Thoughts on Ronda Rousey

So Ronda Rousey just lost her UFC championship belt to Holly Holm. I have thoughts.

1. I think Holly Holms just cost Cyborg Santos (with whom she is reportedly friends) a fortune. A Cyborg - Rousey fight, as long as Rousey stayed undefeated, would have made a ton of money. Cyborg in the UFC against anybody else will never be as compelling.

2. Holms was an awful style matchup for Rousey. The surprise was how well she dealt with the handful of clinch opportunities that Rousey got. None of the analysts expected the standup to go any different than it did; what people didn't anticipate was that Holms, by keeping her hips low and her elbow in, would be skilled enough to negate Rousey's hip tosses. Watch this for a great breakdown.

3. It's hard to imagine that Rousey wasn't distracted by outside the cage issues. She's become exponentially more popular during this prefight period, and facing distractions - Travis Browne's issues and her mom's comments about her coach - that she hasn't dealt with before.

4. Rousey has been learning to throw punches, and she's good at that, but seems to have developed none of the other skills related to boxing. She can't move her head, doesn't defend much, can't cut off a ring (she moves straight in, winging punches, until she can get the clinch, in every fight). The questions at hand are, will she find a coach who can teach her these things? And is she still teachable or is she too full of herself to learn a new skillset?

5. Lube. I'm not even going to make the joke, it's too easy.

6. Holm was unbelievably well coached and unbelievably mentally strong. Her movement was no surprise, but to avoid panic while in the clinch with Rousey? Nobody else has done that. I suspect that her relative experience (lots of boxing) made a big difference. Very few female MMA fighters have a lot of fights under their belts (the sport is fairly new). Holm has lots of experience on a pro stage getting punched and rocked and coming back from it. That's rate.

7. I can't decide if this is good or bad for women's MMA. Rousey brought tons of interest to the sport, and we have no reason to think Holm can duplicate that. But from a sport perspective Holm's win opens up the division - now we have tons of interesting matchups to see, whereas before the UFC seemed desperate to find anybody who could make a worthwhile fight against Rousey.

8. I think we're going to see a lot of casual fans being introduced to the concept of MMA Math. Basically, lots of people will probably expect Holm to completely dominate every female fighter out there - after all, she dominated Rousey, who had dominated everybody else. But styles make fights and she might not turn out to be as dominant as we thought.

9. I wonder if Holm will be willing to move up in weight to fight Cyborg.

10. Most fight fans think Rousey should switch coaches at this point - her coach does not have a good track record with other fighters, and Rousey's skillset does not seem to have developed under him, and his between-round advice was horrifically awful. So, does she find a better coach? Or is loyalty more important? I'm inclined to say she should move on. I wonder if there will be any backlash among fans if she ditches the guy who brought her to this point. (I actually think there won't be).

If you haven't watched the fight, you should. It was a lovely display of technical mastery.

When to try a 'fad' and when to scoff

[Alternate title: The Epistemology of Biohacks]

We live in an era where many or most lay people (i.e. not medical professionals or professional scientists) are somewhat distrustful of the medical orthodoxy in a variety of ways. The reasons for this are complex - some of it is a lack of scientific literacy, but I think more of it has to do with two things:

1. Parts of the medical community has been very glib about lying to us, or at least grossly exaggerating how certain they were about various recommendations, for at least the past 50 years, and have gotten caught, and publicly caught. People are keenly aware about reversals regarding issues like the health risks of dietary cholesterol, the relative value of breast milk vs. formula, and other things, to the point where people are no longer comfortable trusting the recommendations of the medical community. Add to that the rise in obesity and immune disorders (like asthma) over the past 5 decades and it sometimes seems like the medical community doesn't know what it's doing.
2. The internet has massively increased our exposure to 'information' and suggestions that run counter to the medical orthodoxy, some of which have merit while others don't. When I was a kid there were a handful of news channels, a handful of newspapers and magazines, and books you could buy in a bookstore. If you were going to hear from someone who opposes vaccines you had to go looking for it. Today those people, with often very convincing (to a layperson) arguments, pop up in your facebook feed whether you like it or not.

