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Mental Models for Nutrition and Health

25 Frameworks from Ancient Greece, to Nassim Taleb, to Gym Bros

Nutrition and health has been one of the most confusing rabbit holes I have fallen in to. How do you know who and what to believe?

I list down mental models I have used, as well as others I have encountered but don’t use. As examples, I share decisions I have made using these models. I hope you find some of these useful for your own decisions in health and nutrition.

Let me quote the first few sentences of the Farnam Street article. I could not write a better introduction.

My examples are related to the ketogenic diet, fasting and cholesterol, since I applied the mental models below mainly to these.

If you start with different values and goals, I imagine you could use the same mental models to reach different conclusions.

In fact, I’d love to see a similar list from someone with a very different nutritional worldview — perhaps a cholesterol-fearing vegan who snacks continuously.

I started to take nutrition seriously only two years ago. Prior to that I just followed popular wisdom. If you assume that nutrition is not a big deal, this approach makes sense; it takes the least effort. I still use this. For instance, I have not encountered any significant opposition to the following rules, so I just follow them without going deep into why:

Before I started geeking out on nutrition I also avoided fat, or at least did not seek it. That changed when I heard about the ketogenic diet from people I trust.

This also takes low cognitive effort. You just need to decide whether someone is trustworthy. We use this mental model every time we follow advice from friends. Today, we also use this when we follow people we trust in the internet.

There was a problem though. After a year of keto, I got a blood test and my cholesterol doubled! But I solved it with N=1 experimentation.

In science experiments, the lower the “N” (the number of people being subjected to the experiment), the lower the trustworthiness of the conclusions of the experiment.

However, when it comes to a system as complex and as varied as the human body, N=1 (N of one) experimentation makes sense. N=1 is a fancy way of saying that you are trying to find out whether something works for you, in a data-driven way. Compared to relying on convention or on people you trust, this requires more cognitive load. You have to have some familiarity with the mechanism behind the experiment, and its risks and rewards (our next mental model). But it allows you to optimize your nutrition based on what suits you and on your life goals (mental model # 5).

Keto was my first N=1, and my metric was productivity. After doubling my cholesterol (which is bad according to conventional wisdom), I did more research and nutrition experiments. After a year, I finally figured out how to manipulate my cholesterol readings:

A key principle in N=1 experiments is not to kill yourself. Or harm yourself. If you accept risks, the potential payoff better be high.

The opposite is also true. If the risks are really low, I’d do something even if the probability or the magnitude of the potential payoff is not that high.

My best example is fasting. Following conventional wisdom, not eating sounds crazy. However, it turns out that it has very little risks for healthy non-pregnant people, and has lots of upside.

N=1 experiments require a lot of time and effort. After experiencing the productivity increase from keto, I felt the time and effort is an investment with good returns.

The connection between nutrition and your life’s mission must be clear for the time, cost and effort to make sense (see next mental model).

Fasting pro-tip: fasting can be torture if you are carb-dependent. Adapt to keto first before doing an extended fast. Also, drink cold brew green tea throughout the day. It lessens the hunger.

Whatever you are supposed to do in this life, you will have to do it with your meat computer and your meat vehicle. Thus, shouldn’t we all be master operators of our brains and bodies?

At this point of my life, I prioritize productivity. This is why I continue to invest time and money in health and nutrition. I have seen huge returns in learning practical nutrition. So I’m doubling down. For instance, I’m now attempting to increase my drive to get things done by naturally boosting my testosterone.

Other people prioritize weight-loss or fixing a health issue. Knowing your target allows you to design your nutrition, and your research, to focus on achieving your goal.

Knowing the design process behind a system allows you to see what is best suited for that system. The human body is a product of evolution. Homo Sapiens emerged 300,000 years ago. Our nutrition has been that of hunter-gatherers for most of that time. It was only 10,000 years ago that we started eating like farm-fed town dwellers.

This is the mental model behind the paleo diet, or eating like a cave man. Here’s a good intro:

I made a deep dive on the topic of evolution a few months ago, when I found out that a friend of mine was a creationist. One major lesson is that the process of evolution creates very efficient systems.

