The SHN #54: Sham Surgeries, Cronometer, and Strength

Welcome back to The Synergetic Health Newsletter! 

In this edition, we’ll explore the history of sham surgeries and the power of the mind.

After that, an introduction to a handy free nutrition tool, Cronometer.

Then comes another call to work on your strength gains, research summaries, and more!

Joe Burt

🇪🇸 Greetings From Sanxexno, Spain

After five great weeks in London, I’ve arrived in a beautiful seaside town in the Galicia region of Northwest Spain. A hidden gem! Hope everyone is having a great Spring 👏

🔪 Sham Surgeries and the Power of the Mind

In medicine, the gold standard for testing the efficacy of a treatment is the double-blind, randomized, placebo-controlled trial. While this method has been widely used in pharmaceutical research, its application in surgical interventions has been limited due to the inherent challenges of creating a convincing "placebo" surgery.

Enter the concept of sham surgery – a faked surgical intervention that omits the step thought to be therapeutically necessary. This approach has led to some stunning revelations about the power of the mind in the healing process.

The history of sham surgery dates back to 1939 when Fieschi introduced internal mammary ligation as a procedure to improve blood flow to the heart. It wasn't until two decades later that a controlled study demonstrated that the procedure was only as effective as the sham surgery. This finding paved the way for further investigations into the placebo effect in surgical interventions.

One of the most notable studies in recent years was conducted by Dr. David Kallmes at the Mayo Clinic in 2004. He investigated the effectiveness of vertebroplasty, a procedure in which medical cement is injected into broken backs to alleviate pain. In the study, half of the patients received the real procedure, while the other half underwent a sham surgery. Surprisingly, both groups reported the same level of pain relief and improvement in function.

Similar results have been observed in other areas of medicine.

In orthopedics, a study by Moseley and colleagues found that arthroscopic surgery for osteoarthritis of the knee was no better than sham surgery in relieving symptoms.

A 2016 study also showed that arthroscopic partial meniscectomy offered no benefit over sham surgery for patients with degenerative meniscal tears.

In neurosurgery, sham-controlled experiments involving the drilling of holes into the skull demonstrated that surgical interventions for Parkinson's disease were ineffective and possibly harmful.

These findings have significant implications for the medical establishment. They suggest that many commonly performed surgeries may be unnecessary and that the perceived benefits may be largely due to the placebo effect. This has led to a re-evaluation of surgical practices and a greater emphasis on evidence-based medicine. Insurance companies have become more reluctant to fund procedures that have been shown to be no better than sham surgery, forcing the medical community to re-examine the effectiveness of certain interventions.

However, the most profound implication of sham surgery studies is what they reveal about the mind's role in healing. The fact that patients can experience significant improvements in pain and function without any actual treatment is a testament to the power of the “placebo effect”. This phenomenon is not limited to subjective measures like pain; it can also influence objective physiological processes.

The placebo effect is thought to be mediated by several psychological and neurobiological mechanisms. Expectation, conditioning, and the relationship between the patient and the healthcare provider all play a role. When a patient believes that a treatment will be effective, it can trigger the release of endogenous opioids and other neurotransmitters that modulate pain and inflammation. The ritual of undergoing a surgical procedure, even if it is a sham, can also activate these self-healing processes.

The implications of this are vast. If the mind can influence the body to such a degree, it suggests that our current understanding of the mind-body relationship is incomplete. The mind is not merely a byproduct of physical processes in the brain but may be a primary driver of health and well-being. This opens up new avenues for research into mind-body therapies and the potential for harnessing the placebo effect in clinical practice.

Of course, sham surgery studies also raise ethical concerns. Subjecting patients to a surgical procedure that has no intended therapeutic benefit could be seen as a violation of the principle of non-maleficence (do no harm).

However, proponents argue that sham surgery is justified when there is uncertainty about the effectiveness of a procedure and when the risks are minimized. Sham surgery studies have led to the identification of useless interventions that were previously believed to be helpful, thus protecting patients from unnecessary risks and costs.

These studies have provided a fascinating glimpse into the mind's role in the healing process. They have challenged long-held assumptions about the effectiveness of certain surgical interventions and have highlighted the importance of rigorous scientific evaluation. While the use of sham surgery in research remains controversial, it has undoubtedly advanced our understanding of the interplay between the mind and the body.

We need to continue investigating the mechanisms underlying the placebo effect and developing mind-body interventions that optimize the therapeutic relationship, enhance positive expectations, and promote self-healing processes.

This will require a shift in our understanding of the nature of health and disease, recognizing that the mind is not merely a passive observer but an active participant in the healing process.

The lessons learned from sham surgery studies remind us of the resilience and self-healing capacities of the human body. They challenge us to look beyond the traditional biomedical model and embrace a more holistic approach to health.

