The Arrow #128

Hello friends.

Greetings from Montecito.

Where it is still cold, clammy, and misty. According to a long-time resident I spoke with yesterday, this weather has set some sort of record. He said it was the fewest hours of sunshine during the month of May since records have been kept. I didn’t look it up, but I believe it. And it has carried over into June. We haven’t had a sunny day since the month started.

The great shredding continues. MD has been tearing through all the boxes we know we need to shred, converting a couple per day into shards. Her goal is two per day. Her other goal is to hound me mercilessly to start going through all the boxes in another stack—the ones we need to go through before shredding stack—and pluck out anything worth keeping.

So, I did. I went through an old box containing many of the Thin So Fast files.

As most of you probably know, back in 1988 I wrote a book on the protein-sparing modified fast called Thin So Fast. In going through the box filled with most of the proposals, correspondence, and contracts concerning that book, I found a handful of interesting documents that I thought you might find entertaining.

A Short Segment of Low-Carb History

MD and I started one of the first chains of what are now called urgent care clinics in the country. At the time, these clinics were called free standing emergency clinics. We ended up with four different locations throughout central Arkansas. Now urgent care clinics are all over the place and most of them are owned and operated by hospitals or large medical groups. Back when we started our first clinic, they were hated by hospitals and all the other doctors in town. Despite being loathed by all—at first, at least—we ended up with the largest general practice in central Arkansas.

In the early days of our operating these clinics, I began to gain weight. Which was a strange experience for me as I had been thin all my life. At the time, a hospital-based program called Optifast was starting to gain some traction. I didn’t know much about the program until I ended up taking care of a few patients (for general medical issues) who were going through it. From these patients I learned a bit about the program, namely that it involved protein-shake meal replacements and was very expensive.

One day while flipping through a medical journal, I came across an ad by a company called Jason Pharmaceuticals for an in-office fasting program that sounded much the same as the hospital-based Optifast program. The program offered by Jason Pharmaceuticals was called Medifast. Hmm. Similar name, therefore probably a similar program.

I ordered the introductory kit, which included a dozen or so packets of Medifast protein powder and the instructions on how to mix it. Along with this came a binder with a few papers in it on the benefits of the protein-sparing modified fast (PSMF) and a 50 or so page instruction manual on how to put patients on the program.

Due to my own burgeoning obesity, I had begun to root through the scientific literature on obesity. When I read the few papers included in the binder, I noticed they discussed the benefits of cutting carbohydrates. I thought this kind of strange as we were in the midst of a huge media and government campaign to cut fat from the diet. I had sense enough to know that since there are only three macronutrients—fat, protein, and carbohydrate—if you change one, you pretty much have to change the others. I figured if you dropped the carbs, you would have to increase the fat and/or protein. But there was a huge fear at the time about protein damaging kidneys. So you really couldn’t increase the protein very much. Which left only fat. And according to everything I read everywhere, again at the time, fat was bad.

I had ordered the info on Medifast to see if it could be a useful program for patients in our various clinics and also to see if it might be something I could do myself. Before using it on any patients, I decided to give it a go on my own. Which I did. And I lost weight nicely. As I recall, there was a little quiz in the material that I needed to take and send to Jason Pharmaceuticals to demonstrate my understanding of the program. I took the quiz and was duly rewarded with a plaque to show the world I was a participating physician in the Medifast program.

After I had lost 20 or so pounds with no real effort (other than avoiding food and drinking five shakes per day) I decided to start putting patients on Medifast. And at the same time, I started fiddling with the program a little. I added a real meal per day, mainly because that’s what I switched to myself shortly after starting on the program.

After a few years of taking care of patients on the Medifast program—which I continued to diddle with here and there—I realized that there had been no serious side effects from any of the many patients I had treated. No problems with bloodwork, which virtually always improved. I saw no real reason that people needed to have a doctor follow them weekly, as the Medifast protocols demanded. The only problem was, where to get the protein shakes?

Given that entire walls of grocery stores and health food stores today are filled with an enormous variety of protein powders, it’s difficult to believe that back in the 1980s, there were almost none. And those that were available were not flavored. They tasted like absolute crap. All were made for bodybuilders and were designed to be mixed into other foods, applesauce, for example. There were no meal replacement protein supplements people could buy off the shelf and use for a PSMF.

The more I thought about it, the more I thought maybe I should write a book about my experiences with the PSMF. And I could tell people how to do it on their own without have to pay the (literally) thousands of dollars to go to a hospital-based Optifast program or a program like the one I ran in our clinics.

