'd rather not help anybody and only help themselves.
[15:21.600 --> 15:28.200] They also talk about something called compliance motivation.
[15:28.200 --> 15:34.160] So they think that people are, when they actually do help you out, it's less because they want
[15:34.160 --> 15:36.400] to because they're prosocial.
[15:36.400 --> 15:41.100] And it's more literally because they feel like they have to, like they feel a pull to
[15:41.100 --> 15:43.560] comply with a request.
[15:43.560 --> 15:49.000] But it turns out that in these different studies where either they're looking at a real world
[15:49.000 --> 15:54.920] example, they're asking people for imagined examples, the helpers more often than not
[15:54.920 --> 15:57.360] want to help and say that they feel good about helping.
[15:57.360 --> 16:01.760] But the people who need the help more often than not judge the helpers to not want to
[16:01.760 --> 16:06.120] help them and worry that the helpers won't want to help them.
[16:06.120 --> 16:11.200] So this is another example of kind of, do you guys remember last week, I think it was,
[16:11.200 --> 16:15.400] when I talked about a study where people were trying to calibrate how much they should talk
[16:15.400 --> 16:16.400] to be likable?
[16:16.400 --> 16:17.400] Yeah.
[16:17.400 --> 16:18.400] Yeah, so yeah.
[16:18.400 --> 16:20.120] And they were, again, miscalibrating.
[16:20.120 --> 16:22.000] They were saying, I shouldn't talk that much.
[16:22.000 --> 16:23.240] They'll like me more if I talk less.
[16:23.240 --> 16:26.360] But it turns out if you talk more, people actually like you more.
[16:26.360 --> 16:31.480] And so it's another one of those examples of a cognitive bias getting in the way of
[16:31.480 --> 16:37.080] us engaging in social behavior and actually kind of shooting ourselves in the foot because
[16:37.080 --> 16:42.580] we fear an outcome that is basically the opposite of the outcome that we'll get.
[16:42.580 --> 16:46.800] If we ask for help, we'll more than likely get it, and more than likely, the person who
[16:46.800 --> 16:50.280] helped us will feel good about having helped us, and it's really a win-win.
[16:50.280 --> 16:52.040] Of course, they caveated at the end.
[16:52.040 --> 16:53.480] We're talking about low-hanging fruit.
[16:53.480 --> 16:58.120] We're not talking about massive power differentials, you know, where one person, where there's
[16:58.120 --> 17:00.000] coercion and things like that.
[17:00.000 --> 17:05.040] But given some of those caveats to the side, basically an outcome of every single design
[17:05.040 --> 17:07.600] that they did in the study was people want to help.
[17:07.600 --> 17:09.660] And they want to help because it makes them feel good.
[17:09.660 --> 17:13.240] So maybe the next time you need help, if you ask, you shall receive.
[17:13.240 --> 17:15.400] Yeah, also, it works both ways, too.
[17:15.400 --> 17:20.520] People often don't offer help because they are afraid that they don't understand the
[17:20.520 --> 17:26.560] situation and they're basically afraid of committing a social faux pas.
[17:26.560 --> 17:32.560] And so they end up not offering help, even in a situation when they probably should,
[17:32.560 --> 17:33.560] you know, because the fear...
[17:33.560 --> 17:34.560] Like a good Samaritan?
[17:34.560 --> 17:38.840] Well, because people want to help and they want to offer to help, but they're more afraid
[17:38.840 --> 17:41.400] of doing something socially awkward, and so they don't.
[17:41.400 --> 17:47.040] So if you just don't worry about that and just offer to help, have a much lower threshold
[17:47.040 --> 17:49.120] for offering, it's like it's no big deal.
[17:49.120 --> 17:53.400] If it's like, oh, I'm fine, okay, just checking, you know, but people will not do it.
[17:53.400 --> 17:58.080] I was once walking down the street and there was a guy on the sidewalk who couldn't get
[17:58.080 --> 17:59.080] up.
[17:59.080 --> 18:00.640] He clearly could not get up on his own, right?
[18:00.640 --> 18:04.600] And there are people walking by and other people sort of like checking him out, but
[18:04.600 --> 18:06.600] nobody was saying anything or offering to help.
[18:06.600 --> 18:08.560] So I just, hey, you need a hand?
[18:08.560 --> 18:09.560] And he did.
[18:09.560 --> 18:13.080] And then like three or four people right next to him were like, oh, let me help you, you
[18:13.080 --> 18:14.160] know what I mean?
[18:14.160 --> 18:18.320] But it was just, again, it's not that they weren't bad people, they just were paralyzed
[18:18.320 --> 18:21.200] by fear of social faux pas.
[18:21.200 --> 18:24.720] So it's kind of, it's the reverse of, I guess, of what you're saying, you know, where people
[18:24.720 --> 18:27.760] might not ask for help because they're afraid that it's not socially not the right thing
[18:27.760 --> 18:28.760] to do.
[18:28.760 --> 18:29.760] But it is.
[18:29.760 --> 18:30.760] Give help, ask for help.
[18:30.760 --> 18:31.760] It's all good.
[18:31.760 --> 18:32.760] Everybody likes it.
[18:32.760 --> 18:34.720] Just don't let your social fears get in the way.
