Becoming Superhuman

It’s a publishing phenomenon. The video  lasts a minute but shows you can do the impossible – run 100 miles, lose 100 pounds, lift 500. The book promises a a 95% sure way to 15 minute orgasm; rapid weight loss without exercise; “very awesome” sleep in just 2 hours a day; superhuman physical ability – and all you need do is dip in and read for a few hours!

“The 4 Hour Body” by Timothy Ferris fits a standard for American life today and past – our captivation with beautiful fantasies.  That special seduction has been with us since the Virginia  colonists were promised a paradise on earth and starved to death, and it’s with us now.  You can cut taxes for everyone and balance the budget; you can go to war throughout the world with minimal cost in blood and money; you can do your accounting like Enron and become the most admired company in America.

Ferriss is a proud self experimenter who wants to his book to “be a call to arms for a new mental model of living – the experimental lifestyle.” He can provide the truth no one else can, since he has done all these things to himself, – which means he KNOWS it works.  The FDA is at least  “10 years behind current research and 20 years behind compelling evidence.” And though not a doctor or reseacher, his experience is so special and complete that it’s really better than any academic or scientist could provide, for at least four reasons:

1. An unnamed medical academic explains he can be the “dark horse” who can write about experimentation and ideas that mainstream practitioners would lose their careers for – “We’ve trained 20 years to be risk averse.”
2. He’s an insider – “CEO of a sports nutrition company with distribution in more than a a dozen countries” who unlike so many of the others, “followed the rules.”  His company and its product, Brain Quicken, which promised to “double your performance or you money back plus 10%” did not fall prey to the “darker tricks of the trade.”
3. Better, he’s also an outsider – when confiding to an established alternative MD his fantasy about getting a doctorate in the biological sciences (“I was briefly a neuroscience major at Princeton’’) she tells him he can “do more outside the system than inside it.”  Who needs lengthy training when “you’re a meticulous data cruncher with access to many of the world’s best athletes and scientists?”  (Note the similarity between this statement and the recent spate of national political figures spinning their lack of experience and knowledge as major assets – they have not been corrupted by the “insider world.”)
4. As someone who has “pioneered” different ways of learning language, he explains that an active vocabulary of 2500 “high frequency words” is all that is needed to comprehend more than 95% of all Spanish conversation, while 98% comprehension will require 5 years of hard work – so “2.5% of the total subject matter provides 95%” of the results. Somehow this same percentage also works in medicine and biology. Ferriss will move the “Archimedes lever” which will give you that 2.5% of knowledge that “delivers 95% of the results in body rapid body redesign.”

So why does this good guy industry insider, and potent scientific self-experimenter write immediately after the title page “Please don’t be stupid and kill yourself.  It would make both of us quite unhappy, ” and then says you should “consult a doctor before doing anything in this book?” Why is the publisher writing that they and the author  “expressly disclaim responsibility for any adverse effects that may result from the use or application of the information contained in this book?”

Because while Timothy Ferriss is  a persuasive, absorbing, entertaining writer-raconteur, a world class marketer who polled the Net to find out what people wanted (presumably rapid weight loss and very long orgasms,) his sample size generally consists of one single human – himself. Tim Ferriss,  Tango champion,wrestling All-American,  a man who wins a goldmedal in kickboxing by dehydrating and then rehydrating 28 pounds, the “Superman of Silicon Valley,” is no ordinary fellow.  Which means there are real perils, to him and us, of generalizing his results to others.

Checking the Engine

Ferriss is a great motivator, and believes measurement is the key to progress. He uses it obsessively on himself,  certainly in his business life, polling and checking, measuring and making his website work.  His first book, The Four Hour Work Week, which he originally had entitled “Confessions of a Drug Dealer,” is still very successful, but it had only had 26 five star ratings on Amazon before it was published. The Four Hour Body had at least 38. Expect that number to go way, way up.

Well, you’re supposed to consult a doctor before doing anything in Tim’s book.  I’m an ex-medical school professor and researcher, a medical doctor for 31 years,  a sleep doctor for more than 20 years; so let’s look under the hood.

This is a book we’re supposed to dip in, so we can start with something I do know about –  sleep.

Sleep the Four Hour (or Two Hour) Way

Ferris has two chapters on perfecting sleep.  In one he acts as human guinea for a host of gadgets, drugs, and singular behavioral modifications, like sitting ten minutes in a freezing ice bath before slumber. A long term insomniac,  he claims he gets his best sleep when his Zeo shows the highest REM  percentage as part of his sleep. He also sleeps better when three hours before sleep he eats meals of at least 800 mg of cholesterol and 40 gms of protein.  Sleep researchers can tell you that the group that really increases its REM sleep percentage is alcoholics, and that meals late at night (Ferriss is an owl) are particularly good for raising lipid and glucose levels. His next chapter,  partly written by Dustin Curtis, describes how to sleep 2 hours a day and be “completely refreshed.”  Pointing out that giraffes only sleep 1.9 hours a night Ferriss asks “is there any reason why humans can’t emulate giraffes?’