As I quickly learned, there were a number of stumbling blocks in this process. First, I had no idea about how to go about contacting a publisher to pitch my idea. Second, I had no idea how to come up with a recipe for the protein shake.

In situations like this, my first impulse is to go to the bookstore and look for a book on how to do it. For everything that has ever been done, there is someone who has written a book about how to do it. (Nowadays it would include a blog, article, or video online.) I hastened to my local Barnes & Noble, which had just recently opened, and looked for a book on how to get a book published. I figured that was the first step. What point was there to cooking up a protein shake powder if I didn’t have a book to write about it in?

I found a book titled The Awful Truth About Publishing: Why They Always Reject Your Manuscript and What You Can Do About It, which I still have today. It provided me with step by step instructions on how to go about getting a book contract. I discovered that most people who want to get published send their manuscript to a publisher. Where upon receipt it immediately goes into the slush pile. These books almost never get read. The author of the book I bought said if you wanted to get published, you needed to go through the following process. You write a book proposal outlining in detail the book you want to sell to the publisher. This proposal contains a section about you, about why you are qualified to write this book, a section on how the book is different from all the other books out there on the same subject and a listing of similar books, and a chapter by chapter layout of your book. Plus, in many cases, a sample chapter.

Once you’ve got the proposal finished, then—and this is the critical part—you write a query letter to a specific editor in each publishing house you’ve picked out as a potential for your book. How do you find these editors? Easy. You go to the bookstore and look through the acknowledgments section in books in your genre to find the name of the editor, who is almost always thanked by the author. Then you write to that editor directly at the publisher’s address.

So, off I go again to the bookstore, where I find a bunch of books on diet. I copy the names of the editors and the address of the publishing house, which is always listed in the front.

Once I’m in possession of all this information, I set to work. First, I lay out a sort of chapter outline for the book proposal I’m going to write. Then I think to myself, wait a minute here… If I write this long book proposal (most book proposals are 50 or so pages) and no one wants the book, I’ve wasted a huge amount of time. Instead of writing the proposal, I’m just going to send out letters to the various editors asking if they would like to see the proposal. If I get any interest, then I’ll go to the trouble of writing a proposal. That’s the thinking man’s way of approaching the task. [The bride is just shaking her head. As she did when I decided to fire off these letters first and write the proposal later.]

So I put all my efforts into writing the query letter. I didn’t want to think about a 50 page proposal, because, at this point in my life, the longest thing I had ever written was probably a five page theme in college. And even that opus was, I’m sure, turned in late. Fifty pages of anything were more than I could contemplate.

I mailed the query letter to about 15 different editors. Everything I had read led me to believe the publishing industry works slowly, so I wasn’t expecting to get any replies for weeks.

Just in case you’re wondering what the query letter said, here is a copy. I can’t remember if I sent this one out or not, but it was in the box.

Within a week, one editor had written back asking for a proposal. Within two weeks seven had written back. I was stunned. I was also in a blind panic as I had to crank out 50 pages in a matter of days. When I was in college, if a professor had told me on the first day of class that I had to write a 25 page paper by the end of the semester, I would have felt totally ill used. And would probably have dropped the class. That’s how much I loved writing.

Thank God I already had the chapters laid out. Nothing written, but at least I knew what the chapters were going to be about. In one long weekend, I wrote the proposal.

I sent it off on Monday and waited. Within a week or so, I began getting rejection letters, which threw me into a funk. Then, out of the blue, I get a letter from an editor at Warner Books asking me if I’ll come to New York and meet with her and the Warner team.

MD and I hopped a plane and flew to NYC. MD stayed in the hotel while I met with the folks at Warner. It was a terrific meeting. The editor took me to a big corner office to meet with the managing editor and a group of other folks. She introduces everyone around the room—there were maybe 15 people in there—then she says, “Dr. Eades, you’re on the Oprah Winfrey show and you have two minutes to persuade us, the audience, why we should buy your book.”

I hadn’t known what would happen when I went to Warner Books, but I hadn’t anticipated this. Fortunately, I had spoken with enough patients over the years that I knew all the hot buttons. I just pretended the audience were patients and started talking.

When I stopped talking, the gallery all started peppering me with questions, which were the same questions patients all asked, so I answered them well enough. The woman who was to soon be my editor asked me if I had an agent. I told her I didn’t. She then said Warner was interested in my book, but would much prefer to negotiate with an agent.

