The Skeptics Guide #1111 - Oct 24 2026

Guest Rogue: Alice Howarth; What's the Word: Centripetal-Centrifugal; News Items: Christina Applegate's MS Diagnosis, Ultraprocessed Food and Cancer Risk, Superworms Clean Skeletons, Goodbye Leap Second, Wellness and Hyperoptimization; Who's That Noisy; Science or Fiction

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:02Speaker 00

  You're listening to The Skeptic's Guide to the Universe, your escape to reality.

• 0:09Speaker 01

  Hello and welcome to The Skeptic's Guide to the Universe. Today is Thursday, October 22, 2026, and this is your host, Steven Novella. Joining me this week are Bob Novella.

• 0:19Jay Novella?

  Hey, everybody.

• 0:19Speaker 01

  Cara Santa Maria.

• 0:21Cara Santa Maria?

  Howdy.

• 0:21Speaker 01

  Jay Novella. Hey, guys. And we have a special guest rogue this week, Alice Howarth. Alice, welcome to The Skeptic's Guide.

• 0:28Speaker 04

  Hello, thanks very much for having me.

• 0:29Speaker 01

  So Alice, tell us a little bit about yourself. You are with the Merseyside Skeptics.

• 0:33Speaker 04

  I am. So I am in the ridiculous position of wearing a ridiculous number of hats in my day job. So by training, I'm a cancer cell biologist. I did a PhD in cancer cell biology. I then decided that that wasn't enough. I moved into the field of research on research, where I work in my day job on interventions for making research process and outputs accessible and exclusive, but inclusive even, both within and beyond research. And then in my spare time, if you could call it spare time, I am the Vice President for the Merseyside Skeptic Society. I co-host Skeptics with a K podcast, which I've been doing since 2014. I've been investigating the wellness industry, alternative medicine practitioners, and a whole range of other skeptical topics for over a decade.

• 1:17Speaker 04

  And the co-organizer of the QED conference, which you guys appeared at in 2018.

• 1:22Speaker 01

  Yeah.

• 1:23Speaker 04

  And if that isn't enough, I'm Deputy Editor of the UK's Skeptic Magazine.

• 1:27Speaker 01

  So you, it sounds like you're challenging me for the busiest skeptic in the world. Alice, so you, your, you know, your expertise sounds like a conspiracy theory. It's like, I research the researchers.

• 1:38Speaker 04

  Yes, yeah, exactly that. Research on research is very, it's a hot topic at the minute. We're talking a lot about research on research. Meta research, some people call it, metas science.

• 1:48Speaker 01

  Yeah.

• 1:48Speaker 04

  So yeah, it's, it's fun and interesting. I'm trying to understand how research culture is particularly problematic and what we can do to fix it.

• 1:57Speaker 01

  Do you ever stand behind someone who's actively doing research? Like, and you have a clipboard and you go, every few minutes, you just go, huh?

• 2:04Bob Novella?

  Why'd you do that?

• 2:07Speaker 01

  Alice, we'd love to have you write for us at Science-Based Medicine. We talk about that meta research stuff all the time.

• 2:13Speaker 04

  Oh, nice. Sounds great, yeah.

• 2:15Speaker 01

  That is one of our core topics.

• 2:16Jay Novella?

  We're starting 32 more blogs, too. We want you to write to those.

• 2:20Speaker 01

  We just got a submission for SBM. I don't know if you guys run into this problem, and it was clearly written by AI.

• 2:28Speaker 04

  Everything seems to come through to us through AI at the moment. And this is, I mean, this is the issue in the academic publishing industry as well, that academic publishing is getting very challenging at the moment because of AI.

• 2:38Speaker 01

  We have a strict no AI-written submissions policy. People have to do the writing. So tell us what, you guys have had some recent awards recently with the Merseyside Skeptics.

• 2:48Speaker 04

  Yeah, so the Skeptic Magazine, that myself and their editor, Michael Marshall, work on, we've been giving the Occam Awards and Rusty Razor Awards at various conferences in, over the last few years. We used to give it at the QED conference. This year, we gave it at the European Skeptics Congress, which we hosted in Liverpool this year, which is very exciting. So the magazine's been going since 1987. So it's the longest, UK's longest-running publication dedicated to skeptical analysis of pseudoscience, conspiracy theory. We talk about the paranormal, all sorts of different topics on there. And we've been giving this award to the Best Skeptical Activist, the Occam Award, each

• 3:30Speaker 04

  year, and the Rusty Razor for the Most Prolific Promotion of Pseudoscience.

• 3:34Speaker 01

  Who won this year?

• 3:36Speaker 04

  So this year's winner for activism was a chap called Martin Lewis. Don't know if he's made his way over the pond, but he is very, very, very famous in the UK. He's a consumer protection specialist, broadcaster, and anti-scam campaigner. He was once named the Most Trusted Man in Britain.

• 3:52Speaker 01

  Wow.

• 3:53Speaker 04

  He does this amazing website called Money Saving Expert. He helps consumers save money on all sorts of things. But in particular, he's been working on a bunch of scams that have been running under his name, using his name to sell cryptocurrency investment scams. And he's been challenging that, as well as all of his other brilliant consumer protection work. And then the Rusty Razor Award for the Most Prolific Promotion of Pseudoscience, we gave to Lord Toby Young, Baron of Acton.

• 4:26Cara Santa Maria?

  What a title.

• 4:26Speaker 04

  I know. It's quite remarkable that this, this person has been given a lordship as a member of the House of Lords in the UK. He's the founder and editor of an outlet called The Daily Skeptic. It started life during the pandemic as lockdown skeptics and writers were kind of campaigning against public health measures, like wearing face masks and social distances, distancing and underplaying the severity of COVID-19. More recently, they've kind of pivoted into quite a lot of climate change denialist material. So they're sharing an awful lot of material about climate change from some of the big, big climate change denial players in the UK and some, some big lobby groups.

• 5:08Speaker 04

  And an investigation from a campaign group called Democracy for Sale found that one of his other organizations, Toby Young runs the apparently non-partisan Free Speech Union. This, this campaign group, Democracy for Sale, found that the union were receiving significant funding from conservative Christian lobby groups and organizations linked to climate change denial. And in fact, the Free Speech Union took out a High Court injunction to prevent journalists from reporting on their other sources of funding.

• 5:41Speaker 01

  So he's a bad kind of skeptic.

• 5:42Speaker 04

  He's a bad kind of skeptic.

• 5:45Cara Santa Maria?

  That other definition of skeptic.

• 5:50Speaker 01

  We have the same kind of political division on this side of the pond as well, as I'm sure you're well aware of.

• 5:57Jay Novella?

  I'm not aware of that, Steve. How many more?

• 5:59Speaker 01

  So Alice, as a total aside, you're in Liverpool right now, correct?

• 6:04Speaker 04

  Yes.

• 6:04Speaker 01

  But you don't have a Liverpool accent. Where's your accent from?

• 6:07Speaker 04

  I do not. I'm from the East Midlands of the UK. So for most American listeners, I think the thing you might have heard of is, I'm from not too far away from Nottingham, which is where Robin Hood is from, where Sherwood Forest is.

• 6:20Speaker 01

  So you have a Nottingham accent? Is that accurate?

• 6:23Speaker 04

  It's probably the closest accent that, that your listeners will have heard of.

• 6:27Speaker 01

  Okay, sounds good.

• 6:28Cara Santa Maria?

  And Steve, Steve clearly does not in calling it Nottingham.

• 6:31Speaker 01

  Nottingham. Now, before we get on to the first segment, I wanted to point out that you are joining us on an auspicious episode, because this is episode number 1111.

• 6:45Jay Novella?

  Oh, my goodness. I love it.

• 6:47Speaker 01

  1011.

• 6:48Jay Novella?

  Is that my 111st verse?

• 6:50Speaker 01

  That won't happen again for 21 years, where all the four numbers match.

• 6:55Cara Santa Maria?

  Which means nothing.

• 6:56Jay Novella?

  It's Carol, we're doing the podcast by herself.

• 7:00Speaker 04

  You've got to keep going for a really long time.

• 7:03Bob Novella?

  Our AI surrogates will be here, don't worry.

• 7:05Speaker 01

  It means nothing, but it's just funny.

• 7:07Speaker 04

  Yes.

