Generally Speaking

Old talks that still seem relevant

I am still working out how best to use this site.

Although it got several likes, which were much appreciated, I think my Sea Monster and the Whirlpool address is much better placed on its own page rather than here on the chronological blog. So I have moved it to its own page, tidied up the formatting and added some of the slides. That lecture, which I gave as the keynote on ‘Science’ to the 50th Anniversary Symposium of the Royal College of GPs, attracted thousands of hits when I posted it on my first website www.friendsinlowplaces.co.uk and was largely responsible for me coming up as the first ‘James Willis’ on Google for several years a decade or so ago – not bad for what is a fairly common name.

I have now added another talk which meant a lot to me and which I still believe said something important. Professionalism – Red and Grey – discussing the meaning of that confusing word and arguing that we need to restore respect for its more subtle, but ultimately more fundamental, colour. Flavour, if you like. Of course, I would love to receive comments, contributions and discussion. To this end, I have appended the complicated Venn diagram of the two aspects which I and my colleagues developed at the time – you can see that it is very much work in progress. If you are intrigued, have a look at the talk itself.

Red Grey chart

 

 

Intermittent Fasting – another thought

Further to last week’s item under this heading, it isn’t just the dietary pattern which means you never have a really empty stomach which would have been so unusual throughout most of our evolutionary past. Surely, having a bloodstream suffused with high quality nutrients absolutely all the time would have been another thing which would have occurred rarely, if ever, during hundreds of thousands of years of hunter-gatherer ancestry.

It seems to be open season for speculation about this new dietary idea, because we lack the body of scientific evidence that would support a claim that any particular way of doing it is better than any other. All that can be said with confidence is that a wide variety of eating patterns which result in the stomach being empty – and therefore not  releasing fresh nutrients continuously into the bloodstream – for periods of about a day at a time, all seem to result in weight loss. What’s more people trying out these patterns report that they are surprisingly easy to maintain, that they do not cause ravenous hunger the next day, and that they seem to be associated with feelings of well-being and clear-headedness. And possibly also with improved memory.

All this is of course so subjective that anecdotal reports (and even one’s own experience) must be treated with the greatest caution. But they are effects which would be eminently testable in controlled conditions. Just so long as nobody comes up with a ‘right’ way of doing it which destroys the complete flexibilty which is its greatest attraction.

Intermittent Fasting – DIY gastric banding?

An article in this week’s New Scientist tells us that the stomachs of competitive eaters become disgustingly distended

“…Somewhere into the seventh [hot] dog, the normal eater reported to Metz that he would be sick if he ate another bite. His stomach, on the fluoroscope, was barely distended beyond its starting size. Eater X, by contrast, effortlessly consumed 36 hotdogs, downing then in pairs. His stomach, on the fluoroscope, became “a massively distended, food-filled sac occupying most of the upper abdomen”. He claimed to feel no pain or nausea. He didn’t even feel full…”
(The body: Can you eat yourself to death? New Scientist, 16 March but behind pay-wall)

So, perhaps, the stomachs of people who fast moderately on one or two days a week become correspondingly smaller.

One of the many attractions of this trending dietary pattern (See BBC News 5 August 2012: The power of intermittent fasting), is that it is completely flexible. Many of the people I know who have adopted it, including myself, fast on a single day in more weeks than they actually fast on the nominal target of two days a week. Certainly, nobody I know adopts the grim-sounding alternate day fasting that the above BBC news item refers to.  Nonetheless, gentle and sustained weight loss seems to be the rule. And although the greatest attraction of all is that you can gorge as much as you like on the non-fasting days, people actually find that they simply don’t want the size of portions that they did in the past.

My expertise in this area extends no further than having been a family doctor, but it seems eminently plausible to me that a stomach which remains more or less empty for 24 hours tends to shrink and stay shrunk, so that it fills up more quickly for some time afterwards. This is the opposite of the way stomachs which are grotesquely stretched, as the New Scientist reports, tend to stay stretched.

It also seems plausible that eating three square meals, regularly, every day of your life, so that your stomach is almost never empty, would have been an exceptionally rare pattern during our evolutionary past.

Surely this should be properly investigated as a vastly simpler alternative to gastric banding. But with nobody standing to gain from the research except you and me it is hard to see it being funded any time soon. Although the necessary research would be relatively simple to do. Until then, the anecdotal evidence is suggestive.

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