She gave me the name of an agent who was accepting new clients. I called her and MD and I met with her the next day. I signed on, and she negotiated me a nice advance the next day after that.

We flew home and all the contract negotiations started. The advance—which is the important part—was done on a handshake, but there are a million other details, about which I knew nothing, that had to be worked out.

Then I started writing. Which is a task I had loathed probably since the first grade. But I soon took to it and found out that not only was I halfway decent at it, but that once I got going I actually enjoyed it.

As time went on and the number of written pages mounted, I kept worrying about the actual protein shake powder recipe I had promised in the proposal. Finally, I was near the end and still no recipe. So, before I had some sort of mental breakdown, MD started fiddling with stuff to see what she could come up with. As I mentioned above, there were a few protein powders available, but taste-wise they sucked. MD combined those with non-fat dry milk and a little bit of fructose (I know, I know, but at the time fructose was hailed as a better sugar because its glycemic index was lower than that of sucrose) along with some No Salt, which is potassium. And she added a bit of cocoa powder in for an alternate flavor.

When she mixed this all together, it tasted pretty much like the Medifast powder. The protein powders used in the Optifast and Medifast programs were meant to be blended with ice and diet sodas to suit the drinker’s taste. It sounds kind of revolting now when most of the currently available protein powders mix like a shake. But back then, they didn’t—they were just raw protein. The diet soft drinks provided the taste and the ice provided the consistency. Pour a diet Dr. Pepper (or whatever) in a blender, add the protein powder, a handful of ice, and blend. Awful as it sounds even to me now as I type these words, it was actually pretty good and filling. Rich and sweet and kind of creamy.

Once we (MD primarily) had cobbled together the protein shake powder, my angst vanished and I finished the book. The next part to come is an almost unbelievable coincidence.

I don’t know how many of you were Oprah watchers back then, but at that time, we’re talking later 1980s here, she was on a secret diet she was going to reveal when she hit her goal weight. People were speculating as to what kind of diet could be giving her the results viewers could see daily. Media-wise it was a huge deal. Everyone wanted to know what Oprah was doing.

When I finished the manuscript of the book, I took it to the FedEx (there was no electronic sending of anything back then) and sent it off. I came back to the clinic, and everyone was in the back in the break room watching Oprah, because that was the day she was going to reveal her diet. She came out in her size 8 Calvin Klein jeans, pulling a little red wagon carrying 67 pounds of fat, which represented how much she had lost. And she revealed that she had lost it on Optifast.

The very next day Warner received the completed manuscript of a book telling people how they could do what was essentially the Optifast program themselves at home without paying thousands of dollars. The people at Warner Books thought they had died and gone to heaven. They were beside themselves with joy because it was all Oprah all the time on the media. Which, as it turned out, was not such a good thing for them, or me, but we’ll get to that later.

The original pre-Oprah plan was for the book to come out in December of 1989 to be ready for diet season on Jan 1, 1990. Which is typical. Usually when you get a book contract, you have nine months to a year to write the book, then it takes the publisher about another nine months to a year to get it out. Which was the plan with my book. But Oprah’s revelation changed all that.

I sent the finished manuscript off on November 15, 1988. The book was in bookstores by early January 1989. Talk about a rush job. They flew me to NYC to copy edit the book. The copy editor was in one room; I was in another; and someone shuttled the pages back and forth. I went through kind of a rinky dink media training course (if you could call it that) to prepare me for the upcoming book tour in mid-January.

During this frenzied preparation for the early release of the book, I got blindsided by an attack that threatened the book’s publication. So from early December through early January not only was I mired in editing and getting trained for media assaults, I was fighting this other battle I hadn’t anticipated.

Here’s what happened.

Back in the early days of my writing the book, William Vitale, M.D., the founder of Medifast (and the guy who signed my Medifast diploma shown above), somehow got wind that I was writing a book on the PSMF. He reached out to me, congratulated me on getting a book deal, and said he and his wife were going to be in Little Rock and would like to take my wife and me to dinner. I kind of knew that was all bullshit, because no one ever just happens to be in Little Rock. You have to be going to Little Rock to get there. It isn’t a stopover for anywhere else. I said, Sure, we would love to have dinner.

He gets into town, and we meet for dinner. He was a great guy and his wife was lovely. He didn’t really ask what the book was about other than it was about the PSMF. He asked if I would consider letting him write a foreword to the book. I said, sure. I figured having his imprimatur would help sales, and I’m sure he figured the book would help Medifast. MD and I always went to the big academic obesity meetings, so we met up with him again at one of those. And he bought us a nice dinner yet again.