• 7:07Speaker 01

  All right. Cara, start us off with a what's the word?

• 7:11Cara Santa Maria?

  Okay, so we got an email from Jeremy Albert, who said, Jeremy Albert from Philly, who said, "Hello there. I don't love pointing out the meaning of centripetal versus centrifugal to someone who just used one of the words, but I thought you might find this as interesting as I do, since you have an entire segment on word etymology, which I appreciate. I hear people use them interchangeably, but they in fact imply a direction and effects directly opposite of one another." Now, he wrote in the title of his email, "Centripetal versus centrifugal, episode 113." So he may be going back to the beginning of the catalog, but of course, not just a few weeks ago, we've referenced these, I'm putting in air quotes, forces.

• 7:55Cara Santa Maria?

  I think, if I'm remembering correctly, there was a, oh God, I always get these mixed up. Hang on, hang on. And so I was like, okay, this might be a good time to talk about these words. So, anybody know who coined the word centripetal?

• 8:09Bob Novella?

  Ooh, I don't.

• 8:11Cara Santa Maria?

  I think you do.

• 8:12Bob Novella?

  I mean, I probably know who it is. I mean, who?

• 8:15Cara Santa Maria?

  I think you really know who it is.

• 8:17Bob Novella?

  Oh, crap.

• 8:18Jay Novella?

  I would say Newton's.

• 8:19Cara Santa Maria?

  It was Newton.

• 8:20Bob Novella?

  Yeah. Of course, that makes sense.

• 8:23Cara Santa Maria?

  Do you know who coined the term centrifugal?

• 8:25Jay Novella?

  Newton's Galileo?

• 8:27Cara Santa Maria?

  Newton!

• 8:28Jay Novella?

  Newton.

• 8:29Cara Santa Maria?

  Yeah. This is also a reason that this is so confusing. So oftentimes, scientists will make a distinction between the two by saying that centripetal, or put another way, centropetal or centropetal, right? P E T A L. Is a physical force. This is a real force, right? This is a force that is real according to how physics defines what a force is. And they will say that centrifugal or centrifugal or centrifugal. So that's F U G A L is actually a not real force.

• 9:10Bob Novella?

  Yeah, fictitious force.

• 9:11Cara Santa Maria?

  It's a fictitious force. Now, that does not mean that it doesn't happen. It doesn't mean that you can't feel it or that it's not real. What it means is that we are kind of misinterpreting an experience. So in order to define them, let's go back to their etymology because I think part of the confusion between the two could be clarified simply by understanding what the words mean. So when we say centripetal or centrifugal, the prefix there comes from the Latin sentry. And what does sentry refer to?

• 9:46Bob Novella?

  Middle, center?

• 9:47Cara Santa Maria?

  The middle, yeah, the center, right? So it's center and then pedal is to rush or to fly, which became petir, which is to make for, to go, to seek, to strive after. It's moving towards a center. It's going towards the center. Centripetal, centripetal. And then fugal, the, on the alternative side,

• 10:16Bob Novella?

  Yeah.

• 10:17Cara Santa Maria?

  is to flee, right? A fugue state, fugitive.

• 10:20Speaker 01

  Fleeing the center.

• 10:21Cara Santa Maria?

  You're fleeing the center. So in centripetal, you're going towards the center. In centrifugal and centrifugal, you're going away from the center. The problem is, we use both of these terms when we talk about spinning.

• 10:36Bob Novella?

  Yeah.

• 10:36Cara Santa Maria?

  And we use both of these terms when we talk about what's happening when an object is turning or spinning. So let's get into for a quick second why they're sort of equal and opposite, but referring to the same thing. Because I think that's where people get really, really, really confused. So by definition, this centripetal force, this physical force, means that when objects are spinning, the movement is towards the center. So here's a perfect example. You're looking at a car and that car is doing donuts.

• 11:14Cara Santa Maria?

  Does everybody know what a donut is?

• 11:15Speaker 01

  Yes.

• 11:15Bob Novella?

  Yeah.

• 11:16Cara Santa Maria?

  Okay, I don't, is that an American thing, Alice?

• 11:18Speaker 04

  No, we definitely do it here, too.

• 11:19Cara Santa Maria?

  You do donut, okay, okay, great. So the car is doing donuts over and over and over.

• 11:23Speaker 01

  But how do you spell donut?

• 11:27Bob Novella?

  That's the important question here.

• 11:30Cara Santa Maria?

  Right, very important. So the real physics is that we are observing this from the outside, right? This would be the, the centripetal force. And we are looking at, let's say, one portion of the car, the car door. As the car is spinning around, the door is pushing inward towards the center, right? All of that momentum is going towards the middle. The problem is, if you're on the inside of the car and you are observing it from the inside, you experience a weird illusion. We know the door is pushing inward. That push of the door inward on your body is perceived as your body pushing outward, even though your body's not actually going anywhere.

• 12:14Cara Santa Maria?

  It's going in circles, but you like, and this is an inertial thing, you like to go in a straight line if you're going in a straight line. So imagine there's a curve and you're trying to go in a straight line and you keep falling. You keep falling along the curve over and over. The door pushing inward on your body while it's trying to go in a straight line feels like you're going outward, but you're not actually going outward. There is no physical force pushing you against the door. The force is the door pushing you in.

• 12:45Speaker 01

  Yeah.

• 12:46Cara Santa Maria?

  Does that make sense?

• 12:47Speaker 01

  Yeah, inertia wants you to go in a straight line. The door is pushing you into a curve. That's the real force.

• 12:53Cara Santa Maria?

  That's the force. But we observe, it feels real to us.

• 12:57Speaker 01

  Because that's the frame of reference. Your frame of, you're in a, you're in a rotating frame of reference. And then from your perspective, there is an outward force. That's the fictitious centrifugal force.

• 13:08Cara Santa Maria?

  And that doesn't mean it's not real. It just means it's not a measurable physics force.

• 13:13Bob Novella?

  Right.

• 13:13Cara Santa Maria?

  It's the actual, it feels real.

• 13:16Bob Novella?

  Within your frame of reference, it's absolutely real. But if you can get outside of that frame of reference, you would then see, oh, okay, this is what's going on. You'd have to get outside.

• 13:24Speaker 01

  I always think of the roundup ride, right? So.

• 13:26Cara Santa Maria?

  That's what I was gonna say. We call it the spinnaker. When I was growing up, there was the spinnaker in the.

• 13:30Speaker 01

  Yeah, we call it the roundup. You're, you're, you are being pushed against the, the outer, you know, circle of the roundup. But actually, it's pushing you in and keeping you from flying off in a straight line.

• 13:43Cara Santa Maria?

  Exactly. It feels like you're being magnetized to the wall inside the ride. You physically can't pull your body off. It's so crazy. But what's actually happening is that that centripetal force is pulling inward and keeping you from going straight. You not going straight feels like you're being pushed out, but you're not actually being pushed out, which is bananas, honestly, when you think about it.

• 14:09Bob Novella?

  Have you ever seen anyone stand up on the wall while it's spinning on that ride? The roundup or the spinnaker?

• 14:16Cara Santa Maria?

  No, I'd be way too scared to do that, too.

• 14:18Bob Novella?

  I mean, I've seen pictures of it. I've never seen anyone do it when I used to do it like many decades ago. But as the picture blew me away, like, oh, my God, you actually did that on that ride?

• 14:27Speaker 01

  That's crazy.

• 14:28Bob Novella?

  Yeah, but cool.

• 14:29Cara Santa Maria?

  Yeah. So remember the difference. Pedal towards, fugal away. And if you have a hard time with that, you know these roots of, you know, a fugue state.

• 14:41Speaker 01

  Tempest fugit, time flies.

• 14:43Cara Santa Maria?

  Yeah, yeah, fugitive, refuge. And so, once you know that, you'll always be able to remember the difference between out and in. The inward is the true physics force. The outward is the observer bias or the sort of referred force, which is not actually what's happening, it just feels like it.

• 15:02Speaker 01

  All right, thanks, Kara. Have you guys heard about Christina Applegate's MS, misdiagnosis?

• 15:08Bob Novella?

  Yeah.

• 15:09Cara Santa Maria?

  Yes. Misdiagnosis?

• 15:10Speaker 01

  Yeah.

