Tuesday, December 19, 2017

Evidence-based Medicine

I guess we're not allowed to use the words evidence-based medicine anymore. Regardless of the current administration's desire to control words, let's actually poke at evidence-based medicine a little bit.

I often use the term "NPR smart" to describe academics and pseudoacademics who think that they're smarter than those around them. Taleb uses the term IYI. Tom Naughton calls them The Anointed. These are the folks who require randomized controlled trials for everything, use the phrase "because science proved it", and would laugh at anything that's not "western medicine". These same folks have really been touting "evidence-based medicine" for years.

What is "evidence-based medicine"? It sounds like a good idea: you try something, examine the evidence and see if it worked, and then use that to learn. If it works, keep doing it it, if it doesn't work, stop. The trouble is that the "if it doesn't work, stop" part is being ignored. Here's a great summary of what these folks do (from Tom Naughton, here)

  1. The Anointed identify a problem in society
  2. The Anointed propose a Grand Plan to fix the problem
  3. Because they are so supremely confident in their ideas, The Anointed don’t bother with proof or evidence that the Grand Plan will actually work
  4. If possible, The Anointed will impose the Grand Plan on other people (for their own good, of course)
  5. The Anointed assume anyone who opposes the Grand Plan is either evil or stupid
  6. If the Grand Plan fails, The Anointed will never, ever, ever admit the Grand Plan was wrong

I see this play out over and over again. In the context of nutrition and health we see it all the time. Someone gets an idea of what should work because it sounds like a good idea. Then they rush to promote it. But when it doesn't work they just say we need to try harder instead of admitting maybe it just didn't work.

I've been trying to work with some local health care providers to see if we can get something together where we could use the gym as a resource. But I keep running into a roadblock when I explain my approach - paleo-inspired diet, sustainable strength training (#lazystrong), you know, the stuff you see every day.

It seems that unless I'm willing to submit to "evidence-based medicine," they don't want to talk to me. Things like getting your 60 minutes of moderate activity (right in the middle of the heart rate zone that I don't want you in). Or like eating a plant-based "balanced" diet from the USDA recommendations. Basically, all of the things that haven't been working for the last 30 years. But apparently, that is "evidence-based".

I'm burying the lead here a bit, but apparently, Robb Wolf is running into the exact same thing I did. Of course, we're just a small-time S&C gym, while Robb has been beating this drum for 20 years. His latest rant on the health care system and evidence-based medicine is a great read. Take 5 minutes, read it and see what we're up against. Unless we can find a way that actually gets people healthier (the evidence being actual health), we are going to bankrupt the country. Doing more of the same isn't going to work, we need a new approach.


row 500 / run 400
crawling lunge
10 KB swings or snatches
double KB overhead lunge
10 TGUs or windmills
10 goblet squats
5 pull-ups or push-ups or dips


squat 8-8-3x8


2 pull-ups + 2 dips between strength sets

Group Workout

5 rounds:
10 goblet squat
6 full range high pull


as quickly as possible, 4 rounds:
20 pull ups, scaled as needed
20 weighted lunges
20 kettlebell swings


2 minute bar hang


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