11 Questions with Robb Wolf

Robb Wolf doesn’t really need an introduction, now does he?

Because I am nosy, what kind of books do you read the most, and what are you reading currently?

Not surprisingly, I’m a pretty big geek, so I bounce between sci-fi and econ/systems  books. In sci-fi I’ve been reading John Ringo’s stuff (Citadel, Live Free or Die) and I really enjoy them. On the econ/systems side I’m re-reading Antifragile for the 3^rd time and it’s as if I’ve never read the book. I’ve enjoyed all of Taleb’s books (The Black Swan, Fooled by Randomness) but Antifragile is like eating the best chocolate you have ever had…it is just smooth and I think that’s an outgrowth of both the passion Taleb takes to his work and his vast experience in the financial scene, risk forecasting etc. If more people could wrap their heads around what he is talking about they would be much happier, less deluded, and a lot more effective in life.

Nassim Taleb is awesome! He’s like Malcolm Gladwell, only angrier and Paleo. What would you say is your biggest personal accomplishment in the Paleo Movement?

Hmmm…I guess this risk assessment program in Reno that we are preparing to take national (and international). I think the potential to integrate food production, fitness, community, sustainability, decentralization in healthcare (and food)…so many seemingly separate but intimately connected systems might be yoked together in a way that has never really happened before. The interest we have received from big business, government and all the folks in the Ancestral Health scene has been amazing…It’s just a matter of bringing this thing to fruition. I feel like it’s “crowning” and we just a need a few more good pushes.

You’re right, it appears that this thing is coming to a head.  Now, If you had a microphone and you could reach the world with just one message, what would you say?

I feel like this should be something profound, which seems to create performance anxiety on par with bedding a famous porn star. Will I live up to expectations? Will I be “good”?

Anyway, I guess something along this line: Ignorance of the nature of the Human Animal, condemns humanity to continue living like animals.

*Drops mic*

That’s it for the personal questions, now for the fun stuff. Critics often point to the fact that there are relatively few Randomized Control Trials (RCTs) to support the benefits of a grain and legume-free diet, and more that support it’s inclusion into a “healthful diet,” what do you make of this?

We have lots of studies that seem to indicate grains and legumes are healthy, but that is typically in comparison to a refined, Westernized diet. The few studies we have looking specifically at a Paleo intervention vs. say, a Mediterranean intervention (ahem) seem to indicate that “paleo foods” may in fact be superior to some of these other staple foods. What we see from this is a spectrum that goes perhaps from bad (highly refined, low nutrient foods) to better (unrefined grains, legumes etc) to “best” (grassfed meat, wild caught fish, fruit, veggies, roots shoots, tubers). We can look to the nutrient density work by Dr. Mat Lalonde and we see exactly this story play out. So, to the folks who are dismissing the paleo/ancestral health concept, I’d simply ask: “can we compare apples and apples?” If we have some indications that certain foods may in fact be better for health than others (perhaps looking at nutrient density and degree of immunogenic compounds) perhaps we should look into this. I’d also mention that RCTs ONLY occur once we have observed some interesting phenomena and create a hypothesis that needs looking into. Which brings us to your next question.

The N=1 experimental design is often scrutinized for rendering poor “scientific” evidence to support a dietary theory relative to RCTs. Do you agree?

There is an interesting mix of both arrogance and “chicken-shittedness” in the Evidence Based Medicine crowd. Most of the medicine that you receive from your doctor, dentist etc. has NEVER had an RCT performed to establish efficacy. What has happened is Docs in their clinical PRACTICE have tinkered, observed favorable (or unfavorable) outcomes and much of that has become what is routinely used. Occasionally these observations will lead to RCTs to provide a higher level of validation, but the EBM folks have a tendency of picking and choosing what they attack (there are few studies to support X position) vs. what they ignore (most of medicine and coaching). It’s a flaccid, limp-weenied, double standard.

Much of the success of Paleo, relative to say Atkins or the Zone has been from the results we have observed with autoimmunity. There are quite a number of ways to get people back into their skinny jeans but no effective means of dealing with conditions like multiple sclerosis, lupus or rheumatoid arthritis. The EBM folks will tell us that that examples we have of lab work indicating a reversal of brain lesions in MS (via MRI no less) or a normalization of antinuclear antibodies in RA (to say nothing of either complete or significant improvements in the symptomology of these conditions) is a mass delusion we are suffering. It will remain a mass delusion UNTIL these folks see an RCT that fits their criteria…then we will not longer be deluded.