The evolutionary logic of paleo makes sense. But perhaps due to my engineering background, it was the systems-based explanation of keto that led me to this rabbit hole of nutrition.

The theory is that your brain could be powered by glucose or ketones. Ketone production is activated when you deplete your liver of glycogen. This can be done by fasting or by the ketogenic diet. I checked out these claims and they turned out to be uncontroversial facts. My N=1 as well as those of many other doing keto validate this further.

The same mental model helped me fix my high cholesterol after doing keto. Here’s the data from my diet experiments spanning 11 months:

The violet line in the graph — LDL — is what freaks doctors out, based on some studies correlating high LDL with heart disease. Why did it shoot up and how do I bring it back down?

My N=1 data only made sense when I understood the role LDL plays in the body. It turns out LDL is a key player the body’s energy distribution system. LDLs are made by the liver to transport triglycerides which power your muscles and organs. Triglycerides are made from the fat you eat, and need to be transported inside LDLs because they don’t flow well with blood, the way oil does not mix with water.

Like any well-designed system, the body’s energy distribution system has redundancies. Aside from triglyceride-carrying LDLs, the blood stream transports triglyceride-carrying chylomicrons made by your gut, as well as glucose, which don’t need a carrier.

Like keto, the individual components of this system (eg, the role of glucose, LDLs and chylomicrons) appear to be uncontested facts. This systems view however appears to be a novel perspective in terms of understanding high LDL.

There’s a killer app for that. It’s called the scientific method.

There are realities which we accept but never directly perceive. We think the Big Bang is true not because we experienced it but because it is the theory best supported by facts. This is the same with the theory that stuff are made of atoms and the theory of evolution.

Feldman’s LMHR hypothesis also cannot be directly observed. We can only validate it by running experiments. Here’s the experiment that Dave Feldman formulated related to this:

This has become know in the keto community as the Feldman Protocol:

Increasing fat to lower cholesterol just sounds wrong (admit it — it sounds bonkers), but it is a logical deduction from the energy distribution framework described above.

There appears to be more than a hundred N=1 experimenters who have tried the Feldman Protocol at the time of writing. Feldman mentioned in some interview that more than 80% have lowered their LDL (both LDL-C and LDL-P, for you nutrition nerds). It certainly worked for me:

Most appear to have applied the Feldman Protocol to avoid getting prescribed statins by their doctors. Collectively, it is further validation of Feldman’s hypothesis. This is now called “citizen science,” but before the professionalization of science in the 19th century, this was how scientific discoveries were made.

Metaphors help make unfamiliar concepts easier to understand using familiar images. I find metaphors especially helpful as a layman trying to understand health and nutrition. However, if the metaphor inaccurately represents reality, our conclusions from it would likewise be wrong.

One of the most popular and most misleading metaphors in nutrition is thermodynamics applied to the human body, understood as simple calorie container, where the difference of calories in (food) and calories out (physical effort) is converted to fat.

My N=1 with keto made me question this. I did not want to lose weight, so I maintained the calories I was consuming prior to keto. I simply exchanged my carb calories with fat calories. After just a few months, I lost 10kg despite my efforts to stuff myself with gloriously fatty food.

Here is a better metaphor. It explains my weight loss despite my efforts against it.

The body has a Systems Preferences panel. You adjust these settings mainly through food.

One setting, for instance, is how much fat you store. You adjust that dial mainly though the hormone insulin. Insulin in turn is influenced by the amount of sugar and other simple carbs you eat.

Ketosis is another setting. You can toggle this setting through the ketogenic diet, through fasting, or through exogenous ketones (ketones you ingest instead of making in your liver).

Another setting is testosterone levels. For people seeking productivity, this is relevant due to its influence to the drive to get things done:

The control panel metaphor also makes all these research on nutrition a bit more fun. It is like discovering new features in your life machine.

This mental model is new to me. It turns out systems could be classified into four types, based on their knowability and predictability:

Let’s apply this model to the lipid panel — the blood test that checks your cholesterol levels.