[18:34.720 --> 18:35.880] Don't let your social fears get in the way.
[18:35.880 --> 18:41.360] And also there are ways to buffer if you are scared that you're like putting somebody out,
[18:41.360 --> 18:44.160] is there are different like strategies that you can use.
[18:44.160 --> 18:45.840] You can give people outs.
[18:45.840 --> 18:50.200] You know, if you really do need help, but you also really are worried that you're going
[18:50.200 --> 18:52.880] to be putting somebody out by asking for help.
[18:52.880 --> 18:58.620] You can say things like, I'd really appreciate your help in this situation, but I also understand
[18:58.620 --> 19:02.120] that it may be too much for you and don't worry, I'll still get it taken care of.
[19:02.120 --> 19:08.360] Like there are ways to buffer and to negotiate the sociality of that so that you don't feel
[19:08.360 --> 19:10.200] like you're being coercive.
[19:10.200 --> 19:14.560] And so, yeah, it's like you see it all the time.
[19:14.560 --> 19:16.920] People who get stuff in life ask for it.
[19:16.920 --> 19:22.400] Yeah, or you could, you could do, or you could do with my, what my Italian mother does and
[19:22.400 --> 19:24.280] say, don't worry about me.
[19:24.280 --> 19:25.280] I'll be fine.
[19:25.280 --> 19:28.080] I don't need anything.
[19:28.080 --> 19:29.080] The passive guilt.
[19:29.080 --> 19:30.080] They are.
[19:30.080 --> 19:31.080] They're wonderful at that.
[19:31.080 --> 19:34.800] Don't forget guys, don't forget.
[19:34.800 --> 19:41.480] If you help somebody, they owe you someday.
[19:41.480 --> 19:44.080] You might do a favor for me, you know?
[19:44.080 --> 19:45.080] That's right.
[19:45.080 --> 19:49.600] One of those, one of those things that my dad like drilled into my head that I like
[19:49.600 --> 19:53.000] always hear in my head all the time was he would always say, you don't ask, you don't
[19:53.000 --> 19:54.000] get.
[19:54.000 --> 19:57.280] So like I literally hear that in my head all the time when I'm in scenarios where I want
[19:57.280 --> 20:03.240] to ask for something and I totally do get that way sometimes where I'm like, yeah.
Bitcoin and Fedimints (20:03)
[20:03.240 --> 20:05.240] Let me ask you something, David.
[20:05.240 --> 20:12.800] I have a feeling that fediments are not as tasty as they sound.
[20:12.800 --> 20:15.840] Tell us about Bitcoin and fediments.
[20:15.840 --> 20:16.840] Fediments.
[20:16.840 --> 20:21.520] So a fediments, it's a portmanteau, I just realized I don't think I've ever said that
[20:21.520 --> 20:22.520] word out loud.
[20:22.520 --> 20:23.520] You said it right though.
[20:23.520 --> 20:24.520] Welcome to the show.
[20:24.520 --> 20:28.680] That's one of those words I've probably read like a million times.
[20:28.680 --> 20:31.820] I don't think I've ever said it in conversation or ever.
[20:31.820 --> 20:40.480] So a fediments, a portmanteau of a federated Chowmian mint, which basically it's a way
[20:40.480 --> 20:43.960] to scale Bitcoin.
[20:43.960 --> 20:54.780] There's two big problems with Bitcoin scaling to achieve its goal of being a worldwide payment
[20:54.780 --> 20:59.120] settlement system that's decentralized.
[20:59.120 --> 21:03.240] So one of those is that it doesn't provide very good privacy.
[21:03.240 --> 21:11.280] And the other one is that custody is kind of a sticky issue.
[21:11.280 --> 21:17.800] You've got people on two extremes when it comes to custody of Bitcoin.
[21:17.800 --> 21:24.760] You've got people who are kind of the old school Bitcoiners who will say, not your keys,
[21:24.760 --> 21:30.640] not your Bitcoin, which basically they're 100% self custody.
[21:30.640 --> 21:34.480] If you're not self custodying your Bitcoin, then you're not doing it right.
[21:34.480 --> 21:39.000] But there are problems with self custody, which is basically if you theoretically had
[21:39.000 --> 21:44.480] your life savings in Bitcoin and you lost the key to your Bitcoin, then you lose all
[21:44.480 --> 21:45.840] your life savings.
[21:45.840 --> 21:47.640] It's completely irretrievable.
[21:47.640 --> 21:49.920] There's no way to get back.
[21:49.920 --> 21:54.480] So the other option is third party custody, which the most common form is like people
[21:54.480 --> 21:59.860] will have it on Coinbase or Binance and they hold the keys for you.
[21:59.860 --> 22:02.360] All you need to have is your username and password.
[22:02.360 --> 22:07.400] And even if you lose that, you could prove your identity to them and they could restore
[22:07.400 --> 22:08.400] that for you.
[22:08.400 --> 22:10.540] They could restore your account for you.
[22:10.540 --> 22:15.840] The main problem with that is that you're hackable.
[22:15.840 --> 22:18.600] It's hackable.
[22:18.600 --> 22:25.320] It could be part of, you got a lot of rug pools, especially in the past, you had a lot
[22:25.320 --> 22:30.680] of situations where somebody created some third party custody things simply to get people
[22:30.680 --> 22:37.480] to put their Bitcoin on there and then they just like walked away with it.