We have a proposed mechanism for autoimmunity that includes gut permeability, systemic inflammation, molecular mimicry, vit-d issues…really a syndrome which is not amenable to the reductionist approach seen in most research as it may not be one singular issue that is at play here and it may not be a binary “yes/no” cause, but rather a spectrum of causation and disease process.  What this does lend itself to is an outcome based approach which applies treatment of as many of the factors as we have knowledge of and compare this to standard of care. We are close to a high level, well-controlled trial of exactly this nature rolling out. If we see zero benefit of a Paleo intervention under these controlled circumstances, then I guess it’s time for me to start that coconut farm and quit peddling pseudo science.

Not to beat this into the ground, but I’d like to mention a few other points for people to consider: The 400lb bench and off-label drug use. There is NO RCT establishing how to coach someone to a 400lb bench press. By the criteria of the EBM folks, this should not exist and anyone claiming to have produced this in people is suffering a delusion and we cannot trust their OBSERVATIONS. Clearly, this is horse-shit. Well educated coaches understand training theory, periodization, biomechanics etc and are routinely able to help people achieve impressive numbers in the gym. It’s an outcome based issue, but one that is not routinely attacked for a lack of clinical trials. Another interesting story is the off-label use of various pharmaceuticals. When a drug goes through the FDA process it is essentially vetted for a specific use (we will ignore the fact that many drugs are routinely labeled as safe, only to be subsequently pulled when doctors OBSERVE negative side effects in their patients…observations are merely delusions after all if we do not have an RCT to tell us the sky is blue…but do we trust the original RCT that established safety or the clinical observations indicating otherwise?) but may be used at the discretion of the physician for non-studied situations: ie-situations which have NEVER seen an RCT. What these doctors are doing is either using a knowledge of pharmacology and proposed mechanism to tinker in their practice OR they are following the OBSERVATIONS of other doctors who might have stumbled onto otherwise unrecognized therapeutic applications of a specific pharmaceutical.

If evolution via natural selection is the central dogma of Biology, and medicine is a sub-discipline of biology, shouldn’t being well-versed in evolution theory be mandatory? Do you suspect that would be a boon to hypothesis generation and, perhaps, improved patient care?

I think your question is perhaps better than any answer I can muster! Medicine is being practiced in the same way physics was being utilized pre-quantum mechanics: I.E.— with lots of holes in our understanding, with no way to start with fundamental principles. The history of physics is interesting (really!) as there was a time when we had no explanation for things like the photo-electric effect, Brownian movement, and a host of other phenomena. We OBSERVED these phenomena (there is that pesky observation again) but had no predictive mechanism for explaining what was going on in these situations. Then people like Einstein, Plank and Bohr developed what we now recognize as the cornerstone of physics: relativity and quantum mechanics. Without these theories we would not have GPS phones, certain aspects of computing and a number of other innovations. Now, one of the really interesting elements of this story is that quantum mechanics was not embraced with open arms. People launched personal attacks against those advocating this new theory…scientists are about as prone to irrational behavior as anyone. Einstein himself spent the last 15 or so years of his life largely ignoring his own work as his religious faith convinced him the universe could not ultimately be random…that “God does not play dice.”

As you alluded in your question, it might be helpful to practice medicine with some notion of the fundamental principle underlying biology, evolution via natural selection. We have done a pretty good job dealing with infectious agents (bacteria, virus, parasites) via public health, sanitation, vaccination and antibiotics. We have made little headway in dealing effectively with chronic, degenerative disease like cancer, autoimmunity, neurodegeneration and cardiovascular disease. Instead of looking first to pharmacology as a solution to these complex issues, it might be time to start with an evolutionary medicine approach and try to figure out what the gene/environment mismatch might be that is causing these problems.

Does the increase in the gluten-free market trend delight you or disturb you?

I’m actually pretty happy about this. Yes, these foods are still highly refined, yes some folks over consume them…but middle America is now getting a message that at a minimum, gluten containing grains might not be great for them. That is a momentous thing. I see a lot of folks who have been in the ancestral health scene for only a few years (or months) get seriously panty-twisted about gluten free foods or the ubiquity of paleo deserts etc. These folks are making elitism the order of the day instead of looking at this on the longer view. I see damn near ANY movement in these directions as a good thing as people are at least curious, open an aware. Then we have an opportunity to educate on what frequency folks should have these.

Do you believe that the Paleo Movement has been, or will be instrumental in upending a centralized food system? What do you think the biggest benefit of a decentralized food system would be?

I absolutely think paleo will be THE force of change towards a decentralized, sustainable food distribution system. Now, as to “upending’ the current model, I doubt what we are doing will cause that outcome, but the overextension of out economic and environmental scene, THAT will unravel things like farm subsidies and agribusiness as it’s been practiced for the past 50 or so years.

The benefits of an alternate system that is decentralized and “Antifragile” are many:

1-If one area is impacted by environment or other unforeseen factors, it will not grind all food production to a halt.

2-Working biodynamically requires less energy inputs. Fluctuations in oil prices will have less impact on food costs.