• 15:11Speaker 04

  No.

• 15:12Cara Santa Maria?

  Oh.

• 15:13Speaker 01

  So this is getting a lot of news and, and there's a lot of discussion online about it, a lot of which is very confused. So I thought I would clarify this. So in 2021, Christina Applegate, who's a famous E-Rex actress, was diagnosed with multiple sclerosis, MS. She was having symptoms of tingling in her lower extremities, progressing to gait difficulty. She walks with a cane. She often will rely on a wheelchair. And so she was diagnosed with multiple sclerosis based upon a standard workup and she has been receiving treatment for MS. For background, very quickly, I do not have any direct access to her medical records, right?

• 15:52Speaker 01

  I have very little information about her actual case and it's all second, third hand. It's very difficult for me to actually, I've read as much as I can about it and there's just not a lot of information in the public domain.

• 16:07Bob Novella?

  So why should we listen to you then?

• 16:08Speaker 01

  So I'm, I'm talking more generally and I'll tell you what has been made public about her case. But there's a ton of questions I have that I can't find the answers to, which is fine. She's, her, her private medical condition is private.

• 16:23Cara Santa Maria?

  Of course, yeah.

• 16:24Speaker 01

  Although she has been, you know, since she was diagnosed with MS, she has been sort of a public spokesperson for MS research and MS treatment, et cetera. So, so she recently said on, on her podcast, which she co-hosts with Jamie Seeler, she said that she was recently told that she does not have multiple sclerosis, that that was a misdiagnosis. And now she's quote unquote, back at square one. She like doesn't know what her diagnosis is, which she is very upset about, understandably.

• 16:57Cara Santa Maria?

  Yeah.

• 16:57Bob Novella?

  Steve, did any of the MS treatments she got actually help?

• 17:01Speaker 01

  No, and that's part of the story here. So, so first, you know, multiple sclerosis is an autoimmune disease, right? Where the immune system is attacking the central nervous system. It's kind of the classic central nervous system autoimmune disease. The way it's diagnosed is very complicated. It's always been a very complicated diagnosis. There's no single test that tells you definitively that you have MS, right? It's not like diabetes where your blood sugar is over a certain number. You, by definition, have diabetes. It's not the same thing. The, the classic way to establish the diagnosis is that you have multiple lesions in the central nervous system that are separated in time and space, which means that they've clearly occurred, not all at the same time

• 17:46Speaker 01

  and in different locations within the central nervous system.

• 17:50Cara Santa Maria?

  Okay.

• 17:51Speaker 01

  Right? So if it all happens at once, it's not MS, it's something else, right? There, there are disorders which give you like a single episode of inflammatory lesions in the central nervous system. That's not MS. MS has to be over time, separated over time.

• 18:05Cara Santa Maria?

  Or if they're all in the same place, that could be a different disease as well.

• 18:08Speaker 01

  Also doesn't meet the criteria. It needs to be different places, different times. And there needs to be evidence that it's inflammatory, right?

• 18:16Cara Santa Maria?

  Right, it can't be just an injury.

• 18:18Speaker 01

  Right.

• 18:18Cara Santa Maria?

  Or another, another source of lesion.

• 18:19Speaker 01

  The etiology has to be autoimmune, has to be inflammation. And the third component is you rule out anything else that can do that, right? So it's partly a diagnosis of exclusion, but you have these positive things. You have to have multiple central nervous system lesions, time and space, inflammatory.

• 18:36Speaker 04

  And how, how do they identify the lesions? Do they do scans, specific scans?

• 18:41Speaker 01

  The most important piece of information is the MRI scan, right? So MRI scans of the brain and the spinal cord, those, that's the central nervous system, will show you these lesions that look like what MS can do. The problem is that those lesions on MRI scan, a lot of things can cause lesions to look like that.

• 19:05Speaker 01

  And so it's not by itself definitive. So from, again, from what I'm reading, when her diagnosis was initially made, she presented with her symptoms. She had an MRI scan and she had 40 different lesions that were identifiable on the imaging. And she had a spinal tap, which showed what we call oligoclonal bands. Oligo just means a few, right? Clone is clone, which means you have a few different clones of antibodies that are unique to the CSF, meaning they're being produced in the central nervous system.

• 19:38Bob Novella?

  Cerebral spinal fluid.

• 19:39Speaker 01

  From the periphery. So then, so if you have that, and there shouldn't have many, but she had some. So she had some oligoclonal bands, unique to the CSF, with multiple lesions on her MRI scan.

• 19:51Speaker 04

  So that's your sign that there's inflammation?

• 19:53Speaker 01

  Yeah, so a sign of inflammation, sign of multiple lesions. That's highly suspicious for MS.

• 19:59Bob Novella?

  What about different times?

• 20:01Speaker 01

  I'm assuming, well, I'm assuming that they ruled out other causes at the time, which is a standard part of the workup. It would have been now practiced not to do that, right?

• 20:09Cara Santa Maria?

  Right, yeah.

• 20:10Speaker 01

  And I'm also assuming that either they scanned her at multiple times. So there's two ways you get time, right? One is there is a lesion there, then there is a lesion there, right? So you, you scan over multiple, like if every six months, every year, you get a scan and new lesions are popping up, that's time. The other way is you could look at the lesions and some of the lesions can appear old. They have, they have different characteristics that make them look like an old lesion. Like this lesion is acute, it's happening right now. This lesion over here is not acute, it's old. It's already gone through the inflammatory process and now it's just a hole or whatever. And so those are different ways you could say, that you could say that these are happening over different periods of time.

• 20:56Cara Santa Maria?

  And to clarify, sorry, Steve, but when we think about, you know, the different types, like the relapsing remitting, like over time, is this always aggregate? Like, do, do lesions ever spontaneously heal or go away?

• 21:10Speaker 01

  They never go away.

• 21:11Cara Santa Maria?

  Okay, so you're just gaining more and more.

• 21:14Speaker 01

  They may, they may no longer be inflammatory and you can improve, but they don't vanish from your MRI scan, they leave a scar behind.

• 21:24Cara Santa Maria?

  So that would be, that would be the tell you're describing.

• 21:27Speaker 01

  Yeah.

• 21:27Cara Santa Maria?

  Active lesions with some of the lesions kind of a scar tissue.

• 21:30Speaker 01

  Some look new, some look old, yeah.

• 21:32Bob Novella?

  All right, Steve, you, you mentioned ruling out other potential causes. I assume that, that some of the other causes are very difficult to rule out, right?

• 21:40Speaker 01

  Yeah, so some, yeah, so some could be challenging. Some are more obvious, like there's a specific antibody you test for. If you have that antibody, you have this other disease. Some are actually subtypes of MS that are now considered their own disease because they have specific antibodies and specific clinical syndromes. Some are other autoimmune diseases. Lupus can give you CNS lesions, shoguns can give you CNS lesions. So there's other things that are known MS mimickers that you have to evaluate for. All right, so here's the thing, MS is really a spectrum, it's a very broad spectrum. So there are some people who unequivocally have MS. They not only have the lesions, the lesions have these classic features for MS lesions. There's something called Dawson's fingers, where you have these lesions which are

• 22:23Speaker 01

  sort of projecting away at right angles from the ventricles. This is the structure inside the brain. Like if you see these characteristics, like, oh my God, that's MS. Like that is, nothing else has that classic look to it. There's other specific features as well that make an MS lesion clearly an MS lesion. So there are some patients who have classic MS on MRI scan. They have clear oligoclonal bands, they have MS, right? And then the final piece to the puzzle is they respond as they should to MS treatments. And so those cases are pretty clear cut, there's not really much of a controversy there. We also see patients who, you know, I've seen patients who come to my clinic and they have symptoms, I do an MRI scan, they got a couple of lesions.

• 23:08Speaker 01

  They are, they don't look acutely inflammatory, who knows what caused them? Their spinal tap is negative. Do they have MS? I don't know, I send them to the MS clinic because they need specialty evaluation at that point. And it's, you take a look at the MRI scan, you tell me if these lesions, to your trained MS expert eyes, is this look like an MS lesion or, or not? And the real question now is, do they get treatment? Or do you monitor them for a while to see if they progress enough to then they cross that threshold where they should get treatment? So there's this gray zone, this diagnostic gray zone, there always has been with MS.