I wanted to see for myself, so I collected several of these guidelines and ran my results from each diet experiment through them:

We can see a pattern here.

The earliest guidelines were one-dimensional. For instance, “the higher the LDL, the greater the risk of heart disease.”

Researchers then present metrics which are claimed to be more correlated to heart disease. These have more dimensions. For instance LDL to HDL ratio and total cholesterol to HDL ratio. Risk calculators consider factors such as age, blood pressure and smoking.

This makes sense. The body is a complex system. I imagine its components (like cholesterol) have complex relationships with the rest of the body.

Here’s an interesting section (emphasis mine):

The human body is clearly a complex system. While these metrics and correlations probably have some use, we should not forget that they are simply thin approximations of the seething real world.

When I first got my high cholesterol readings, my only mental model was popular wisdom. And popular wisdom said that LDL causes heart disease.

Scratch the surface a bit, and you immediately question this. For instance, if you search “cholesterol” in Amazon books, the top results are almost all about how we got it all wrong (I read the third one).

At best, LDL is correlated with heart disease. And it is not even the LDL reading we get in the usual lipid profile (LDL-C). It is LDL-P and “small dense LDL” that are correlated with heart disease. More on that here:

But why settle for weak correlations? It turns out that there is a test that measures “Coronary Artery Calcium” or the CAC test, which appears to be the closest thing to seeing the cause of heart attacks.

(For people in the Philippines: the CAC test costs PhP12,300 in St. Lukes and PhP5,500 in Philippine Heart Center (as of a few months ago). You’ll need a referral from a doctor. You’re welcome.)

Nassim Taleb — of all people — is the reason why my main exercise now is weight lifting (mostly squats and deadlifts).

In Antifragile, Taleb also introduces the concept of “iatrogenics,” which is the harm caused by medical treatments.

I took personality tests as I was writing this post. It made me realize that there may be mental models that I am not considering because of my personality, which relies heavily on reason and data. Here are other personality types I thought would view nutrition decisions differently:

The next 5 mental models are based on these personality types — dietary purity, listen to your body, trust in the system, bro science, and conspiracy theory.

This is probably the most common mental model outside the mechanistic and systems approaches that dominate this list.

Looking at this from an evolutionary perspective, there is probably a survival advantage in developing food aversion based on communal experience.

I also experienced this. I never thought this would happen, but I now have an aversion to sugary food. I don’t think this is simply my body adapting to keto. I immersed myself in the keto worldview for the past two years, and continue to do so. This is probably a form of brainwashing, and I’m possibly edging toward radicalization (discussed below).

Growing up in a Catholic country, I never had experience with the concept of dietary purity. My experience with sugar, at the very least, gives me an idea about how vegans feel about meat, Muslims with pork and Hindus with beef.

This is something new to me and I’m still trying to learn this. Keto has taught me to be mindful of my mental energy — how the volume, timing and types of food affect my productivity. Fasting has trained me to acknowledge my hunger without being overcome by it.

This entire mindset of taking care of this instrument — the only one we have to achieve our mission in life — has made me respect sleep, exercise, meditation and taking regular rests from the intensity of the city.

I now listen to my body more. It is a sophisticated system, which probably means it also has pretty good feedback mechanisms.

For most of my life, my mind has tried to become the master of my body. I’m now trying to work out a peaceful partnership. I used to rely on pure will power. I found more success in creating systems, N=1 experimentation and researching the hell out of things:

It turns out there is a personality type though which tend to simply trust in authority. They are called “Sentinel-Guardians” in some classifications.

I have a colleague who is like this. He has a fatty liver. He simply takes the meds his doctors gave him, and avoids fats and alcohol (but has no hesitation eating processed sugary food, which makes me just face-palm).

But he prefers to simply trust his doctor. Full stop. After reading up on different personality types, I have a better understanding of his decision, even if I’m still dumbfounded by it.

Bro Science is also trusting in authority — the authority of the sacred traditions of the gym.

I think there are some gems of wisdom in bro science, amidst a lot of superstition. Diets and regimens are tested generation after generation. Ineffective ones are discarded. Effective ones are passed on. Why they work does not matter. It only matters that they do.