[22:37.480 --> 22:44.660] Fedimint is an idea that they call second party custody.
[22:44.660 --> 22:51.640] The basic idea of a fediment is where a small group of people could come together, they
[22:51.640 --> 23:00.320] could create this fediment and it would have some of the advantages of self-custody where
[23:00.320 --> 23:04.240] there would be no one point of failure where one person could get up and walk away with
[23:04.240 --> 23:11.000] everything and so that also gets rid of the risk of hacking as well because you would
[23:11.000 --> 23:14.920] need, well, it doesn't get rid of the risk, but it minimizes the risk of a hack because
[23:14.920 --> 23:21.200] you would need consensus of a group of people that say you had five people who were, they
[23:21.200 --> 23:26.280] call them the guardians of the fediment, you would need three out of those five people
[23:26.280 --> 23:28.680] to do anything for anything to happen to the Bitcoin.
[23:28.680 --> 23:33.840] So three out of those five people would have to all get hacked by the same person in order
[23:33.840 --> 23:38.120] for somebody to be able to walk away with the Bitcoin.
[23:38.120 --> 23:43.600] It's resistant to the third party custody problems of being hacked or somebody just
[23:43.600 --> 23:52.280] pulling the rug under you and the other problem it can help alleviate is the privacy problem
[23:52.280 --> 24:01.240] which is not really achievable on the main blockchain of Bitcoin, on the base level.
[24:01.240 --> 24:05.440] If you're like a really technically savvy person you can do a lot of extra steps to
[24:05.440 --> 24:13.640] make your transactions somewhat private, but it's not anything that even a moderately technically
[24:13.640 --> 24:18.280] savvy person could do and there's a lot of steps that you could mess up where it would
[24:18.280 --> 24:19.280] fail.
[24:19.280 --> 24:25.720] So anyway, so Fediment by Design is much more private, it works using kind of an old technology
[24:25.720 --> 24:31.640] called eCash and using blind signatures, which I don't know if we want to get to that, that's
[24:31.640 --> 24:38.600] kind of old stuff, that blind signature makes it so that once you have your Bitcoin in the
[24:38.600 --> 24:45.920] Fediment any transactions you do with that are essentially anonymous and it would only
[24:45.920 --> 24:50.680] be dealing with anything on the blockchain if you were to withdraw from the Fediment.
[24:50.680 --> 24:53.800] Let me see if I have my head wrapped around this the correct way.
[24:53.800 --> 24:59.920] So it's a blockchain where three different people have to be hacked in order for a person
[24:59.920 --> 25:03.840] to actually get their hands on the Bitcoin or on the crypto.
[25:03.840 --> 25:09.960] And isn't the other hard part about that that would they know who the three people are inherently
[25:09.960 --> 25:13.280] by the blockchain or would that be part of the problem?
[25:13.280 --> 25:20.440] So the people who are the guardians, there could be, I think they said up to 15 and the
[25:20.440 --> 25:25.600] guardians could be anonymous or they could be public people.
[25:25.600 --> 25:31.720] The idea of the whole Fediment is it's supposed to be, whereas the base layer of Bitcoin is
[25:31.720 --> 25:33.720] meant to be completely trustless.
[25:33.720 --> 25:41.320] There's no like third party involved in really any of the process of Bitcoin, it's all completely
[25:41.320 --> 25:45.920] automated and that's how it's designed to be.
[25:45.920 --> 25:48.120] And so this is supposed to bring a little bit of trust into it.
[25:48.120 --> 25:53.960] So realistically, most of the guardians probably you would want to be a publicly known person
[25:53.960 --> 26:01.880] so that people would trust you and your small group to custody their Bitcoin for them.
[26:01.880 --> 26:07.960] But that person who was the guardian wouldn't know any information about the people who
[26:07.960 --> 26:14.400] were participating in the Fediment and they wouldn't have any information about what Bitcoin
[26:14.400 --> 26:17.160] is moving where or anything like that.
[26:17.160 --> 26:23.200] The other thing that is hitting me is that you also want those people would need to like
[26:23.200 --> 26:28.720] be there, you know, they would have to have a presence that isn't going to just go away
[26:28.720 --> 26:29.720] suddenly.
[26:29.720 --> 26:30.720] Right.
[26:30.720 --> 26:35.440] You know, if or would those three people be picked at random when a trade is happening?
[26:35.440 --> 26:37.340] Is it like permanent or random?
[26:37.340 --> 26:38.340] It's permanent.
[26:38.340 --> 26:43.720] So somebody would basically create or a small group of people would basically create a Fediment.
[26:43.720 --> 26:51.180] The idea is that it would be implemented on different scales, but their ideal scale that
[26:51.180 --> 26:55.640] they're trying to what they're trying to do is create this for community level.
[26:55.640 --> 26:58.080] It's almost comparable to like a community bank.
[26:58.080 --> 26:59.080] Oh, OK.
[26:59.080 --> 27:00.080] That makes sense.
[27:00.080 --> 27:01.080] Yeah.