When I sent the completed manuscript to Warner, I told them to send a copy to Dr. Vitale whenever they got it into galley form, so he could read it and write his foreword. Which they did.

I was way down in the backyard of our house late one afternoon doing some sort of dirty manual labor when MD yelled at me that Dr. Vitale was on the phone. I trudged up and said Hello. He proceeded to unleash a torrent of invective on me that I couldn’t believe. I figured he might be a little pissed when he read about how people could make the stuff themselves, but I figured he would get over it when he realized the Medifast name would be on the book and he would reap a lot of PR. I had badly misjudged. He screamed at me. He told me I would be responsible for the deaths of thousands of people if my book saw the light of day, and that he was going to do everything he could to stop publication. Then he hung up on me.

I didn’t know what to think. But then my red neck Scots-Irish genes kicked in, and I fought back. I figured two could play this game. I wrote him the following letter.

Dr. Vitale (by that time it was way past the Mike and Bill phase of our relationship) then contacted Warner Books and basically told them the same thing he told me. The blood of thousands of people would be on their hands if my book saw the light of day. Etc., etc., etc.

Which, of course, got the Warner lawyers’ attention. They then sent the manuscript out for a second opinion, which came back with a few questions. Which I answered to their satisfaction.

When Warner didn’t crumble after Dr. Vitale’s phone call, he followed up with a strong letter referring to the letter above I wrote to him.

Vitale was bringing out all the big guns to go after me. I guess he knew George Blackburn (RIP), who was a Harvard professor and one of the developers of the Cambridge diet (as I recall). He had Blackburn write a letter to Warner (none of the others on the list did, which led me to believe it was all simply for intimidation purposes). Warner duly forwarded Blackburn’s letter to me, so I could answer his criticisms of my book. The folks at Warner also told me they had been in discussions with Blackburn about his writing a book for them, which he mentioned in his letter. In comparison to mine, he said, his would be a “real book.”

When I read Blackburn’s letter, I was stunned. Not because he had any serious criticisms that might have derailed my book, but because it was totally illiterate. Grammatically, it looked like it had been written by a third grader from a bad school who skipped class a lot. Unfortunately, I have not found his letter yet, but I’ll post it here when I do.

I did, however, find the first page of the letter I wrote back to Warner about his criticisms. It’s only the rough draft and has my edits, but you’ll get an idea of my response. By this time I was pissed, so I didn’t hold back. I specifically used Barry Sears’s name because Barry and Blackburn were friends.

That was pretty much the end of it. I had one more indirect attack from Vitale, but it was more a capitulation than anything else. In his next periodic newsletter to physicians using Medifast, there appeared on the back page his final salvo.

By this time the book had been out for a few weeks, and I didn’t notice it had any impact on sales.

The book didn’t sell as well as they’d hoped (they printed a 150,000 first run, which is unheard of for an unknown author.) Warner sent me on a three-week book tour, which was a total nightmare. A city a day for three weeks. It seemed like a lifetime. Problem was that the book company couldn’t get me any decent media because all the main stations had already done their piece on Oprah and her diet. We’ve just done protein sparing fasting, they’d say. I learned a lot about the media on that seemingly never-ending tour, and one of the things I learned was that timing is everything. Had the book already been available at the time Oprah made her announcement, it would have immediately become a bestseller, and I would have been on every television station in the country.

As it was, I kind of got smallish shows and second tier markets that didn’t have a lot of coverage. And, in a logistical screw up, since my itinerary changed as the shows Warner could get okayed an appearance, the folks selling the books into bookstores had them in places where I got no coverage and didn’t have them in places I did. Remember, this was long before there was an internet as we know it today. The only place people could buy books was in a bookstore. So if there were no books in the stores, there were no sales.

Our eldest kid was in college at the time at Washington & Lee. He flew in and out of Washington, DC when he didn’t drive back and forth coming home. He told me there were huge stacks of Thin So Fast at the airport in DC. But, unfortunately, there was no media booked in DC. The only place I went on the entire tour where there was both good media and plenty of books was Seattle, and Thin So Fast became a Seattle bestseller, but that was about it.

Here is a snapshot someone took of me at one of my many book signings during the tour. I have no idea where it was. I just found it in a file in the box. Nothing noted on the back of it. It was a little printed snapshot and didn’t reproduce very well.