My answer – yes.  We’re not giraffes. Our evolution and physiology are very  different.

Next up – can you cut your  sleep time in half and feel completely refreshed? Ferriss writes “the short answer is yes.” He claims you  can do this following a polyphasic sleep pattern, interspersing 20 minutes naps around the 24 hour day. In this section, Curtis writes “Remarkably, adding just one nap during the day shaves an hour and forty minutes off your total sleep requirement.

Power nappers pay attention – you can now sleep 100 minutes less each night.

Unfortunately, human research does not show that people can cut their sleep time in half and be healthy.  Of course, not everyone needs 8 hours sleep. There are people who can do well on 3 hours of sleep.  One woman I know sleeps 3 hours, is 96 years old and sharp as a tack. The CEOs Ferriss sites as doing polyphasic sleep may well be in this group.

But the epidemiologic evidence is that people in the US are now often sleeping between 6-7 hours, with working women on the low end of that.  At six hours or less people gain weight; look prediabetic; don’t learn very well; can’t remember well;  have higher rates of coronary narrowing and hypertension; and die more quickly.  Do you really want to live on 3 hours sleep a day? I worked as a doctor like that for years, and now it’s clear such work schedules are a prelude to disaster – particularly for the patients we served.

As for Ferriss’ other idea of just getting along with REM and deep sleep and forgetting “the rest,” Professor Mike Bonnet and others have done fine research on that. No way – it doesn’t work.  People can’t function.  They’re also miserable.

The reason is that rest is regeneration.  Animals that are sleep deprived die. Rest lets your body rapidly replace itself.  You essentially get a new heart inside three days.

But clinical research like that comes from studies of groups.

The Four Hour Diet

People really,really want to lose weight, so Ferriss has a lot in the book on his slow carb diet.  He reports that the group of 194 people who reported to him on twitter and Facebook lost 21 pounds on average.

Let’s disregard the fact that this type of sample represents an extraordinary level of  volunteer bias Ferriss later uses to blast observational studies.  Let’s check out the diet –

Proteins, legumes, and vegetables.  No fruit.  No starches. No bread. No nuts (“domino” foods). No oats. At least 20 grams of protein each meal.

And you have to binge one day of the week. It’s required to perform DGW  – “Dieters Gone Wild.” It’s supposed to reset insulin sensitivity and lots of other good things.

Following this diet you can also save money – one 245 pound, 6 foot 5 inch male made it on $1.34 a day and lost 10 pounds in two weeks – so you can be thrifty and lean.  But some of the money you save might go to the biological testing required, including the X ray DEXA scans or body fat machines you buy for yourself as you measure your body’s recomposition.  It appears that  a main goal of this diet seems to be lowering body fat percentage down to around 10%.

As for the bingeing part, you can control that over the top weekend or holiday weight gain by starting with a small meal, adding fructose to grapefruit juice before your second “crap meal,” using  supplements like policosanol and alpha lipoic acids plus others, add lots of caffeine so you won’t be able to store and digest the stuff, and do some sharp muscle contractions right before eating as this will increase glucose transporter protein number 4 whose properties will cause more glucose to flow into muscle rather than fat.

Got it?

For some this diet should cause weight loss.  It’s a modification of many others like the Zone and  South Beach, with the added wrinkle of programmed bingeing.

For which there may be some physiologic basis.  However, what will the teenage anorexic or bulmic do when she sees a diet telling her the necessity of bingeing?  And if we believe the observational China study, all that protein will lead to greater cancer rates down the road.  And if we accept the ideas of epidemiologist Walt Willett, all that protein may eventually help rot our bones.

But that’s why people do clinical trials.  Because you often get unexpected results – particularly over longer time spans.  Who knew that lithotripsy for gallstones would lead to diabetes 20 years later?

Which brings us back to Tim.

The Results

Ferriss has a section by retired Professor Seth Roberts that  claims self-experiments are better at determining causality, are faster and cheaper, and that “more wisdom is acquired.”  Ferriss  later declares people don’t want to wait the 5-10 years mainstream science takes to get its facts straight – and quotes Martin Luther King that “justice too long delayed is justice denied.”

So let’s look at what Tim did to himself in that department.

