How I learn: From knowledge to application

"Nothing in biology makes sense except in the light of evolution" 

                -Theodosius Dobzhansky

Many of the topics that I discuss in this blog are controversial and do not have a clear cut answer. Some of the ideas conflict with conventional wisdom and institutional or government recommendations. The purpose of this post is to explain why and how these conclusions are attained.

Learning is a constant pursuit of knowledge; a persistent attempt to delve in to the true nature of an issue. My basic philosophy is that knowledge must be evidence-based. For this reason, my ideas are never static, they reflect the greatest preponderance of quality evidence available. As new evidence becomes available, my ideas will change and update. I am an epistemocrat, as defined by Nassim Taleb, "one who holds his own knowledge in the greatest suspicion".

Confirmation bias is "a tendency for people to favor information that confirms their preconceptions or hypotheses regardless of whether the information is true." The human brain will naturally want to believe things that are in accordance with what it already believes; it's own confirmation bias. We try to fit all new information in to the lens of our world view. Sometimes this provides a barrier to learning if we hold any belief too close to our core values. This is why I always seek out information that could possibly disprove the ideas I hold to be true. If you consistently fail to prove a well supported theory wrong, it strengthens it much more than if you are always looking for evidence to prove it right.

To really understand something, we must keep our minds open but think critically about everything we learn. Seeking new information is good; believing things without evidence is not. In the pursuit of knowledge we must understand systems and look through a systems thinking point of view: how does it fit in to the larger system? This method of learning contrasts the reductionist "nutritionism" that has dominated the field of health for several decades. As Michael Pollan describes it, "nutritionism" is assessing the qualities of nutrients in a vacuum, as opposed to assessing them based on how the interact together and with other systems". In real life, nutrients are not isolated from each other.

Thinking in systems provides a useful tool for explaining the behavior of a system and the function of a part of that system. The function of a system is often not revealed just by summing up the parts. For example, the different parts of a car interact to produce an effect that would not be evident by looking at each part individually. The performance of a system does not depend on the parts, it depends on how the parts interact with each other. The human body is the same way; the overall function of the system can not be explained by looking at each organ and structure, it has to be explained by looking at how the parts interact together to create an entirely new behavior. The human body is a complex network of systems within systems that all tie in together and are regulated by integrated feedback loops. Keeping this in mind while studying health is very important. Small changes have effects on multiple body systems.

An example of how reductionist thinking can cause harm: Statins, the most profitable drug in the world work by blocking the rate-limiting enzyme for cholesterol in the liver and all extra-hepatic tissues (brain, adrenal glands, reproductive organs). This effectively reduces cholesterol levels; unfortunately they systemic effects are often ignored by doctors:

"Statin use was associated with... increased risks of moderate or serious liver dysfunction, acute renal failure, moderate or serious myopathy, and cataract. Adverse effects were similar across statin types for each outcome except liver dysfunction where risks were highest for fluvastatin." (1)

So where statins do reduce cholesterol (and have a small effect on cardiac risk in very specific disease population), they also cause systemic problems associated with these reductions. See how reductionism can get us in trouble?

When looking at health and exercise, my strategy for finding the nature of an issue is to look at it through the scope of different disciplines, and see how they integrate in to a whole. Looking at the evidence from just one discipline can be misleading at times, you must integrate it in to a general theory of how the systems work together. In health I look at the evidence from evolution, physiology, biochemistry, epidemiology, anthropology, clinical studies, and individual case studies. This is how I evaluate all information; based on how it fits in with other knowledge.

The ultimate proving ground is the real world; what works in real life. In the end, we always see if the application of information creates real world results.


Sources:

1. Unintended effects of statins in men and women in England and Wales: population based cohort study
    using the QResearch database. Julia Hippisley-Cox, Carol Coupland
    BMJ 340:doi:10.1136/bmj.c2197 (Published 20 May 2010)
         Full Text: http://www.bmj.com/content/340/bmj.c2197.full