Now if you are even remotely logical and scientifically literate it's clear that the medical community is absolutely excellent at dealing with many issues. Know anybody with polio? Know anybody who has broken a bone, say in a fall, and then had the limb amputated? 

But there are clearly areas where things aren't working as well. Obesity is a huge problem in this country (I refuse to provide a reference for that), and it is pretty clear that your doctor does not have a 'cure' for obesity that is healthy AND works most or all of the time AND that most people are capable of following. And it seems like the more Americans as a whole have followed the general guidelines put forth by the medical community (reducing saturated fat and total fat intake, reducing dietary cholesterol) over the years, the worse things have gotten.

The result? We, as a country, have grown susceptible to the fad diet. Get a physician, or even just a well read blogger, to propose some dietary adjustment that promises to cure our obesity or asthma or arthritis or whatever, and whereas people might have once scoffed, today we are generally much more willing to give these notions a try.

And while I'm very sympathetic to the Paleo Diet, and a gluten free regimen, and the Mediterranean Diet, those live side by side with some horrible stuff, like the maple syrup cleanse (and cleanses in general).

It's not just dietary advice. In some ways the anti-vaccine movement is similar - people don't trust the medical community, they believe whatever alternative they year. Homeopathy, 'alternative' cancer treatments, and cleanses (again) are taken seriously as medical procedures by a large segment of the population.

Then, naturally, there is a backlash. For every Paleo Diet evangelist there are those who sneer at the gluten free aisle at the supermarket and rub their hands with glee whenever a new 'study' is published showing that gluten (or meat, or wine, or whatever) isn't really the culprit.

[I'm not going to debunk those studies today - it's easy to do, and others have done it. I've written about my own feelings about gluten in other places.]

You are probably well aware that I'm not going to recommend that you sit tight and eat the standard american diet until the medical community gets its act together and comes up with a unified set of recommendations based on solid, double blind studies that tell you the right way to eat and live your life for optimum health. First of all, you'll be dead of old age centuries before that happens. Second of all, even if your doctor isn't corrupt, the government boards that make these recommendations are clearly influenced by politics as much as by science, and politicians are clearly being bought and sold by major corporations all the time. The traditional food pyramid had as much (or more) to do with the needs of agricultural big business as it ever did with nutritional science.

So... what should we do?

My first inclination when dealing with any of these schemes (dietary or otherwise) is to look at the evidence. Now evidence is itself tricky - do we mean wait for double blind studies showing the efficacy of a scheme? That's not going to happen. I graduated to saying, 'wait for a plausible mechanism.' In other words, try some intervention only if there is at least a plausible explanation for how it might work, one that's consistent with physiological principles as we know them. That's not a bad idea, but it might prevent us from trying interventions that work for us. Just because we don't know why something works does not mean it doesn't work.

So, try everything? That seems dangerous and problematic. And it's not what I'm suggesting.

Instead of starting your analysis with the evidence or with the science, start by analyzing the cost.

The cost can come in several varieties:

• Does this intervention cost money? Supplements, herbs, cleanses, seeing a practitioner (acupuncture, massage, whatever) all cost money. Some cost more than others. A gluten free diet doesn't necessarily cost more - replacing your bread with white potatoes is not going to bust your budget - but it might depending on how you implement it.
• Determine the social cost. Skipping breakfast is unlikely to cost you a ton of friends, but skipping dinner is tough. Adding or subtracting alcohol might impinge on your social activities. Being gluten free or low carb isn't too hard if you eat at nicer restaurants, but it is if your friends do a lot of pizza and burgers.
• If you're removing something from your diet, think of the possible health consequences. This can be very tricky. Giving up wheat? Sounds like a problem, but there aren't any nutrients that we know of that are present in wheat that you can't find in abundance in cheap, easy to find non-wheat foods (potatoes, corn, etc.) Refusing vaccines? I don't think I have to answer that. The potential health consequences of not vaccinating your kids are devastating. Going very low carb? That's tough. You certainly don't NEED dietary carbs to sustain life, but the long term consequences of depriving your gut bacteria of fermentable carbohydrates are an open question. In the end, you have to do your best to make educated guesses. Giving up your chemo for a homeopathic cancer treatment? Please put me in your will. On the other hand, giving up diet soda (in favor of, say, plain water) is clearly going to be at worst just fine - there's nothing good in diet soda, even if the stuff in there turns out to not be harmful (that is, the jury might be out on whether aspartame is harmful, but there is certainly no reason to think it's helpful).
• If you're adding a lot of something to your diet, think of the possible health consequences. This is somewhat guesswork as well, but there are guidelines you can use. More fresh vegetables? Probably fine. More fruit? Probably fine, but there might be an upper limit to how much fructose you should be shoving into your piehole. Fruit juice? Drinking a lot of fruit juice dramatically increases the amount of fructose you can get in... which probably isn't good. 
• Think of the psychological consequences. How much do you love the thing you're adding or removing from your lifestyle? Keep in mind that sometimes there's a short adjustment period, after which you won't miss the thing you're abstaining from. That was my experience with wheat (the first few days were awful, now it's easy). I had the opposite reaction to diet soda. I've managed to cut back slightly, but I just can't give it up.

When you start taking a nuanced and comprehensive look at the 'costs' side of the analysis, I think a pattern starts to emerge. Very low cost interventions probably shouldn't be looked at too critically. I've been eating baked potatoes instead of rice - even if that turns out to have no benefit, it certainly isn't going to be detrimental. Why be overly skeptical of the science behind the idea? On the other hand, skipping your kids' measles shots is very different.

The second part of the analysis, as you can probably guess, is to analyze the benefits of the intervention in question. And that's where people typically go wrong.

If someone is evaluating a 'cure' for cancer, and they think that the intervention will, in fact, cure their cancer, that's an enormous benefit (saving your life in the presence of a terminal illness is pretty much as big as a benefit can get). So if we presume a very, very high value of the benefit, then when compared to almost any cost, the treatment seems worth it.

And that is where you have to add in consideration of how confident you are in your evaluation. How confident are you that the treatment will cure your cancer? What are the costs?

It is a horrible tragedy when somebody stops their chemo treatments because they think they have found a miracle cure. Or when somebody spends large sums of money on snake oil. We are right to scoff at those people.

But does that mean we should scoff at somebody who, to overuse my example, gives up wheat while undergoing cancer treatment? The difference in cost is enormous. Will giving up wheat improve that person's chance of surviving cancer? Probably not. The science certainly isn't there to support it. But - and this is the important question - is there much risk or cost associated with that choice? Obviously not.

I'm certainly not arguing that going wheat free will cure your cancer. And it would be massively irresponsible to suggest that going wheat free is so sure to cure your cancer that you can skip traditional medical treatments. But in addition to regular treatment? Why should we be any more than slightly skeptical?

I try fads and so-called hacks all the time. Some make a noticeable difference in my quality of life; most do not. It can get difficult to evaluate them - if some intervention is supposed to help you sleep, that's easy to evaluate, but if it's supposed to improve bone density, that's much harder to measure without expensive tests and a lot of time.

My latest is replacing my starch sources with potatoes that have been cooked and allowed to cool. The cost is very low - I like potatoes, they're cheap, the prep time is relatively low, and they're nutritionally equal to or better than the foods I'm replacing. Will it make a significant difference to my waistline or general health? We'll see. But the lack of rigorous scientific support for this intervention should not be a good enough reason to not try it (especially when there are reasonable arguments as to why it should work, ones that I find plausible, which I'll share at some other time).

So if something is a 'fad' diet or whatever, and you want to try it, carefully evaluate the cost. If the cost is really low, why not give it a month or two and see how you're doing? And if the cost is moderate or high, spend a lot more time evaluating the supporting evidence before you commit yourself.