• 23:47Bob Novella?

  Steve, has AI been helping with this gray zone?

• 23:49Speaker 01

  Well, I don't know, because I assume it has been, but I've, I've been retired now for a year and I've, I've been out of, I've been out of MS for a long time because I got too specialized for a non-MS specialist, which I am not, I am not an MS specialist. So I don't know, I don't know the answer to that question. But anyway, so with her, what she is saying, you know, and what, what information that we're getting that has been made public is that she never really responded to standard MS treatments. And so for that reason, the doctors who were taking care of her said, you know, we have so many treatments, they're so good now, that the lack of response is enough

• 24:32Speaker 01

  that we should reexamine your diagnosis. Also, just in the last couple of years, I mean, the technology to make the diagnosis is improving. There's MRI scans now are, we're always getting more and more subtle features that they can distinguish. And so they redid her imaging, you know, they checked more up to date serology, like looking for antibodies and such, and they basically concluded, based upon the redoing her workup, that she does not have MS.

• 25:02Speaker 04

  When was she originally diagnosed with MS?

• 25:04Speaker 01

  2021, so five years ago.

• 25:06Speaker 04

  That must be really hard to hear if you feel like you've had answers and then suddenly those answers are completely taken away.

• 25:12Cara Santa Maria?

  Right, and it becomes a part of your identity.

• 25:15Speaker 01

  Yeah, so she's, I think for her, because she was an outspoken proponent of MS, you know, as a disease.

• 25:21Cara Santa Maria?

  Like a spokesperson.

• 25:22Speaker 01

  A spokesperson, that is hard for her to hear that she doesn't have it. And I'll tell you, as a clinician, clinicians and patients approach this differently and we always have to be aware of that because according to her, her doctor walked in the room and said, "Good news, you don't have MS." Right, so the doctor thought that was good news and she thought it was bad news.

• 25:45Bob Novella?

  Yeah.

• 25:46Speaker 04

  Which is, which is totally understandable, right?

• 25:48Speaker 01

  Totally understandable.

• 25:50Speaker 04

  If you have those symptoms, you want answers. And if you have the answer taken away, you're back to square one of not knowing what's causing the symptoms. The symptoms are still real, presumably, right? The symptoms don't go away.

• 26:00Speaker 01

  Of course.

• 26:00Cara Santa Maria?

  Sometimes bad news, I see this all the time with my cancer patients. Sometimes getting bad news is easier to handle than the uncertainty of no news.

• 26:08Bob Novella?

  Yeah.

• 26:09Speaker 01

  Absolutely, and I've had to, as a clinician, to wrestle with that. And I've been in the position many, many times where I've had to explain to patients why it's good news that they don't have a horrible disease.

• 26:22Cara Santa Maria?

  Yes.

• 26:23Speaker 01

  And because patients do, this is what I call the Dr. House syndrome, that patients are led to believe by everything they watch in media that there's only one pathway to a good outcome. And it goes, that pathway goes through a very specific diagnosis. But that is not true.

• 26:44Speaker 04

  I would say it's not just through the media though, because certainly in my experience as, as somebody who has chronic health conditions and have dealt with doctors, often doctors are also kind of pushing you towards a diagnosis. And whenever they can't get a diagnosis, they don't want to listen to what your concerns are as well. Not all doctors, but definitely some.

• 27:04Speaker 01

  I agree, there's good bias doctors as well. But, and I think this might be specialty specific as well. As a neurologist, I'm very comfortable with not knowing what a patient has specifically because that's just the nature of the job. But I, what I often tell patients, first of all, sometimes it's more important for me to know what you don't have than to know what you do have. So that's not square one, that's not nothing. Knowing what you don't have is extremely valuable. It narrows the range of possibilities here that we could be dealing with. Also, knowing what kind of process is going on may be enough, even if I can't put a very specific label to it. And always not having a horrible diagnosis. Now, I'm not saying MS is universally horrible. It isn't. Don't get that impression.

• 27:49Speaker 01

  But not having a, like, I often have to tell patients, this is a diagnosis you don't want to have. You should be happy that you don't have it. I would rather not know what you have than know that you have this. And they have a, I can often get them to appreciate that, but they still just their, their emotional reactions. I'd rather know what it is than not know what it is.

• 28:11Cara Santa Maria?

  Yeah, and I can imagine, Steve, that in your line of work, especially when you're talking to people who have pain.

• 28:19Speaker 01

  Yeah.

• 28:20Cara Santa Maria?

  Pain in their head and they don't know why. And sometimes you're never gonna know why. Knowing that it's not a, you know, I was about to say something that I knew would evoke.

• 28:30Speaker 01

  Yeah.

• 28:31Cara Santa Maria?

  Knowing it's not a tumor. Knowing that.

• 28:34Jay Novella?

  Not a tumor.

• 28:35Cara Santa Maria?

  Yeah, there are cer, thank you. There are certain things that aren't responsible for it is a huge relief off the bat.

• 28:41Speaker 01

  Well, yeah, I also have to tell patients, not having a more specific diagnosis doesn't mean we can't treat it. We can always treat you symptomatically regardless. And I can treat for the worst things that it could be that I can't rule out.

• 28:55Cara Santa Maria?

  And some diseases are only treated symptomatically. There is no sort of mechanistic treatment.

• 29:00Speaker 01

  But people think, but if I have a label to it, then there's a cure. It's like, no, that's also not true.

• 29:06Speaker 04

  Sometimes that label is also their access to the adjustments and support that they need outside of medical support.

• 29:13Speaker 01

  That is exactly correct. And oftentimes, that is, that's the final piece in the, in the United States especially. That is, opens up insurance coverage and resources and whatnot. But that's why we have a lot of diagnoses that we give patients when we don't know what they have. Right? We have diagnoses to cover that.

• 29:32Jay Novella?

  Oh, that's interesting. Yeah.

• 29:33Speaker 01

  Like fibromyalgia. You have chronic fatigue syndrome. You know, you have whatever.

• 29:38Jay Novella?

  Just labels.

• 29:38Speaker 01

  And, and they're also, you know, to be fair, in the code, there are MRI lesion of unknown etiology. Like, there's, there are codes for, for what we, what we can say, even when we don't have a very specific diagnosis.

• 29:52Cara Santa Maria?

  We see it in cancer. And you probably see this too, Alice. Like, you know, unknown malignancies, because they have all of the hallmarks of a malignancy, but we don't know the source of that cancer tissue yet.

• 30:01Jay Novella?

  Like dark matter or dark energy. Yeah, we don't know what the hell that is, but we got some cool names for it.

• 30:05Speaker 01

  Yeah.

• 30:07Jay Novella?

  But Steve, if, see, if she, if she, that happened to me and this guy, the doctor comes in, good news, everyone. It's not MS. My, my knee jerk would probably be like, it's like he said, good news, we've been incompetent for five, for half a decade.

• 30:20Speaker 01

  No, but so that's part, what I really want to point out here, that because her diagnosis was in flux with MS, which is this notoriously difficult thing to nail down, that does not imply incompetence. That is, that is, even if the doctor did 100% expert care, that still can happen and does happen. Sometimes we have to wait for things to progress before they declare themselves. Sometimes they just don't proceed the way we thought. We have a working diagnosis, but then, you know, the fact that the doctors were able to pivot and say, wait a minute, things are not going as expected. Let's rethink this and then change the diagnosis. That's a good thing.

• 31:00Jay Novella?

  That's a good thing. And I hope you explain that, you know, to her soon after he came in with the good news.

• 31:05Speaker 01

  Yeah, again, we don't know. And we're just getting a third hand here. So we just, and I've learned never to judge another doctor's behavior based upon secondhand information. Because it's never, and I mean, never accurate.

• 31:17Cara Santa Maria?

  Right, right. Like, what did the doctor say? Okay, well, let's see what the doctor actually said.

• 31:22Speaker 01

  Actually said it's never the same thing. I'm telling you, in 30 years, it has never been the same thing. It's always dramatically different. Anyway.

• 31:28Jay Novella?

  Steve, can a misdiagnosis lead to a lawsuit?

• 31:31Speaker 01

  Oh, no, not necessarily, right? So only you, a bad outcome does not mean malpractice. You have to have practice substandard care. So someone would have to demonstrate that they failed to do something that was clearly within the standard of care.