[27:01.080 --> 27:08.240] So and the idea of having Bitcoin banks goes all the way back to 2010, basically this idea
[27:08.240 --> 27:15.340] that you would have a bank that was very similar to to a regular bank, but it would be based
[27:15.340 --> 27:16.340] on Bitcoin.
[27:16.340 --> 27:20.880] This is one of the first attempts to actually implement that, though.
[27:20.880 --> 27:25.800] As like a protocol, as opposed to being like, you know, most other solutions are just like
[27:25.800 --> 27:32.100] a company, an app, whereas this is more of a protocol layer solution where anybody could
[27:32.100 --> 27:33.100] use it.
[27:33.100 --> 27:37.120] It's not like, you know, it's not like proprietary app or something.
[27:37.120 --> 27:38.120] That sounds interesting.
[27:38.120 --> 27:44.360] I mean, it does sound like it solves the problem of basically having your Bitcoin stolen by
[27:44.360 --> 27:48.160] someone who creates a totally like temporary exchange.
[27:48.160 --> 27:53.400] I mean, it does it does seem to have more, you know, more of anonymous security built
[27:53.400 --> 27:56.880] into it in a sense, you know, like it does seem like it could do it.
[27:56.880 --> 28:01.320] But I mean, is it is it something that is is happening right now or is this is this
[28:01.320 --> 28:02.360] in the works?
[28:02.360 --> 28:07.600] They're hoping to have like to be able to like launch probably like a prototype or,
[28:07.600 --> 28:11.700] you know, maybe like a beta version or something around around then.
[28:11.700 --> 28:15.560] So it's not available right now, but should be available soon, hopefully.
[28:15.560 --> 28:17.100] Well, thanks, David.
Multivitamins for Memory (28:17)
- [link_URL Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial][5]
[28:17.100 --> 28:23.640] On the live stream this last Friday, somebody asked us about the recent study on multivitamins
[28:23.640 --> 28:27.880] and memory, which I hadn't done a deep dive on yet, and I said I would do it for the show
[28:27.880 --> 28:28.880] this week.
[28:28.880 --> 28:29.880] So here I am.
[28:29.880 --> 28:35.120] So the study is effects of cocoa extract and a multivitamin on cognitive function, a randomized
[28:35.120 --> 28:36.780] clinical trial.
[28:36.780 --> 28:44.520] This essentially was studying both a multivitamin and cocoa extract individually and together
[28:44.520 --> 28:45.680] versus placebo.
[28:45.680 --> 28:51.600] So there were four, you know, four groups in this trial was randomized and placebo controlled
[28:51.600 --> 28:52.780] and blinded.
[28:52.780 --> 28:58.080] And then they followed older subjects over three years.
[28:58.080 --> 29:02.540] It was a telephone evaluation, but you could do that because it was essentially just a
[29:02.540 --> 29:04.560] verbal mental status exam.
[29:04.560 --> 29:09.640] You know, they asked them to do verbal tasks, naming tasks, trail making, whatever.
[29:09.640 --> 29:13.960] Then they were these were standardized cognitive evaluations that you could be that can be
[29:13.960 --> 29:14.960] scored.
[29:14.960 --> 29:17.920] And then you can attach a number to it.
[29:17.920 --> 29:23.960] And the bottom line is that what they found is over those three years that taking a multivitamin
[29:23.960 --> 29:31.280] every day was associated with a greater improvement in performance on these cognitive tests than
[29:31.280 --> 29:34.780] was placebo or the cocoa extract.
[29:34.780 --> 29:39.800] The cocoa extract had zero effect, so there was no apparent benefit to that.
[29:39.800 --> 29:40.800] Now I say a greater.
[29:40.800 --> 29:44.520] Yeah, I say a greater increase because everyone improved, right?
[29:44.520 --> 29:47.040] I mean, every group improved.
[29:47.040 --> 29:49.600] And that's a well-known phenomenon.
[29:49.600 --> 29:53.480] Whenever you do a study like this, it's a practice effect, right?
[29:53.480 --> 29:56.640] The second time you do the set of standardized tests, you're going to be done.
[29:56.640 --> 29:57.640] You're going to do better.
[29:57.640 --> 29:59.600] The third time, you're going to do better.
[29:59.600 --> 30:01.040] And then it kind of plateaus.
[30:01.040 --> 30:04.600] So you can do this one of two ways.
[30:04.600 --> 30:11.840] You can give the test to your subjects until they plateau and then that's their baseline,
[30:11.840 --> 30:13.000] right?
[30:13.000 --> 30:18.520] Or you just have to compare it against the placebo and then you see who improves more,
[30:18.520 --> 30:19.520] right?
[30:19.520 --> 30:21.000] Is there a difference or not?
[30:21.000 --> 30:22.000] So that's what they chose to do.
[30:22.000 --> 30:29.920] They did not establish, they didn't do a practice series to get them to their plateau first.
[30:29.920 --> 30:33.480] So a few things to put this into perspective.
[30:33.480 --> 30:36.720] First of all, this is not the first study to look at the effects, the correlation between
[30:36.720 --> 30:42.560] taking a multivitamin and cognitive function in older patients or in patients in general
[30:42.560 --> 30:43.560] subjects.
[30:43.560 --> 30:48.320] There's been, you know, decades of research into this with pretty mixed results.
[30:48.320 --> 30:52.200] Like there's no consistent effect here, no huge effect here.