In a coda to this long, dreary tale, I’ll leave you with one last tidbit. Almost ten years ago, I had to give a talk on what it was like in the early days of low-carb. I wanted to tell this story, but I didn’t have all the info I found in this one box. Because, of course, the box was in storage somewhere, and I had no idea where.

I wanted to find out what had happened to Dr. Vitale and see if he was still involved with Medifast. I did an online search and came across what I think was his obituary in the Baltimore Sun newspaper. RIP.

I copied this part of the obituary (if that’s what it was) to put in a slide for my talk. James vitale is Dr. Vitale’s son.

So, Dr. Vitale himself did the same thing MD and I did. He fiddled around in his kitchen and came up with a ripoff of Optifast. And then had the nerve to take me to task for doing what he did.

There was one last bit of treachery to all this. As I wrote above, MD and I always went to the big academic obesity meetings. In 1989, the year Thin So Fast hit the bookstores, the meeting was in Washington, DC. MD and I went only to find that George Blackburn, Harvard professor, and illiterate letter writer was to give a presentation on how people could safely do the PSMF at home. We attended, but Blackburn didn’t give the talk. He sent an underling. But it was the same thing as in Thin So Fast, except he was developing a company to sell the protein powder. We just had to shake our heads.

All the BS I went through with Thin So Fast, MD and I have gone through to one extent or another with all of our books. Nothing has been hassle free. Which is why I refuse to write a crappy review of a book. If I hate the book, I just don’t write about it. I know what it takes to go through the process, so I don’t want to diss anyone who has done it.

I have one small favor to ask. As I wrote above, I think the quote from James Vitale is from his father’s obituary. Which I would like to have in its entirety. What I put up came from the slide I made for the talk, but I copied it from the article/obituary I found online.

I tried to google it and came up with this, which shows the first few lines in the piece.

When I tried the link, it took me to today’s Baltimore Sun. If any of you reading this live in Baltimore or have a subscription to the Sun, maybe you could find the entire article. The paper has probably archived it. Thanks in advance for checking.

Although Thin So Fast was a disappointment to Warner Books and to me, it paved the way for things to come. In the next year or so, I came up with the insulin diagram I showed in last week’s Arrow. I began moving patients away from the protein shake supplements and onto whole food diets. I tried to get Warner to buy a follow up book on all this—contractually I was required to offer them my next book—but they had no interest and turned me down. Which released me to sell it to anyone.

I wrote the proposal for what turned out to be Protein Power and my agent submitted it to many publishers. William Morrow signed me on, and it was off to the races. Except that there were all kinds of battles brewing on that one. More even than with Thin So Fast. Which I’ll maybe relate another day.

Suffice it to say that despite all the hassle in getting Protein Power published, unlike Thin So Fast, it did not turn out to be a disappointment.

Speaking of Protein Power…

Protein Power and AI & Misc AI

A few days ago I received an email from a reader who had been playing around with Artificial intelligence.

This may amuse you. I asked ChatGPT to give an account of your dietary philosophy in the language of the King James Bible. It said it couldn’t do that and could only give me general dietary advice—which amounted to an injunction to practice “moderation”. I then asked it to give an account of your dietary philosophy as expressed in Protein Power. It complied but appended a warning that “dietary philosophies can vary” and I needed to seek professional medical advice. I then asked it to take the summary it had just given and express it in the language of the King James Bible. Here is how it responded:

I’ve got to admit that I would never have thought of this, but I kind of like how it came out. After all one of the things you are supposed to do as an author is write in an authoritative tone. Anything coming from a sacred document is pretty authoritative.

Verily, I shall convey unto thee the dietary philosophy as professed by Dr. Michael Eades, as set forth in the sacred tome known as "Protein Power." Hearken unto these precepts:

1. The significance of Protein: Behold, the Eades extol the virtues of protein, for it is deemed a vital substance that nourishes the body and sustains its functions. Yea, it curbs hunger, promotes muscle growth, and bestows health upon mortal souls.

2. Restriction of Carbohydrates: Lo, the Protein Power Plan doth counsel the limitation of carbohydrates, especially those refined and high-glycemic in nature. Forsooth, excessive consumption of such comestibles is said to breed insulin resistance, weight gain, and sundry maladies.

3. Control of Insulin: Aye, the Eades exhort the diligent governance of insulin through wise choices of sustenance. By curtailing carbohydrates, particularly those that swiftly elevate blood sugar, they seek to forestall surges in insulin and foster righteous control of the sacred life force.