3-Farmer Welfare (farm subsides) are a hidden tax on us all in two ways. First, we are redistributing money from tax payers to farmers, creating a false market of products that may not reflect true market needs (overproduction of grains for example). Secondly, that over production of grain or grain derivatives begs for something to be done with them, like turning them into cheap, long shelf life refined foods. This clearly plays into generally poor health and we all end up paying for that with increased healthcare costs, increased sick time etc.

Many Paleo adherents, like myself, experience a change in political leaning during their Paleo “enlightenment” period. Why do you suppose that is?

I’ve noodled on this a lot and I think it boils down to learning how the world actually works. If you can get in and embrace this whole evolutionary biology story you really get a deep appreciation for how the natural world AND human physiology works. From there it is not a huge leap to start considering the different economic and political systems in play and to start looking at these critically. That said, trying to get people to look objectively at their views of economic systems is a lot harder than asking people to reevaluate their eating habits. With eating I can ask people to run a 30 days experiment (eat paleo), see how they look, feel and perform, track biomarkers of health and disease and the story is pretty clear. Then it’s just a matter of whether or not that person feels the effort is worth the reward. With economic and political views there is no way for me to have someone embrace market vs collectivist principles for a month or two to see the results. We don’t really get an N=1 experiment opportunity with this.

So, we largely default to uninformed debate. Let me give some examples of how this debate is (in my opinion) ill informed from both the collectivist and market based views. The more anarchist leaning folks in our community will say it’s morally repugnant to embrace collectivism…a sense that I am responsible for my neighbor, that my neighbor is responsible for me. What is being missed here is that woven into our DNA is a tendency/desire to be part of a group, to practice reciprocity and to take care of one another. This is the story of our hunter gatherer forebears and to ignore this is a bit short sighted. BUT—with few exceptions— we do not live in a way that we literally rely upon each other for life and death issues. People move, have anonymity from the group and can exploit things like government assistance with no repercussions, only short term upside. That is a problem, and it’s one that the collectivists largely ignore. These folks cite examples of say the Scandinavian socialized democracies and suggest that a country like the US should head in this direction. What is missed here is these Scandinavian countries are largely homogenized in terms of ethnicity, culture and values. People more or less follow the rules and if they don’t their neighbors lean on them in a way that folks in the US would be appalled by. Also, these countries are small (total population of Sweden for example is similar to several US cities) and have benefitted greatly in the past from a favorable demographic bulge. Historically, these countries had a large, young productive workforce that paid into the generous social welfare programs these countries are famous for. Those demographics are changing however. Where once we had a large workforce we now are expecting a large retiree population with pensions, health care needs etc, and not much contribution to GDP or tax base. That’s a problem.

I won’t go too much deeper on this topic but I’d encourage folks to do some thinking in these areas. I’d highly recommend looking at the Singapore healthcare model built on Health Savings Accounts, price transparency and little 3^rd party insurance which creates enormous moral hazard.

Have you ever considered running for office? If you did, what would be the first item on your agenda?

I have never really thought about this but of late I’ve given some thoughts to participating in our local and state government. I’d be disinclined from participating in any type of federal government position as that system is both ineffective and out of touch with the needs of local populations. So, once the risk assessment program is rolling, I get a few more books done, you might see me sniffing around the local political scene.

As to an agenda…I guess I’d just say that every decision that is made, all planning that is considered needs to consider the following: Economics, Energy and the Environment. We can’t continue making decisions in a vacuum with no thought about down stream effects or repercussions.

Robb, are there any questions that I failed to ask you that you think deserves an answer?

I think we pretty much covered it, hugely honored to be allowed to ramble. I guess one question that does come up actually does relate back to politics a bit. Folks often ask me if I think it’s a good idea for me to talk about this stuff. Do I think it might hurt my ability to “sell” to people if I talk about markets, healthcare etc? I’m not a dummy, I know this is not great stuff for building a huge email list I can pander to. I know these are polarizing topics and from a short term financial perspective it’d be better for me to keep my head down and my mouth shut and just post the occasional “anti-Monsanto” piece to feel like I was doing my part.

Well…I’ve never been good at keeping my mouth shut when I see something wrong happening. I got fired from CrossFit for saying that food quality was more important than weighing and measuring beer, pretzels and jerky. That unwillingness to fold for short term personal gain not only ended up helping a lot of people, it likely tripled my income. Sometimes, doing the right thing does work out. In this bigger picture I know that all these issues of healthcare, food production etc are interrelated and we will not fix the problems unless you apply systems thinking. I guess what I’m trying to say is that I don’t bring these thorny topics up for a love of conflict, but rather a sincere belief that if people understand the world we might make it better.

And here is the irony: this market-oriented Libertarian loves this community (and humanity) enough to take some personal risks to try to help the group.

Comments

comments