[30:52.200 --> 30:55.920] And the general interpretation of all the research has been, yeah, there's just no,
[30:55.920 --> 31:00.120] nothing that you can point to that's clearly demonstrated.
[31:00.120 --> 31:05.760] The reason the results are mixed is probably because there isn't a huge effect here.
[31:05.760 --> 31:10.440] But you know, the researchers took all the previous research into consideration.
[31:10.440 --> 31:14.920] They wanted to do a larger study with, that's more, that's with a longer follow-up.
[31:14.920 --> 31:18.920] Most studies were only like six months or a year, so they did three years and et cetera.
[31:18.920 --> 31:23.360] Basically just do a bigger, better, longer study to see if they could squeeze out a statistically
[31:23.360 --> 31:25.560] significant effect that way.
[31:25.560 --> 31:26.560] And they did.
[31:26.560 --> 31:27.560] So what does that mean?
[31:27.560 --> 31:31.760] So we need to, again, statistical significance, as I've said many, many times on this show,
[31:31.760 --> 31:37.440] is not the only thing to look at when evaluating the clinical significance of a study of a
[31:37.440 --> 31:38.980] medical trial.
[31:38.980 --> 31:44.180] So you have to also look at the clinical significance of the difference, right?
[31:44.180 --> 31:47.560] So what, how much of an effect size is there here?
[31:47.560 --> 31:52.940] And the bottom line is that the overall effect size was fairly small, right?
[31:52.940 --> 31:59.120] It was less than the amount that everybody improved just from the study effect, right?
[31:59.120 --> 32:01.200] Just from the practice effect.
[32:01.200 --> 32:04.700] So it was pretty small, but it was statistically significant.
[32:04.700 --> 32:07.520] And then the other question is, well, what could be going on here?
[32:07.520 --> 32:12.200] So first of all, this could be a spurious effect and as the researchers acknowledge,
[32:12.200 --> 32:18.480] we need to do this study with more individuals and with a more diverse population and we
[32:18.480 --> 32:21.600] need to gather more data to see like, is this real?
[32:21.600 --> 32:25.500] And if so, what are the, what's the probable mechanism?
[32:25.500 --> 32:33.520] For me, the big glaring omission in this test was that they did not test vitamin levels
[32:33.520 --> 32:41.660] before doing the study, because let's say older patients, older people do tend to have
[32:41.660 --> 32:45.380] lower vitamin B12 levels, for example, cause that's a hard vitamin to absorb.
[32:45.380 --> 32:48.040] You need a special molecule to bind to it.
[32:48.040 --> 32:53.400] It's called intrinsic factor and then sort of usher it over, you know, the gastric membrane.
[32:53.400 --> 32:58.000] So it doesn't just get passively absorbed and you know, that, that can decrease as we
[32:58.000 --> 33:02.480] age and people could become B12 deficient as we get older.
[33:02.480 --> 33:05.600] Pretty much I check it in every single patient that I have, cause it's just that one of,
[33:05.600 --> 33:10.120] it's a basic neurology lab that we do because it affects neurological functioning.
[33:10.120 --> 33:16.960] And you know, it's, it's a pretty high incidence of B12, either insufficiency or deficiency
[33:16.960 --> 33:23.620] in the population being studied here and you know, multivitamins typically contain B12.
[33:23.620 --> 33:32.200] So how do they know they're not just treating undiagnosed B12 deficiency in this population,
[33:32.200 --> 33:35.920] which has a measure, which is, has a known benefit to cognition, right?
[33:35.920 --> 33:40.760] As a known benefit in terms of dementia, you know, B12 deficiency contributes to dementia
[33:40.760 --> 33:44.320] and can cause it by itself if it's bad enough for long enough.
[33:44.320 --> 33:47.920] But so anyway, that seemed like a pretty big omission to me.
[33:47.920 --> 33:51.760] And I think that definitely a follow-up study would do that because that might, you know,
[33:51.760 --> 33:57.240] treating otherwise undiagnosed deficiency could be the entire explanation here, could
[33:57.240 --> 33:58.240] be the entire effect.
[33:58.240 --> 34:02.760] For the vitamin industry, isn't that also kind of their argument?
[34:02.760 --> 34:07.280] The there's an important difference though, between targeted supplementation and routine
[34:07.280 --> 34:10.040] multivitamin supplementation.
[34:10.040 --> 34:16.180] And there is known harm, at least, you know, correlations between routine multivitamin
[34:16.180 --> 34:20.600] use and, and other, you know, health, negative health outcomes like heart disease.
[34:20.600 --> 34:21.600] Right.
[34:21.600 --> 34:22.880] Cause you're taking too much of something.
[34:22.880 --> 34:23.880] Yeah.
[34:23.880 --> 34:27.800] And I'll tell you just from again, having tested vitamin levels on hundreds and hundreds
[34:27.800 --> 34:33.360] of patients of all ages, but certainly many of them older, um, you know, we diagnose levels
[34:33.360 --> 34:38.100] that are, that are too high as frequently as we diagnose levels that are too low.
[34:38.100 --> 34:42.200] And so often I'm telling my patients, stop this, stop that, and add this, you know what
[34:42.200 --> 34:43.200] I mean?