🥗 Using Cronometer To Optimize Your Diet

Cronometer is a comprehensive nutrition tracking app that can help you gain a deeper understanding of your diet and allow you to make informed decisions about the foods you consume.

By inputting the foods you eat, either by volume or weight, Cronometer calculates the nutrients you've consumed and compares them to your personalized daily targets.

Why Use Cronometer?

Ensure You're Meeting Your Nutrient Targets

One of the primary benefits of using Cronometer is that it allows you to see if you're meeting your targets for protein, fat, carbohydrates, vitamins, and minerals. If you discover that you're lacking in certain nutrients, the app makes it easy to identify foods that can help you fill those gaps.

Conduct Self-Experiments

Cronometer serves as a tool for self-experimentation. By establishing the components of your food as independent variables, you can test hypotheses about how specific nutrients affect your health and well-being.

Develop a Deeper Understanding of Your Food

Using Cronometer regularly can help you develop a better understanding of the nutritional composition of the foods you eat. You'll start to internalize rules of thumb, such as which foods are high in protein, healthy fats, or specific vitamins and minerals.

While keeping a simple food log can be helpful, it lacks the quantitative precision that Cronometer provides. By taking the time to input your food intake into the app, you'll gain valuable insights into your diet that can help you optimize your health.

In the following sections, I'll share some screenshots from my own Cronometer diary. Note that I have been following a bioenergetic approach to my nutrition for quite some time now, which I have written about often in this newsletter.

So you’ll see liberal intake of fruit, fruit juices, dairy and less intake of nuts, seeds, oils, and vegetables (not because vegetables are bad).

I’m quite pleased with how my dietary approach seems to give me a well-balanced nutrient profile. This matches with my subjective lived experience, where I feel good, rarely get sick, sleep well, and have solid levels of mental and physical energy. If anything, I think I could probably handle more calories, especially carbohydrates.

The few things that seem to be lacking according to Cronometer are fiber and polyunsatured fats, two things that are intentionally minimized in a bioenergetic approach to nutrition.

💪 Strength Leads to Greater Lifespan

“By expanding the strengthspan with muscle strength activities at every stage of life, individuals may not only live longer but may be more likely to move independently, function safely and perform a range of physical tasks effectively throughout the lifespan.”

From the editorial “Bridging the gap between strengthspan and lifespan.”

At any age of life, it is a valuable undertaking to engage in strength training activity.

🐟 Fish Oil Causes, Not Prevents, Cardiovascular Disease: A large, long-term study published in BMJ Medicine found that regular fish oil supplementation, often recommended for its anti-inflammatory effects, may actually increase the risk of first-time heart disease and stroke in healthy individuals. The researchers found that “using fish oil on a regular basis might actually increase the risk for healthy people to go on and develop first-time heart disease and stroke.”

The findings indicate that replacing all polyunsaturated fatty acids (PUFAs) with saturated fatty acids (SFAs) might be more beneficial for CVD prevention, rather than the current medical recommendation of replacing omega-6 with omega-3. This is a hotly debated topic, so do your own research. I personally do not take fish oil.

🌊 Being Near Water is the Best Place to Relax: My mom’s beach addiction has scientific validity. A two-part study investigated the effects of viewing water in outdoor settings on autonomic tone and subjective relaxation. The first study found that viewing water in a swimming pool for 1 min 40 s reduced blood pressure and heart rate compared to viewing a tree or sign. The second study, conducted in a university arboretum, measured blood pressure, heart rate, and subjective relaxation at six sites along a path next to water features and adjacent ground.

Results showed that the systolic/diastolic ratio for blood pressure and heart rate were reliably lower when viewing water compared to the adjacent ground, an effect associated with subjective relaxation. These findings suggest that viewing water can influence autonomic tone in a way that may account for the subjective experience of relaxation.

🤯 The Dangers of Stress and Anxiety: In this podcast interview on the Modern Wisdom podcast, author Mo Gowdat discusses how “young people are comfortably numb, how to assess stress and where it is probably coming from, the things you’re not aware of which cause emotional stress, the most important habits you should implement if you want to become peaceful.” In the search for better health, managing your stress remains (IMO) the biggest lever.

🔗 One Hitters

⚕️Reductive stress- the hidden culprit of chronic disease (Video Interview)

☀️ Sunlight cures eczema (Post)

💡 You’re not fat, you’re starving (Interview)

✔️ That will do it for this time! Hopefully you got some value out of it. If you have any questions/comments/things you’d like to learn more about please don’t hesitate to reach out.

🔗 If you know anyone who loves learning about these types of topics, send them this link!

📰 To read all past newsletters, go here.

📖 Read “Accelerated SELF-Development” and the accompanying "Resources” for free.