4. Awareness of Glycemic Load: The notion of glycemic load, which doth consider the measure and quality of carbohydrates, holdeth sway in the Protein Power Plan. The Eades entreat thee to partake of foods with low glycemic load, which gentler upon the blood sugar doth play.

5. Sufficiency of Fat: Whilst the Protein Power Plan doth not espouse a meager fat intake, it doth encourage the inclusion of wholesome fats. Behold, avocados, nuts, olive oil, and fatty fish are deemed worthy, as they contribute to a balanced regimen of sustenance.

6. Personalization and Endurance: Yea, the Eades proclaim the value of tailoring the diet to each individual's needs and proclivities. They advocate for a flexible approach that may be sustained throughout the ages, accounting for personal goals, metabolism, and the rhythm of one's life.

Take heed, however, that the interpretation of such sacred teachings may vary, and individual responses to these precepts may diverge. I counsel thee to seek counsel from wise healers or learned dietitians ere thou embark upon profound alterations to thy diet or thy life.

All the above, including the numbered paragraphs were in the ChatGPT output, but, for whatever reason, Substack would not let me put the numbered list in quotes.

One other thing… I’m not a big fan of the glycemic index and the glycemic load, so I don’t think I included anything about those in the book, other than to maybe say I wasn’t a fan.

Otherwise, it was a pretty good summary.

AI and Mass Balance

After seeing this, I decided to try to provoke ChatGPT a bit. Since there isn’t a lot out there about the mass balance principle, I figured I could have some fun.

I went to Richard Nikoley’s site so I could use the latest iteration of ChatGPT without paying the $20 monthly subscription for ChatGPT-4. Here is how I approached it. I started with a query about the ketogenic diet. I knew if I went long enough, the program would respond in terms of calories.

Aha. We’ve finally hit the calories explanation, which opened the door for me.

I haven’t had enough experience with ChatGPT-4 to know if it just abandoned the field of play or if it really was overloaded with requests.

Tiny the Tadpole and AI

When MD was in third grade, she wrote a story she called Tiny the Tadpole about a tadpole who didn’t want to change into a frog. A few years ago, she came across her original handwritten, third grade manuscript in a box of her kid stuff we had stored somewhere. It was really a cute story, and I encouraged her to polish it up a bit and sell it as a children’s book.

She made some slight changes in the story and searched for a graphics artist on Fivrr to illustrate it for her. She finally hired one and went back and forth again and again, but couldn’t get the artist to come up with what she wanted. It wasn’t that MD was demanding—though she is—the artist just wasn’t getting the idea. There is a little girl in the story, and the artist would make her first with hair of one color, then a different color in the next picture. The same with clothing. Colors of clothing would change, even though it was all one continuous scene.

MD decided it was too much of a pain in the ass with all the rest of what she was doing at the time, so she shelved the project till a better time. Which, so far, hasn’t come.

A few days ago, I watched a webcast on how to use some of the various AI platforms now available. One I became fascinated with is called Midjourney, which is a phenomenal piece of graphics AI. It’s a pain in the rear to set up, because you have to get Discord first, then load Midjourney on top of that. Once you go through all the brain damage to get the thing set up and provide your credit card for the $20 per month fee, you can get unbelievable images. You just have to learn how to request them. Some of the requests are hundreds of words long.

The images just continuously scroll down as people request them. Here is one that just happened to pop up. It will give you an idea of the descriptions and the AI designed images the program spits out.

Once you’ve received the four images, you can either start fresh and repeat. Or you can pick one of them and refine from there.

In her book, MD wants images that look like water color paintings, so she described what she wanted her tadpole to look like. She kept getting images of frogs. She has altered her requests numerous times, and all she gets are images of frogs. She first tried ‘tadpole’ and got 4 legs. Then polliwog with the same legged result. All frogs. Not tadpoles. Here is her latest.

This is the umpteenth time she’s asked for a tadpole, which made me wonder if maybe no one teaches what a tadpole is in school these days. We asked our grandson who just got out of the 5th grade if he knew what a tadpole was. He answered, “A baby frog that swims like a fish.” So, he knew.

I told MD to try just requesting an image of a tadpole. No amplification. She did so. She asked for a tadpole with no legs. Midjourney finally spit out what approximates a tadpole, but still has arms and legs.