[34:43.200 --> 34:44.840] Like I'm, I have to direct their supplementation.
[34:44.840 --> 34:48.560] They're taking too much of certain things and not enough of other things.
[34:48.560 --> 34:49.560] That's very, very common.
[34:49.560 --> 34:56.840] So just, you know, a blanket multivitamin without any pre-testing of vitamin levels,
[34:56.840 --> 34:58.160] I don't think is the right approach.
[34:58.160 --> 35:02.280] I don't think the evidence supports that, but the, you know, the, the, the, all the
[35:02.280 --> 35:05.780] other evidence, if you look at it in its totality, it does support, there's a lot of instances
[35:05.780 --> 35:11.560] where targeted supplementation is proven to be effective and is, is good, you know, medical
[35:11.560 --> 35:16.520] management, but routine multivitamin supplementation really isn't.
[35:16.520 --> 35:21.000] And this study does not really answer that question because they didn't test vitamin
[35:21.000 --> 35:22.000] levels.
[35:22.000 --> 35:26.720] So, um, they didn't make the key distinction in my part, in my, in my opinion.
[35:26.720 --> 35:31.480] And of course a good scientific study should, but I guess for the devil's advocate thing
[35:31.480 --> 35:36.640] that I'm asking, just trying to kind of channel the people who take multivitamins regularly
[35:36.640 --> 35:43.280] is, is there a, is there a benefit to a certain percent of the population who you know are
[35:43.280 --> 35:48.120] not going to be going in for this routine testing, who you know are very likely not
[35:48.120 --> 35:54.880] on top of their levels, a just in case multivitamin, it just, does the good outweigh the harm?
[35:54.880 --> 35:58.520] So again, if you look at, you can't answer that question from looking at this study,
[35:58.520 --> 36:02.280] but because it's only looking at a certain number of things, but if you look at the totality
[36:02.280 --> 36:06.800] of the research into multivitamins, there seems to be a net negative, if anything, you
[36:06.800 --> 36:10.680] know, correlation with, with just taking a routine multivitamin.
[36:10.680 --> 36:13.580] Here's here's one reason why that could be a bad thing.
[36:13.580 --> 36:18.400] If you're in your sixties, you know, let's say like for seventies, the target population
[36:18.400 --> 36:22.220] in this study, you should be seeing your primary care doctor at least once a year.
[36:22.220 --> 36:26.000] So if you take a multivitamin and go, I don't have to see my primary care doctor, I'm taking
[36:26.000 --> 36:29.720] a multivitamin, that's, I'm covered, you know, that actually can have an unintended
[36:29.720 --> 36:31.520] negative consequence.
[36:31.520 --> 36:35.160] But it's hard to know how that all shakes out, you know, because there's, there's multiple
[36:35.160 --> 36:38.880] possible unintended consequences here.
[36:38.880 --> 36:42.600] But the thing is you should be seeing your primary care doctor at least annually.
[36:42.600 --> 36:47.540] And if you do, I guarantee you that they're checking your B12 level and other, and other
[36:47.540 --> 36:48.680] vitamin levels as well.
[36:48.680 --> 36:51.600] And if you certainly, if you have any neurological symptoms, you're going to get pretty much
[36:51.600 --> 36:56.080] a full metabolic screen, you know, nutritional screen, you should anyway.
[36:56.080 --> 37:01.560] And then you'll be able to take personalized, you know, targeted supplementation.
[37:01.560 --> 37:08.000] And so, you know, there, there may be negative unintended consequences here that are not
[37:08.000 --> 37:11.680] being picked up by this study, which is mainly concerned with cognitive function.
[37:11.680 --> 37:12.680] Yeah.
[37:12.680 --> 37:15.720] And by the way, there's another consideration here and I'll use a personal anecdote.
[37:15.720 --> 37:21.400] I, you know, did have B12 testing when I was struggling, have been struggling with some,
[37:21.400 --> 37:28.960] some specific symptoms and my physician recommended, and same thing actually with iron.
[37:28.960 --> 37:34.440] So I was iron deficient and B12 deficient and sure, I could have like done targeted
[37:34.440 --> 37:38.480] supplementation by going down the vitamin aisle, but these are like not FDA approved
[37:38.480 --> 37:40.120] and I don't really know what's in them.
[37:40.120 --> 37:43.260] And you know, this is, they're not regulated very well.
[37:43.260 --> 37:46.820] And ultimately I had some issues with absorption, like with like gut problems from trying to
[37:46.820 --> 37:48.240] take a oral iron.
[37:48.240 --> 37:54.640] So whatever I was able to do B12 injections and I ended up having to get iron infusion.
[37:54.640 --> 37:59.400] So now I'm getting prescription medication that I know is FDA approved.
[37:59.400 --> 38:02.880] I know it's made in a lab, it's clean, it's been tested.
[38:02.880 --> 38:05.640] And the same is true of many oral vitamins as well.
[38:05.640 --> 38:12.920] And, and I write prescriptions for vitamins to my patients so they know exactly what they're
[38:12.920 --> 38:15.120] getting and what dose and everything.
[38:15.120 --> 38:16.280] And that's the other thing.