• 31:46Cara Santa Maria?

  Right, like if they didn't do a differential diagnosis at all.

• 31:49Speaker 01

  If they didn't rule something else out or whatever. But if you're practicing within the standard of care, that's no guarantee that 100% of things are gonna work out. Right? That's not, medicine doesn't work that way. People are variable. We're applying general data to specific individuals. It's all statistical at the end of the day. So I doubt, I mean, given who she is, I doubt that she had substandard care. That would really shock me. And this story is so common, MS, to up to 20% of people who are initially diagnosed with MS have something else. That's just, that's just part of the, the nature of this very squirrely disease. Right? The, just the narrative that's out there in the public, this, there's misdiagnosis implies bad care. Nope, that is not true. That she's back to square one? Not exactly. They actually know a lot of information.

• 32:34Speaker 01

  They may not have as specific a diagnosis they had previously, but that's not the same as square one. Or that not having a diagnosis is necessarily horrible. It really isn't. It doesn't mean we can't manage a patient or manage their symptoms or have a lot of information about what is and what is not going on. So I just want to dispel those kind of myths based upon the public reporting of this.

• 32:59Cara Santa Maria?

  That makes sense. And I can't help, you know, I, it's my bias, but I can't help to see this through an oncologic lens. And it's something that we see all the time in oncology, where there's an idea of what's going on that gets clarified through new biopsies, through new, you know, DNA analyses. And not just that, early on in a patient's course, there is a treatment plan. That treatment plan has to be updated based on how they respond to treatment. And I think sometimes the, the struggle is when the changeability of how this disease can be managed is not made explicit at the top. Because I think there's just an expectation, and this is cultural, that if you have a plan

• 33:43Cara Santa Maria?

  and you do the plan, you're gonna have an outcome. And if things change, it means you screwed up somewhere along the line. Not that like, no, no, new information.

• 33:52Speaker 01

  Medicine's complicated.

• 33:53Cara Santa Maria?

  Means that there's a new calculation.

• 33:55Speaker 01

  Yeah. And in fairness, you could explain all of that exquisitely to a patient and they generally remember about half of what you say. And if you just dropped a bad diagnosis on them, they remember almost nothing of what you say.

• 34:07Cara Santa Maria?

  Yeah. And it's a lifetime of heuristic thinking that way. Like, you know, it's, you're not gonna undo that in, in one or two meetings.

• 34:14Speaker 01

  Exactly. It's a process. All right, Jay, I was very interested in this study because this confirms all of my biases. But anyway, tell us about this study of ultra-processed food.

• 34:25Jay Novella?

  Well, Steve, you know, the, this isn't conclusive. Like, there's a lot of lessons that we can learn inside this study and what's there and what's actually not there. But let me start with a question for you guys. So what, what percentage of calories, I'm going to go with people in the United States, that's, because that's where most of the data came from. What, what percentage of calories from American adults do you think comes from ultra-processed foods?

• 34:52Bob Novella?

  Oh, geez, 60%.

• 34:54Cara Santa Maria?

  American adults, yeah, I'd say over, over half.

• 34:57Speaker 04

  Yeah, in the States, I'd go quite high.

• 34:59Jay Novella?

  Why is that? Because we're all fat? Is that what you're saying?

• 35:02Speaker 04

  No, not at all. But because I think.

• 35:05Jay Novella?

  But we are.

• 35:05Speaker 04

  The food processes are slightly different than, than in the UK, I think. And, and they're pretty high here as well. Ultra-processed foods are quite high here.

• 35:13Jay Novella?

  Alice, be honest with me. Does this podcast make me look fat?

• 35:18Jay Novella?

  Steve, what do you think?

• 35:19Speaker 01

  Well, I know the answer. It's a little bit less than half.

• 35:22Jay Novella?

  No, it's actually a little bit over half.

• 35:23Speaker 01

  That's 48% in this study.

• 35:24Jay Novella?

  Not from the study, Steve. The CDC, the CDC has data that I'm quoting here, not the study itself.

• 35:32Speaker 01

  Yeah, so if you look at the methods and findings, they say, this is how, this is, you know, these are tiny detail we're getting stuck on. But they said the median ultra-processed food intake was 43% of daily calorie, daily energy intake. But whatever, it depends on how you, you know, how do you want to define it?

• 35:47Jay Novella?

  Yeah, it's about half. This is according to the CDC. So you, basically, everyone was, was close or very close. This data was coming from 2021 and 2023. So now, let's go back to the early 2000s, like 2001. What do you think the percentage was back then? 40?

• 36:08Cara Santa Maria?

  Maybe it was higher.

• 36:10Speaker 04

  That's what I was just wondering. It's definitely still high. But I think we've, we've definitely moved towards reducing processed food intake with all the, the scaremongering that we've had.

• 36:21Cara Santa Maria?

  Yeah, that's what I would assume.

• 36:22Jay Novella?

  In this country?

• 36:23Speaker 04

  And 2001 isn't that long ago.

• 36:25Cara Santa Maria?

  No, it's not.

• 36:26Jay Novella?

  Okay, so it, according to the CDC, it was up by 0.5%.

• 36:32Cara Santa Maria?

  Yeah.

• 36:33Jay Novella?

  So it was a little bit higher, a tiny bit higher in 2001. And that estimate rises to 57% in 2018. I tried to find out what it was and I think it's frozen pizza that was pushing it up that high.

• 36:48Speaker 04

  What was it in 2020 when we were all at home?

• 36:50Cara Santa Maria?

  Right.

• 36:51Bob Novella?

  That doesn't count, man. That's, that's.

• 36:54Speaker 01

  COVID is a blip in every data site ever. I'm sure.

• 36:59Bob Novella?

  The pandemic exclusion, I mean, come on. We get that once a century.

• 37:04Jay Novella?

  So talking about the CDC data and the study data, and, you know, they aren't apples to apples, which means that we have to, of course, take every, every statistic here with a grain of salt. But the larger point, I think, is pretty clear that ultra-processed foods, you know, they haven't suddenly taken over our diets in the United States. And, you know, they've been supplying around half of our calories for, for decades, without a doubt. And interestingly, these foods existed pretty early, too. Like, we became, the United States became increasingly addicted to, or they became popular in the United States during the 50s with things that they call convenience food, Swanson's frozen TV dinners. Alice, did they have anything like that?

• 37:47Speaker 04

  Um, yeah, we have stuff like that. Probably not quite to the, to the same scale, but definitely we, we have things like that.

• 37:53Jay Novella?

  Well, this became, like, these frozen TV dinners and Betty Crocker cake mixes and sugary cereals like Frosted Flakes, all of this stuff became really prevalent. Like, I remember growing up, we would have, like, frozen TV dinners a lot and we loved them.

• 38:08Cara Santa Maria?

  I always associated this with World War II. I always associated it with, like, during and immediately after the war, the sort of like MRE translating into keeping things easier at home while mom was working because dad was fighting. I don't know. I, that, that mid-century boom of packaged food.

• 38:29Jay Novella?

  Packaged or like TV dinner type food?

• 38:32Speaker 04

  We definitely have some tinned pies that I'm pretty sure you could find one from the Second World War and still be able to eat it.

• 38:38Jay Novella?

  Well, Karen, you're not wrong. I mean, this does go back, I think, into the 40s. But I'm bringing up the 50s because that's when it really hit consumers. This was what the big boom, you know, replacing whole meals with processed foods and things like that. So.

• 38:53Bob Novella?

  Jay, does that apply to like TV dinners?

• 38:56Jay Novella?

  Bob, Swanson's frozen TV dinners. That's the first thing I mentioned.

• 38:59Bob Novella?

  Okay, so that, I know that stemmed from an overabundance of turkey. I think after Thanksgiving, some Thanksgiving in the 50s, they had so much turkey. They were like, oh, my God, what are we going to do? We're going to lose a lot of money. Let's make TV dinners out of this turkey. And that's what put it, that's what made it just, you know, eventually just explode, that type, that type of processed food.

• 39:21Speaker 01

  But to be, to be clear, processed food goes back at least a couple hundred years. I mean, this, you know.

• 39:26Cara Santa Maria?

  Yeah, I think so, like so many things, Jay, an important question for, for this study would be, how do we define processed food?

• 39:35Jay Novella?