One year he went to Tempe, Arizona and had a doctor multiply inject  him throughout his body with numerous drugs – “We used everything but the kitchen sink.”  The final, special cocktail – platelet rich plasma; stem cell factor from Israel; bone morphogenic protein 7; and insulin like growth factor 1.

The result was a staph aureus infection that resulted in emergency elbow surgery at UCSF.  Ferriss was completely incensed when the Tempe doctor refused to pay $ 1500 towards his medical costs.  The doctor’s response – “Why would you even waste your time asking me for this when you can just go out and make more money?”

Caveat emptor, folks.

Why did Ferriss take this plunge?  Because in his career of “envelope pushing” he managed 20 fractures and 20 dislocations, two joint surgeries, and “enough tears and sprains to last a lifetime.” An orthopedic surgeon told him he had become “a 30 year old in a 60 year old body.”

So how much envelope pushing do You want to try?

But don’t fret – he’s found a host of experimental  treatments that will reverse permanent injuries.  And “I plan on living to 120 while eating the best rib-eye cuts I can find.”

The Baby and the Bathwater

So what is “The Four Hour Body?”  A revolutionary new book to create “intelligent self-experimenters” around the globe, which Ferriss told the Toronto Globe and Mail is a main goal?  Is it the memoir of an obsessed fitness addict and All American wrestler who ran a supplement company?  Or is it just the “Confessions of a Risk Taker?”

Let’s take a public health view for a moment.

1. What about all those self-experimenters out there?

Many doctors think there are too many already.  They’re the kids who rummage in their parents’ medicine chests and add the pills together for “fun nights” with their friends; they’re the experimenters who try out new designer drugs before the FDA bans them; they’re the movie stars who try one, then a second, then a third sleeping pill when they can’t get enough sleep, who sometimes never wake up; they’re the Lady Gagas of the world who use cocaine to get higher and alcohol to get down; they’re the Facebook generation that texts whenever they drive a car and “tests” how quickly they can message their high school pals.

Ferriss is compulsive in his measuring, careful, obsessive.  He tests and tests and tests, as do some of his world class athlete friends.  Will most of the self-experimenting population do the same, checking their selenium levels and DEXA scans?

Don’t count on it – especially when they’re told self-experimentation is such a great idea. Doctors know how hard it is just to get people to record symptoms and side effects.

And  what happens when the anorexic or bulimic kid decides he or she wants to be superhuman? Will that be a way to  “acquire wisdom?” And what happens when a diabetic anorexic uses the extensive advice on bingeing and ends up in the hospital or worse? Do you tell the parents to read your statement  “Please don’t be stupid and kill yourself.  It would make both of us quite unhappy?”

Is that really good enough?

2. If you have a good idea, do a clinical trial and test it on a group. Ferriss has a lot of good ideas about motivation, and many other ideas that are plausible for scientific testing. Much of his self-testing can be regarded as hypothesis creation for proper scientific work.

So do it, Tim.  If you believe in your diet, take part of your 10% author royalties going to “cure driven” research and put it into checking out the ideas in this book.

And use that terrific chapter on biostatistics by Ben Goldacre.  It’s possible dunking people in freezing  water might help them lose weight – drinking a glass of water before eating works.  But don’t be frightened at the time and expense.

Because research is complicated, and difficult, and takes time to get it right. There are thousands and thousands of actions and ways, mostly unconscious, that  can bias even the best clinical trial.

People can die from those mistakes.

3. Get a coherent view of the human body. The Four Hour Body book has neither “hacked” the human body nor grokked it – because it’s view is primitive – that of the body as a machine – without sociology or psychology.

Input in, input out.  Measurement is all.

But what are you measuring?  For how long? Is measuring your testosterone level the means to true romantic love? What about all those effects you’re not measuring?

Humans are social organisms, not machines. We’ve evolved with innumerable physiologic kludges that work in many different metabolic systems – often simultaneously. We’re also ecosystems, with 100 trillion other critters inside our guts alone, about which, as Ferriss points out, we know little.  We’re not machines – we’re thinking, social beings.  We rebuild ourselves at an astonishing rate, with little of us not replaced in a matter of weeks.

That extraordinary capacity is not addressed in this book, nor the public health wisdom which really does allow people to live long and well.  The things that we know matter are how you eat; how you move; body clocks and when you do what you do; social engagement; and rest, which by regenerating the body is a much, much bigger subject than how many hours sleep you get.

Your body renews itself; that’s how you stay healthy.  Ferriss is right that people have enormous power to remake themselves.  He describes many ways that might be accomplished.

But it has to be done with wisdom, and sense, and purpose, and safety.  We’re not superhuman yet – just human.  And such fallibility carries with it much responsibility.
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