[38:16.280 --> 38:21.840] If I'm prescribing B12 supplements to a patient who has B12 deficiency, who's whatever in
[38:21.840 --> 38:26.400] their sixties or seventies, I then have to check followup levels because they may not
[38:26.400 --> 38:27.760] be absorbing the B12.
[38:27.760 --> 38:28.760] It may not work.
[38:28.760 --> 38:29.760] You know, oral B12 may not.
[38:29.760 --> 38:30.760] That's what happened to me.
[38:30.760 --> 38:31.760] Yeah.
[38:31.760 --> 38:32.760] And then you have, then you have to get the injections.
[38:32.760 --> 38:35.200] You have to bypass the gut and do the injections.
[38:35.200 --> 38:42.160] So again, just taking a multivitamin may not be addressing the actual, the actual problem.
[38:42.160 --> 38:46.720] And if people are doing that, instead of getting their levels checked, that could have a net
[38:46.720 --> 38:47.720] negative level.
[38:47.720 --> 38:51.520] So you have to compare it to, you know, like best practices also.
[38:51.520 --> 38:52.520] Yeah.
[38:52.520 --> 38:56.920] It still could be true that, you know, there's an intention to treat analysis here, although
[38:56.920 --> 39:00.360] I will say that there was about a 10% dropout, which they didn't count.
[39:00.360 --> 39:03.680] And you know, that was probably enough people to affect the outcome of the study because
[39:03.680 --> 39:06.520] the effect sizes were not that huge.
[39:06.520 --> 39:10.040] And you have to wonder why that, you know, there was that dropout and what did, what,
[39:10.040 --> 39:11.440] what was going on with those individuals.
[39:11.440 --> 39:12.440] Right.
[39:12.440 --> 39:13.440] Did that bias the outcome?
[39:13.440 --> 39:14.440] Yeah.
[39:14.440 --> 39:15.440] Right.
[39:15.440 --> 39:16.440] Exactly.
[39:16.440 --> 39:17.520] You know, that's, that's why you have to disclose the dropout rate.
[39:17.520 --> 39:19.800] But in any case, yeah, I mean, the thing is, yeah, sure.
[39:19.800 --> 39:24.040] Some people in the study were probably helped by taking, by taking a multivitamin.
[39:24.040 --> 39:25.040] That's true.
[39:25.040 --> 39:30.280] But you know, we definitely, my concern is that because there's already a huge cultural
[39:30.280 --> 39:35.760] impetus to just take a multivitamin just in case, that if people get the bottom line message
[39:35.760 --> 39:39.560] from this, that taking the multivitamin is good and that's all they have to worry about,
[39:39.560 --> 39:41.800] that could have a net negative effect.
[39:41.800 --> 39:45.640] And that we really do want to get the message out that, you know, vitamins are a medical
[39:45.640 --> 39:46.640] intervention.
[39:46.640 --> 39:50.200] You know, you do need to have your levels checked, especially when you get older, especially
[39:50.200 --> 39:55.800] if you have certain medical concerns or symptoms and things need to be done in an evidence
[39:55.800 --> 39:58.120] based way, not just shooting from the hip.
[39:58.120 --> 39:59.120] Take a multivitamin.
[39:59.120 --> 40:00.120] Don't worry about it.
[40:00.120 --> 40:01.120] Right.
[40:01.120 --> 40:04.080] Like you wouldn't take an, well, maybe aspirin is different, but I wouldn't take like a
[40:04.080 --> 40:08.280] full dose of ibuprofen every day just in case I'm going to get a headache.
[40:08.280 --> 40:12.040] That's dangerous.
[40:12.040 --> 40:16.480] The dose ranges are pretty broad for vitamins, but you know, but we do see vitamin toxicity
[40:16.480 --> 40:17.480] does happen.
[40:17.480 --> 40:18.480] Yeah.
[40:18.480 --> 40:20.320] Because you don't know what else, you don't know what else they're, they're having their
[40:20.320 --> 40:23.000] regular diet, what else they're consuming.
[40:23.000 --> 40:26.080] And sometimes when people are really doing it, like for these health, they're taking
[40:26.080 --> 40:30.640] like thousands, the plural percent of like the recommended daily intake.
[40:30.640 --> 40:32.840] Well, the other thing is, yeah, they might be taking too much.
[40:32.840 --> 40:33.840] They don't know what dose to take.
[40:33.840 --> 40:35.240] The other thing, or they might be taking too little.
[40:35.240 --> 40:36.760] That's the other thing.
[40:36.760 --> 40:42.480] There are, like I've had patients who've had like, you know, vitamin B6 levels that are
[40:42.480 --> 40:47.800] 10 times the upper limit of normal, like really super high levels.
[40:47.800 --> 40:51.720] And they tell me that they don't know that they're not supplementing.
[40:51.720 --> 40:57.120] The thing is there's so much embedded supplementation in, you know, food.
[40:57.120 --> 40:58.600] Oh, like fortified foods.
[40:58.600 --> 41:03.480] Fortified, like are you drinking vitamin water or whatever, the cereal, whatever, that they're,
[41:03.480 --> 41:08.360] they're might be getting too much of certain vitamins without specifically taking a multivitamin
[41:08.360 --> 41:10.560] or specifically supplementing.