  I have that answer.

• 39:36Speaker 01

  Well, the, in the context of the study, they had to go with an operational definition.

• 39:40Jay Novella?

  So the researchers used a system called NOVA, and this separates foods into four groups. And this is based on how they're processed. And this, even in this definition, it's a little murky, right? So ultra-processed foods are generally, you know, these are industrial mixtures. They're containing ingredients that you wouldn't normally cook with. And they also add in additives that change the flavor, they change color and the texture. And if you've ever read the ingredients on common things, like go and look at your average loaf of bread in the supermarket and you're going to see, you know, 30 ingredients, you know, I bake bread. I need four ingredients. So what is all that stuff? And, you know, another question is, is it dangerous and which ones are dangerous?

• 40:23Jay Novella?

  So if we're going to talk about ultra-processed foods, we're going to talk about things like soda, packaged snack cakes, hot dogs, chicken nuggets, again, frozen pizzas, but not frozen vegetables or putting, you know, beans in a can. That doesn't make them ultra-processed. It has to, it has to have a lot of stuff in it that wouldn't not normally need to be there.

• 40:45Bob Novella?

  Dyes and preservatives.

• 40:46Jay Novella?

  Right. And here's where the, this category gets kind of complicated. So it also includes some whole grain breads and breakfast cereals and dairy products. So, you know, foods with very different nutritional qualities can end up under the same label.

• 41:00Speaker 04

  Because some additives are great, right? Some additives are really important.

• 41:02Cara Santa Maria?

  Lots of them are. And, and I mean, it's important for your food to last if you wouldn't have access to food, if it was going to rot within two days. And also, what about fortified foods? Those are processed too.

• 41:13Speaker 01

  I'll just say at this point, and I do think this is like a major conclusion that the authors are talking about in this study, is that I think the whole category of processed, ultra-processed foods is bullshit. Because it seems like it's, it's completely incidental to the health effects of the food. The only thing that matters is the ingredients themselves.

• 41:34Jay Novella?

  Exactly. It's, and it's the dividing line and where we put that. And what does the dividing line even mean?

• 41:39Cara Santa Maria?

  Right. It's no different than GMOs in that way. It doesn't matter how you get there. What, let's look at the end product.

• 41:45Jay Novella?

  Exactly. So I'm going to put a question to you guys that a new study tried to answer. And the question is, are these foods unhealthy because of how they're made or because of what's in them? Or both, right? So there was a new study and PLOS, would you just say PLOS for that?

• 42:01Cara Santa Maria?

  Yeah, it's like PLOS 1, PLOS, yeah, Public Library of Science.

• 42:05Jay Novella?

  So they tried to answer it. They specifically studied colorectal cancer, right? This is colon or rectum cancer. The researchers analyzed information from a huge group, 461,000 Americans. They joined this health study in the mid 90s and the participants reported what they ate. And researchers tracked cancer diagnoses for about 19 years. More than 10,000 people developed cancer during the study. Does that mean anything? Well, or does that track with people who, who they weren't, you know, that they weren't, you know, analyzing what they were eating? Or is that the average, you know, in the general population? But the question is, did eating more ultra-processed foods go along with the higher rates of cancer? And in the researchers' main analysis, they said no.

• 42:50Jay Novella?

  But the overall results did have some important things that poke out, right? So meat from ultra-processed foods was linked to higher cancer rates, while whole grains, fiber, dairy and calcium from ultra-processed sources were linked to lower rates. And the meat findings fit with existing evidence about processed meats, like the hot dogs, the ham and cured sausages and everything. I mean, in general, like these, these meats are, are considered to not be healthy.

• 43:16Speaker 01

  Well, all right, a couple of things about that really quick. Because we've talked about that data just itself, the, the processed meat. Yes, that generally speaking, it's not as healthy to eat that kind of meat than, than not processed meat. But you have to eat a lot of it in order for the signal to appear in the data.

• 43:32Bob Novella?

  Dose makes the poison.

• 43:32Speaker 01

  Like a pound of bacon a day kind of stuff. You have to eat a lot of it.

• 43:36Jay Novella?

  That's doable.

• 43:36Speaker 01

  I also think, that's, yeah, that's probably reasonable.

• 43:40Cara Santa Maria?

  Also, meat is unhealthy in large quantities.

• 43:42Speaker 01

  You shouldn't overeat meat, which we generally do, but also.

• 43:45Bob Novella?

  Shouldn't overeat, we shouldn't overeat anything.

• 43:47Speaker 01

  I suspect that the processed meat is what is causing all of the signal within the processed food research showing that there are any health effects. You know what I'm saying?

• 43:58Jay Novella?

  Oh, that's interesting.

• 43:59Cara Santa Maria?

  It's a large portion of the variance.

• 44:01Speaker 01

  If you eliminate the processed meat from all the other, like, processed food research, I bet you all of the signal goes away.

• 44:07Speaker 04

  It's interesting.

• 44:08Jay Novella?

  So, and then they're saying on the other side, the point, counterpoint here, some whole grain breads and cereals can provide fiber and fiber is incredibly important in the diet. And dairy products can provide calcium and calcium is very important. So even when some of these products fall into the ultra-processed category, it doesn't really prove a particular cereal prevents cancer or not. But, you know, we're kind of throwing the baby out with the bathwater when we just say ultra-processed foods and it's all bad and it's, you know, we're just waving a hand over it, just like everything else that we talk about on the show. There's nuances here and the nuances are important. And understanding them is actually, I think, the only way that you're going to be able to eat healthier.

• 44:51Jay Novella?

  Unless you're just saying, look, I'm just going to eat fresh meats, fruits and vegetables and not play in this game at all.

• 44:57Cara Santa Maria?

  Yeah, good luck. You got to be pretty rich to do that.

• 45:00Speaker 04

  And, and have a lot of free time. Yeah.

• 45:02Cara Santa Maria?

  Right.

• 45:03Jay Novella?

  Right. So there's limits to what we can conclude from this. The researchers didn't assign people different diets, which, you know, that's a big deal. Because they, it seems that they didn't have a baseline here to judge the study against. They observed what people reported eating and other differences between those people, though, could impact their health, health results, of course. There's a lot of data missing from the study. They also measured diet only at the beginning, meaning they asked people back in 1995, what are you eating? And they never asked them that again. So they just went off, right? Which I thought was a major hole here.

• 45:37Speaker 01

  I thought that was the weakest part of the study.

• 45:39Bob Novella?

  Oh, wow, man.

• 45:40Jay Novella?

  Most of the participants were older white dudes, which limits, you know, how broadly we can apply the findings because, you know, that's just one kind of person out there, of course. And this was also specifically about the colorectal cancer, you know, not every possible health effect. So again, there's a lot of information missing and I think that they could have sharpened this a lot. You know, if you're going to go on a 19 or 20 year study, you know, you do need to kind of think about the details that I just brought up, right?

• 46:08Speaker 01

  But Jay, but to be fair, right, when you're doing a study like this. They take, it takes resources and it's, it's difficult. And you basically, there's a trade off between how many people, how much information, how long. You know, you, every study can't have all of those things in optimal amount. Sometimes you have to say, we're going to have a lot of people, but not a lot of data about them. Or it's going to be observational, or we're going to have a few people, but we're going to collect a ton of data about these few people. It's hard to have a lot of information about a lot of people over a long period of time.

• 46:41Jay Novella?

  Yeah, if only the government was funding scientific studies, Steve, you know.

• 46:45Speaker 04

  But also, I guess, I guess they didn't set out to research ultra-processed food, right? Because that term didn't exist 19 years ago. That's, that's a relatively new term. So they've, they've been doing a study that's presumably looking at least a little bit at diet. But I guess they've been collecting other data and looking at other things as well, if they've been going for such a long time.

• 47:04Speaker 01

  There's a lot, there's a lot of demographic data, like smoking history and, you know, that kind of stuff. Yeah.

• 47:08Jay Novella?

  So there's, there's other questions, like separate questions about the additives as well. And I want to take a minute to talk about this. So, you know, we read an unfamiliar ingredient and the name doesn't tell us whether it's harmful or not, right? And again, you know, the dose is a big deal. How much of it is in the product? You know, a lot of, a lot of things that I find that I don't like are minuscule amounts. You know, they're, you know, you'd have to eat like 50 loaves of bread for that hydrogenated oil to do something to you, because there isn't a lot of it in there. So we need evidence about specific ingredients and how much people can consume. And this study wasn't designed to settle those questions, which is fine. Because again, like Steve said, they can't do everything.