I’m not sure Midjourney is going to be MD’s answer to her graphic artist issue. I have a ton of patience to screw with stuff like this until it gets right. She has precious little patience for this kind of frustration, so we’ll see what happens. As it stands now, we’re $20 poorer with no acceptable Tiny the Tadpole in sight. This and my experience above with the back and forth about mass balance tells me we’re a long way from having AI solve all our problems.

Is Berberine the Poor Man’s Wegovy?

Articles appeared a few days ago in both the Wall Street Journal and the New York Times about reports from people who can’t afford the $1,000+ per month for the various forms of semaglutide turning to the supplement berberine instead.

Here is the key paragraph from the NY Times:

Berberine is vastly different from semaglutide, the active ingredient in Ozempic, though. Experts say that while berberine has proven metabolic effects on the body, whether it can actually induce weight loss remains murky. Some limited studies have indicated berberine could play a role in weight loss, which is possibly where the Ozempic comparisons stem from, but there isn’t high-quality data from large clinical trials.

The Wall Street Journal says

Small studies involving people and research in rodents have found that berberine can decrease blood glucose and cholesterol, and improve resistance to insulin. Researchers are exploring its effects on the nervous system and neurodegenerative diseases such as Alzheimer’s, as well as cancer biology.

Still, researchers warn that studies linking the supplement to weight loss are limited, and that other lifestyle changes such as exercise and healthier eating habits might be contributing to shifts. The supplement does have mild side effects including stomach pains, diarrhea and constipation, but it is harmless for most people, according to doctors.

As mentioned above, berberine is not a less expensive version of these expensive weight loss drugs. It’s not the same thing at all. It doesn’t have the same mechanism of action as does semaglutide. I’ve read a handful of studies on it over the years, and what it has mainly been used for is to reduce cholesterol levels. I ran a quick scan through PubMed to see if there were any recent studies showing it might work as a weight loss supplement.

What I found were a few articles showing how berberine improves insulin resistance. And pretty much anything that improves insulin resistance should bring about a bit of weight loss.

One fairly comprehensive paper looked at a number of supplements, including berberine, and described their effects on insulin resistance. I have a couple of concerns about this paper, however. First, take a look at this graphic.

This is a pretty comprehensive overview of a number of factors that are involved in insulin resistance. But, I’ve circled in red in the upper left the one that doesn’t belong. A high-fat diet does not create oxidative stress and drive insulin resistance. When people go on high-fat, low-carb diets or ketogenic diets, which are high in fat, their insulin sensitivity typically improves. Ultimately, there can be some physiological insulin resistance, but typically even then HbA1c gets better. Seeing that bit about the high-fat diet makes me wonder about the rest of the study. I don’t want to be accused of falling for the Gell-Mann amnesia effect.

The rest of the article seems reasonable, however, in its presentation of mechanisms. Looks like berberine has a number of effects on different systems that all tend to reduce blood sugar and cholesterol levels.

I did find a study from China in the list of references that was a randomized, double-blind, placebo-controlled study of almost 160 subjects. About half were put on placebo and the other half on berberine. Here is a chart showing the outcome.

The researchers were looking more at what happens to blood sugar levels and cholesterol than they were weight, so their randomization in terms of weight didn’t give equivalent starting weights. As you can see, blood pressure and cholesterol levels came down nicely in the berberine group. The berberine group also lost more weight, but it doesn’t look like a big difference to me. When I checked the figures in another table, it looks like those on berberine lost a little more than two pounds more than those on placebo, so it didn’t really set the world on fire in terms of a weight-loss supplement.

The researchers used a glucose-insulin clamp on about half the subjects in the study both before and after the intervention, and found that those on the berberine disposed of more glucose than those on placebo. Which means they became more insulin sensitive than those on placebo, but the difference didn’t reach statistical significance. Whatever that means.

Also, the study reported that only about five percent of subjects experienced side effects, with the main one being constipation.

If you want to give it a try, I say go for it. You might want to wait till all the hoopla dies down and the price drops back to normal. I wouldn’t recommend taking it along with metformin, if you’re taking that. And I certainly wouldn’t expect semaglutide-like results.

The Lake Wobegone Fallacy

As I wrote about last week, MD and I drove up to the most recent Broken Science Initiative meeting. William Briggs gave one of the talks, and he showed an example of the exaggerations of the climate change crowd.

The whole talk lasts about a half hour, and I would recommend watching the entire thing. It’s very entertaining and informative. But I’ve queued it to the part about the fallacy in the headline above.