[41:10.560 --> 41:14.040] So again, it's why it's good to sort of have a conversation with them about like what they're
[41:14.040 --> 41:17.840] eating and what they're not eating and then, and what their levels are and, and again,
[41:17.840 --> 41:23.080] try to give them some specific personalized advice about their diet as well as, you know,
[41:23.080 --> 41:26.000] what may or may not need to be supplemented.
[41:26.000 --> 41:28.320] That's the direction I definitely would like to see things go.
[41:28.320 --> 41:31.640] And that's, you know, I think neurology is there for the things that we are concerned
[41:31.640 --> 41:36.440] about because, you know, actual deficiencies in the, in these vitamins can cause neurological
[41:36.440 --> 41:40.680] symptoms and dementia being a big one, you know, so, you know, we're kind of already
[41:40.680 --> 41:41.840] all over that.
[41:41.840 --> 41:49.400] But anyway, it's and again, this is one study embedded in a very, you know, decades of research
[41:49.400 --> 41:51.960] showing results kind of all over the place.
[41:51.960 --> 41:56.840] So we can't, you know, look at this as if this is conclusive, you know, we definitely,
[41:56.840 --> 42:01.480] I would definitely like to see, you know, better controlled, more thorough, larger studies
[42:01.480 --> 42:05.280] with more diverse population and, you know, see, and see if there's a consistent effect
[42:05.280 --> 42:06.280] here.
Refreezing the Poles (42:07)
Neuro Emotional Technique (55:50)
- The Neuro Emotional Technique Is a Bizarre Hybrid of Chiropractic, Acupuncture, and Applied Kinesiology[7]
Who's That Noisy? (1:07:17)
J: ... I did. This Noisy has appeared on the show before.[link needed]
New Noisy (1:12:05)
[gibberish song with trumpet and percussion beat]
J: So if you think you know what this week's Noisy is ...
Announcements (1:13:06)
Questions/Emails/Corrections/Follow-ups (1:16:39)
Followup #1: Chess Cheating
Science or Fiction (1:23:43)
Theme: Global Warming Item #1: A survey of 48 coastal cities finds that they are sinking at an average rate of 16.2 mm per year, with the fastest at 43 mm per year. (For reference, average global sea level rise is 3.7 mm per year.)[8]
Item #2: A recent study estimates the total social cost of releasing carbon into the atmosphere at $185 per tonne, which is triple the current US government estimate. (For reference, the world emits >34 billion tonnes of CO2 each year.)[9]
Item #3: The latest climate models indicate that even with rapid decarbonization it is too late to prevent eventual warming >1.5 C.[10]
| Answer | Item |
|---|---|
| Fiction | Too late to prevent >1.5 °C |
| Science | Carbon release estimate |
| Science | Cities are sinking |
| Host | Result |
|---|---|
| Steve | win |
| Rogue | Guess |
|---|---|
David | Cities are sinking |
Jay | Too late to prevent >1.5 °C |
Bob | Too late to prevent >1.5 °C |
Evan | Too late to prevent >1.5 °C |
Cara | Too late to prevent >1.5 °C |
Voice-over: It's time for Science or Fiction.
David's Response
Jay's Response
Bob's Response
Evan's Response
Cara's Response
Steve Explains Item #2
Steve Explains Item #1
Steve Explains Item #3
Skeptical Quote of the Week (1:41:09)
In the field of thinking, the whole history of science – from geocentrism to the Copernican revolution, from the false absolutes of Aristotle's physics to the relativity of Galileo's principle of inertia and to Einstein's theory of relativity – shows that it has taken centuries to liberate us from the systematic errors, from the illusions caused by the immediate point of view as opposed to "decentered" systematic thinking.
– Jean Piaget (1896-1980), Swiss psychologist
Signoff
S: —and until next week, this is your Skeptics' Guide to the Universe.
S: Skeptics' Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information, visit us at theskepticsguide.org. Send your questions to info@theskepticsguide.org. And, if you would like to support the show and all the work that we do, go to patreon.com/SkepticsGuide and consider becoming a patron and becoming part of the SGU community. Our listeners and supporters are what make SGU possible.
Today I Learned
- Fact/Description, possibly with an article reference[11]
- Fact/Description
- Fact/Description
Notes
References
- ↑ MPR: Arctic ice shrinks to all-time low; half 1980 size
- ↑ Ars Technica: Here are the winners of the 2022 Ig Nobel Prizes
- ↑ NYT: Go Ahead, Ask for Help. People Are Happy to Give It.
- ↑ Bitcoin Magazine: Can fedimints help bitcoin scale to the world?
- ↑ [url_from_news_item_show_notes Alzheimer's Association: Effects of cocoa extract and a multivitamin on cognitive function: A randomized clinical trial]
- ↑ Institute of Physics: Refreezing Earth's poles feasible and cheap, new study finds
- ↑ McGill: The Neuro Emotional Technique Is a Bizarre Hybrid of Chiropractic, Acupuncture, and Applied Kinesiology
- ↑ NTU Singapore: Rapid land sinking leaves global cities vulnerable to rising seas
- ↑ Nature: Comprehensive Evidence Implies a Higher Social Cost of CO2
- ↑ One Earth: Achieving the Paris Climate Goals in the COVID-19 era
- ↑ [url_for_TIL publication: title]
Vocabulary
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