• 47:50Jay Novella?

  And we shouldn't take this study as evidence that processing. Never matters either, right? We have to be careful because this just goes both ways. In a separate NIH experiment, now this only involved 20 adults, but the participants ate about 500 extra calories a day on ultra-processed diets compared with unprocessed diets. They also gained weight during this phase and that, you know, this doesn't identify one ingredient as a culprit, but it is a reason not to just dismiss the study in general, right? Again, I think it pushed the ball forward a little bit. It is, you know, there are some things that are interesting in here. But here, here are the things that I continue to look for. Do we have a fluid understanding of what ultra-processed foods are, right?

• 48:35Jay Novella?

  Because I think a lot of people just think things are being taken out. Like if you, let's say you're processing chicken. And I think, you know, my definition of it like 10 years ago would have been something like this. Oh, they're taking out stuff and it's like they're, they're botching up the nutrition, the base nutrition of whatever it is in the chicken. And then they're adding in other stuff and they're adding in preservatives and food coloring and stuff like that.

• 48:57Bob Novella?

  And more fat.

• 48:57Jay Novella?

  Which might not be necessary or are not necessary. You know, like you definitely don't need it. Now, we could talk about preservatives and, you know, I think that they are needed, but you know, are they safe? These are questions that I think vex consumers and it becomes so nebulous that that's why the categories to the public are like, fast food, it's all crap. And, you know, cereal, most of it's crap. You know, it's super high in sugar and food coloring and all that. But, but people really don't, or don't have the time to, or don't have the resources to drill down into the details. And this is where I think we need it.

• 49:32Speaker 01

  I agree. People need to use, and people always do this, right? They use simplistic algorithms or markers to replace complex, nuanced, detailed thinking because it's, it's time consuming. And you're right, it takes a lot of cognitive energy.

• 49:46Cara Santa Maria?

  Yeah, we don't have the bandwidth always.

• 49:47Speaker 01

  So it's good to have a shorthand, you know, a rule of thumb to stand in for a detailed analysis.

• 49:53Bob Novella?

  heuristic.

• 49:53Speaker 01

  But that's the problem. Yeah, heuristic, exactly. But when your heuristic is fundamentally flawed, that's a problem. And that's my point. I think the processed heuristic is fundamentally flawed. You should be thinking instead about how much fat, sugar, salt, et cetera, I'm eating, not just is it processed or not? Because processing itself, I think, is neutral. And some processed foods are actually good for you. And, and the ones that are not good for you are not good, not because they're processed, but because they have too much fat, sugar and salt. You know what I mean? So that just, but that makes, that would force people to think in a more, in a more complicated way. So I, I always like to substitute my own heuristic.

• 50:37Speaker 01

  And that is just eat a lot of different things, eat a lot of plants, and you're fine. Right? That's it. That's a very simplistic heuristic.

• 50:46Bob Novella?

  You can't go too wrong with that.

• 50:47Speaker 01

  That actually works. It's hard to go wrong with that.

• 50:48Cara Santa Maria?

  Well, and limit, yeah, limit excessive sugar intake.

• 50:52Speaker 01

  Yeah.

• 50:52Speaker 04

  Yeah. But I think also people are now being encouraged to be so anxious about the food that they eat, that they're thinking about it so obsessively. And we're going to come back to thinking about things obsessively later on, all the time, and they're really getting themselves worked up. And that doesn't make anything healthy.

• 51:07Speaker 01

  I agree.

• 51:08Cara Santa Maria?

  No. I just had this like long discussion with a patient about morning coffee. And like somewhere in their head, it stuck that somebody was like, you should limit your caffeine during chemo. And so now all of the constipation problems, all of the joy from their morning. And it's like, everything's a risk benefit analysis. Do you want to have no joy in your life for the, like, what is the percentage improvement that you'd have from limiting caffeine? You know what I mean? And I, we don't talk in terms of risk benefit analysis.

• 51:38Jay Novella?

  What, what we need is a science-based app that you just take a picture of the ingredients and then it can tell you if there's anything that you really need to know.

• 51:48Cara Santa Maria?

  And that you can put in your own medical, you know, concerns. Like I have high cholesterol. Is this safe to eat? I need to limit my salt intake. Is this safe to eat? Like, that would be really great.

• 52:00Jay Novella?

  And there are.

• 52:01Bob Novella?

  Yeah, like a questionnaire before you, you know, use the app.

• 52:04Jay Novella?

  There are ingredients that sound.

• 52:06Bob Novella?

  Secure.

• 52:07Jay Novella?

  Like scary, but they probably aren't. Like this one, tricalcium phosphate. I don't know what it is. You guys know what that is?

• 52:16Bob Novella?

  Something about three calciums.

• 52:17Cara Santa Maria?

  It sounds like it's got three calciums.

• 52:18Speaker 04

  It's got three calciums in a phosphate.

• 52:20Jay Novella?

  But again, you know, like, because I, I said that to myself too. Yeah, okay. I, I think I have an idea of what it is, but it does sound like, oh, man, what kind of chemical is that?

• 52:29Cara Santa Maria?

  Well, isn't that the joke is like dihydrogen monoxide?

• 52:32Bob Novella?

  Yeah, water.

• 52:33Cara Santa Maria?

  Yeah, water. Yeah.

• 52:34Jay Novella?

  But the, so that's the problem because we can't expect consumers to be so on the ball that they could quickly glance at the ingredients of the average thing that they're buying in the supermarket and have a full, get the full picture of what this is to them in their diet.

• 52:50Speaker 01

  Yeah, read the chemical breakdown of a banana. And it's just as, you know, chemophobic as anything that, that people talk about.

• 52:58Jay Novella?

  And it's radioactive. It's radioactive. So I think, Steve, your heuristic is really like, of all the things that we discussed here, you know, I think that's the most, actually the most important thing that our listeners can, can focus on is that there are basic things that you can do and basic decisions that you can make that could greatly improve your diet, where you don't have to be so concerned about everything else. Like, you know, really, really simply, do not eat what you would consider to be classic fast food often. Just don't do it.

• 53:27Bob Novella?

  Yeah, don't do it often. And Jay, another, another kind of indirect heuristic here, unrelated to food intake, is fitness level. I remember reading, now granted, this was many years ago, but I'm sure this is probably held up. But when they did studies of people who were, or maybe not people, but rats. Okay, they did, this is a rat study probably. But fit rats shrugged off the bad effects of like, say, a high sugar diet, then unfit rats. So the fact that you're, that you move or you exercise can actually help you with a slightly bad diet. If you're, it makes your diet essentially a little bit better because you're actually a fitter person and you could shrug off a lot of those effects.

• 54:04Cara Santa Maria?

  Yeah, your, your basal, like metabolic rate is going to be, or there's a lot of other indicators, is going to affect everything. It's going to affect your ability. But, but I think, Bob, what you're not sort of pointing to is that the reason you're fit is probably because you don't overindulge in those kinds of things.

• 54:24Speaker 04

  I don't know. I, I know some really long distance runners who don't eat very healthily.

• 54:29Cara Santa Maria?

  Yeah. Yeah. But I wouldn't call those people necessarily fit. I think that's the thing we have to remember too. You can be athletic and not have a healthy body.

• 54:37Bob Novella?

  Absolutely. But it does, it will help shrug off some of the bad effects of a bad diet.

• 54:43Cara Santa Maria?

  Of course.

• 54:43Bob Novella?

  To a certain extent.

• 54:44Cara Santa Maria?

  It's all a combination.

• 54:46Speaker 01

  Yeah, for most people, the 95%er is just a few things. Exercise regularly, eat a varied, largely plant-based diet, get good sleep, don't smoke, don't drink to excess. And that's it. And we keep repackaging that same basic message over and over again.

• 55:03Bob Novella?

  Steve, write a book. It's, it's only going to have two pages.

• 55:05Speaker 01

  It's a pamphlet.

• 55:06Bob Novella?

  But write a book and sell it. It's going to be a hot.