Bro science is the Eastern medicine of the West.

In Grechen Rubin’s Four Tendencies framework, there is one called “The Rebel.”

One common debate tactic in the nutrition world online fits this tendency. You can easily shoot down studies supporting your opponent by highlighting conflicts of interest among its authors. If the source is someone in authority, you can imply that he or she is in the pay of some large and powerful industry group.

This works because there is some truth to this. There are very bright and hardworking people whose job is to influence thought leaders and scientific research — toward a position that increases profits of their companies.

Check out Dr. Jason Fung’s explanation on how pharma influences doctors with $$$ and how it has corrupted medical research. I’ve heard the same concerns from my family and friends who are doctors.

The problem is that this cuts both ways, and something might be true even if it is backed by powerful industry groups or ideological movements.

I struggle with the question of doctors and when to trust them.

My friends and relatives who are doctors are some of the smartest, most hardworking and honorable people I know. I trust them.

At the same time, I have tried to expand my business with doctors as the target market, and have studied how to sell to them. The best in the game are the pharmaceutical companies. My interviews in the industry showed me that doctors are human like the rest of us. The persuasion and influencing techniques that work on the rest of humanity also work with them. See Dr. Jason Fung’s articles linked in the previous section to see this in action.

I don’t think we can impute malice to both doctors and people in pharma. From their perspective, they are simply doing their jobs. From a patient’s perspective though, I’d like to know when I should believe in medical professionals.

I think doctors have the most skin in the game when:

Patients outnumber doctors. They have to prioritize where they put their time and brainspace. I am told by my friends that saving lives, limbs and eyesight are their top priorities. My high cholesterol on keto is understandably far down in their priorities. I won’t be surprised if a doctor would just go with the recommendations of their associations when it comes to this.

A couple of quotes from Antifragile:

(This is a good place to put a disclaimer. My skin in the game of this post is that I live by the choices I made with these mental models. But I will neither gain nor suffer from any positive or negative impact these frameworks may have on you. Do your own research, test things for yourself, make up your own mind.)

He missed an important battle front: the war between vegans and carnivores.

You may be peacefully learning about nutrition in the internet as you read this, but you will eventually stumble over this war.

You may even end up as a combatant of one side, depending on which rabbit hole you choose.

If you choose to go down the vegetarian path, you might just get radicalized and go vegan.

If you choose low-carb, you might end up radicalized as a zero-carb carnivore.

I feel this is happening to me. Seeing benefits from keto, I read more books and blog posts about it, I watched low-carb conference vidoes, and I followed more and more people in the low-carb and keto communities.

I started writing my own blog posts about keto. I tell my friends about how great it is. Some of them try it out and also find it awesome.

When someone contradicts my posts, my immediate thought is “ha! this guy must be some vegan ideologue under the pay of big pharma.”

That of course is complete nonsense, and I reply politely. I’m not yet that radicalized…

But maybe I’m getting there…

Epikeia is a concept from ancient Greek philosophy. It is the principle stating that rules should be broken when a greater good requires it.

It is unfortunate that English does not have an equivalent word. When we deliberately break from our diets we call it a “cheat” day. We “fail” to follow diets and feel guilty about it.

I would like to reserve my guilt for actual moral failures — like real cheating. As I already have an aversion for sugar, I have identified circumstances where I should eat carbs:

I take advantage of these occasions to prevent radicalization and puritanism , to train my instincts that occasional unhealthy food isn’t that big of a deal.

It turns out the science of decision-making is quite recent. It was only in the past century that people started running experiments to see how people tend to act in certain situations.

In my case, this means acknowledging that:

If you follow this perspective, I’d love to hear what else I’m missing.

Here are three of the best history of science books I have read in the past few years:

It turns out confirmation bias also affects the scientific community as a whole. Scientific consensus does not automatically move forward following data from experiments and discoveries. The old guard tends to maintain the paradigms they have spent their careers on. Progress happens when a new generation of scientists, more open to new paradigms, take on the reins.

This explains a lot of the contradicting expert opinions in health and nutrition.

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