As you can see, Briggs describes an incredible example of what I call the Lake Wobegone fallacy. As those of you who listened to Garrison Keillor’s tales from Lake Wobegone, you’ll remember that he described the town as being a place where all the men were handsome, all the women good looking, and all the children above average. If you watch the short bit I have queued up above, you’ll see the fallacy.

Matt Briggs started a Substack just a few weeks ago. In one of his latest issues, he describes a model. (Modeling is how all climate change predictions are made.)

He’s talking here about the Law of Large Numbers.

The law’s value to Reality is therefore the same as with any model. The closer that model represents Reality, the better the model will be. Reality, though, is not constrained by the model. Reality doesn’t know the model exists, because it doesn’t. The model is purely a product of our fevered imaginations. And nothing more. Which doesn’t make it bad—or good. It makes it a model.

Which precisely describes what a model is. It’s a product of someone’s imagination. Which doesn’t make it accurate. It’s only accurate if it closely approximates reality. As we’ve seen with all the climate change modeling over the past couple of decades, virtually none of the predictions have come true. Which tells you the models are definitely not approximating reality. And anyone who does believe the current model is any better than the previous models is falling victim to the Gall-Mann amnesia effect.

Rochelle Walensky’s Tenuous Relation to the Truth

Take a look at this short video and control your anger.

Jim Jordan often sets my teeth on edge with his style of questioning, but if anyone deserves it, it is the former head of the CDC Rochelle Walensky.

The out and out serial lies are unbelievable. She is so immersed in her own self righteousness that she can’t even speak the truth when everyone knows it.

All she had to do when Jordan asks her all the questions he asks her was to say something along the lines of, “Congressman, I was acting on the information available to me at the time. Later studies showed the earlier information to be wrong. Had I had the later studies, I wouldn’t have made the recommendations I did.”

Instead, she fairly bristles with a smarmy elitism that could piss off the Pope. Her elitist smile throughout as she lies through her teeth is especially annoying. She’s like a giant squid who releases the black ink of ‘she can’t answer because whatever Jordan asks about is under litigation’ to escape from the threat of having to lie even more. Everyone knows the true answer to Jordan’s questions other than those true believers who don’t want to know.

I used to think these congressional hearings were nothing but theater. No one ever gets prosecuted for lying. All they have to do is stall through their five minutes of hostile interrogation until it passes, then a questioner from the other side of the aisle tosses them softball questions.

I changed my mind about it all when I read Jeff Childers’s column this morning.

He was writing about a clip of Ted Cruz working over the Deputy Director of the FBI about withholding unclassified documents from Congress.

People often comment that it’s fun and gratifying to watch clips like these but what does it really accomplish? Besides moving the needle of society, and helping persuade other members of Congress, these types of interviews have a very important function.

All Congressional testimony is recorded in the Nation’s permanent records. It becomes the country’s official history. It is critical for future generations that our official records reflect what REALLY happened in 2023. So we can be grateful to our Republican congresspeople, who heroically endure pallets of mindless word salad from evasive bureaucrats, in order to create a useful historical record.

Makes me feel better just to know that Rochelle Walensky’s dissembling will be there for future generations to see. I hope she’s proud of it.

The only thing I read about this week that was equally disgusting is the White House requiring masks and social distancing for any unvaccinated college athletes coming to be honored for their teams’ championship seasons. This is purely a political and virtue signaling stunt. Covid has been deemed over for over a month. And it’s not the unvaxxed who were last seen spreading it around.

If it were ol’ Dr. Mikey invited to this event under these conditions, he would tell them where to put it. I hope the unvaxxed athletes do the same.

Taurine: The New Life Extending Supplement

This week the medical media was all over a new study that came out touting the amino acid taurine as being a miracle supplement for extending life. Usually when these studies hit the medical press, they also hit the lay press. So, I took a look. And sure enough, there were articles in both the Wall Street Journal and the New York Times.

I looked up the study in Science and planned to write about it this week, but, as you can see if you pull it down, the study is a long one. I got started on it, but did not get it finished. My analysis will have to wait till next week.

I did run to our local whole food grocer with MD to do the weekly food shopping. I stopped by the supplement section and found plenty of taurine on the shelves. I don’t know if all the PR hasn’t reached anywhere but the above two newspapers or what. But taurine was available and inexpensive.

You can read the links now and be ahead of the game.

I’ll have more in a week.

Video of the Week

Here you go.

If anyone deserves this treatment, this putz does.

Enjoy!

Keep in good cheer, and I’ll be back next Thursday.

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