• 55:09Speaker 01

  But, and everything else is noise. You know what I mean? Everything else is this, is faddish. It comes and goes. It's way too complicated or it's misleading.

• 55:17Cara Santa Maria?

  It's marketing.

• 55:18Bob Novella?

  It's all marketing.

• 55:18Jay Novella?

  Misdirection, cash grab.

• 55:19Speaker 01

  Yeah.

• 55:20Cara Santa Maria?

  Well, and there's a reason that what is the thing that is government mandated to be on food? The nutrition label.

• 55:27Speaker 01

  Yeah.

• 55:28Cara Santa Maria?

  That's the thing that matters. Look at the nutrition label.

• 55:32Speaker 01

  Yep. All right. Thanks, Jay. Well, everyone, we're going to take a quick break from our show to talk about our sponsor this week, Quince.

• 55:39Cara Santa Maria?

  Hey, Jay.

• 55:40Speaker 01

  Yeah.

• 55:41Cara Santa Maria?

  You know how sometimes it's kind of a pain to pick what you want to wear every day?

• 55:46Jay Novella?

  Yeah, you know what I do? I wear like the same thing every day.

• 55:48Cara Santa Maria?

  Yeah. Well, that's the thing. Wardrobe staples are the best. Perfect pair of pants, perfect tee in multiple colors. You know, that hoodie that you love, that jacket that you love. That's what Quince does so well. High-quality wardrobe staples made with premium materials, but not at premium price tags. They really change the game by giving you a luxury product without the luxury price tag.

• 56:14Jay Novella?

  Yeah, I got the Mongolian cashmere pullover hoodie. It's exactly like a standard hoodie. It's got a hood, it's got the front pocket, it's a pullover, but it's made out of cashmere. And I'm telling you, you know, the price, I'd pay more for a cotton hoodie than you would pay for the cashmere version.

• 56:30Bob Novella?

  So guys, find your next fall favorites at Quince. Download the Quince app for app exclusive offers or go to quince.com. Get free shipping on your order and 365 day returns. Now available in Canada and the UK too. And when Quince asks where you heard about them, let them know it was the Skeptic's Guide to the Universe. It's the best way to support the show.

• 56:49Speaker 01

  All right, guys, let's get back to the show. All right, Bob, we have a. Halloween use item for us about how super worms clean skeletons.

• 56:58Bob Novella?

  Yes, I've been saving this one for the end of October. So here we are.

• 57:02Speaker 01

  Not the boar worms, not the boar worms.

• 57:05Bob Novella?

  So, super worms in the news, people. And how many times has that sentence been uttered? Probably only a few. The nickname super worm, of course, doesn't have the gravitas of other nicknames like, remember those murder hornets from 2020? That was like the, such a fun name, but super worms are far more macabre. And that's because of recent studies show that, that, that they may be the best way, one of the top ways to turn a corpse into a skeleton. This is from a study published in PLOS One. The name of the study was "A Practical and Safe Alternative Method to Skeletal Cleaning for Museum Specimens Using Super Worms." Pretty straightforward. So what, what is a super worm? It's not a worm. These are not worms.

• 57:45Speaker 01

  They're maggots.

• 57:46Bob Novella?

  It's a, no, it's a larval form of a darkling beetle.

• 57:50Speaker 01

  Well, are all, are all larval forms of insects maggots or only some of them?

• 57:54Bob Novella?

  Oh, interesting. Look, look that up. I'm curious, but.

• 57:58Cara Santa Maria?

  Love how you turned that back on him.

• 58:00Speaker 01

  Well, maggots are larval flies, I guess.

• 58:03Bob Novella?

  The research I've done, the, the word maggot never came, never came up, but who knows? So interesting. So, all right, they're not, they're not worms. They have six true legs near the head, tiny, a little bit tough to see. They've got a segmented body and a chitinous exoskeleton. They're known as king worms, which is pretty cool. You know, if you have a nickname, two nicknames in fact, and one nickname has the word king in it and the other one has super, I think you're doing pretty good.

• 58:30Speaker 01

  All right, Bob, so maggots are only the larval form of true, of true flies.

• 58:34Bob Novella?

  There you go. So they are not maggots. They are not worms. These are larval forms of a darkling beetle. So these are also feeder insects. If you are a pet owner, you may know about these very well. People that can use these, these, you know, wormy larval things for reptiles, amphibians, fish and birds. So they're high, they're high in protein and in fact, would probably make a really good post-apocalyptic protein source. So keep that in mind. So guys, why are cleaned animal skeletons important? Who cares? Why? Why do we even need?

• 59:09Cara Santa Maria?

  They're science.

• 59:10Bob Novella?

  Yes. Scientific research for educations, like in museums, lots of skeletons in there. And of course, they're important for Bob's macabre collection of bones.

• 59:21Cara Santa Maria?

  And there's.

• 59:22Bob Novella?

  Yes.

• 59:23Speaker 01

  So.

• 59:24Bob Novella?

  Steve?

• 59:25Speaker 01

  The, the specific larval type that looks like a worm are called vermaform.

• 59:31Bob Novella?

  Yes.

• 59:32Cara Santa Maria?

  Vermaform.

• 59:34Bob Novella?

  Appendix. Nice.

• 59:36Cara Santa Maria?

  Hey, Bob.

• 59:36Bob Novella?

  Yes.

• 59:37Cara Santa Maria?

  What's your favorite skull you have?

• 59:39Bob Novella?

  Oh, wow. That is. Wait, Kara, what the hell?

• 59:44Speaker 01

  That's a Sophie's Choice for Bob.

• 59:46Cara Santa Maria?

  I have, I think mine's a tie between two.

• 59:49Bob Novella?

  I have a, I have about a dozen skulls. Well, I've got a hell of a lot more now, but I've got a dozen skulls that I keep on top of my bookcase as these are, these are my favorite. So I could give you like a top few, but it's hard to pick. Top three. All right. One was from, I, one was, it's a beautiful kind of, it's, I'm not even sure what it's made of, but I got it in Rome in 94 by the Trevi Fountain.

• 1:00:12Cara Santa Maria?

  Sorry.

• 1:00:12Bob Novella?

  It's beautiful.

• 1:00:13Cara Santa Maria?

  I don't mean human skulls made of other things. I mean actual bones.

• 1:00:17Bob Novella?

  Oh.

• 1:00:18Cara Santa Maria?

  What is your favorite animal skull that you have?

• 1:00:20Bob Novella?

  Animal skulls are fine, but humans really, I mean.

• 1:00:22Cara Santa Maria?

  Yeah, but that's not what we're talking about in this, in this episode.

• 1:00:26Bob Novella?

  All right. My favorite skull that I own is a dragon skull. Are you happy, Kara?

• 1:00:30Cara Santa Maria?

  You know I'm asking, so I can tell you mine, goddammit.

• 1:00:34Speaker 01

  Cut to the chase, Kara. What's your favorite skull?

• 1:00:35Bob Novella?

  I don't have animal skulls. What's yours?

• 1:00:37Cara Santa Maria?

  I have a hyrax, which is very cool. And I also have a puffin skull.

• 1:00:42Bob Novella?

  Oh, that's cool.

• 1:00:43Cara Santa Maria?

  It's very cool.

• 1:00:44Bob Novella?

  Well, how about this? What, does Neanderthal skull, is that kind of closer to what you were expecting?

• 1:00:49Cara Santa Maria?

  A real one?

• 1:00:49Bob Novella?

  No.

• 1:00:50Speaker 01

  No.

• 1:00:50Cara Santa Maria?

  Oh, okay. Then no.

• 1:00:51Speaker 01

  I have a replica of a chimpanzee skull, which is pretty cool.

• 1:00:55Cara Santa Maria?

  That is cool.

• 1:00:55Bob Novella?

  Yeah, I actually don't have a lot of real bones. I mean, I've got, Steve gave me a, a real skull years ago. Jay, Jay gave me a real skull as well, many years ago. So those are, those are obviously very, very cool. But that's, that's basically the extent, the extent of real, real bones.

• 1:01:12Cara Santa Maria?

  Talking about, right?

• 1:01:13Bob Novella?

  Yes.

• 1:01:13Cara Santa Maria?

  Bone cleaning.

• 1:01:14Bob Novella?

  Absolutely. Real bones.

• 1:01:16Cara Santa Maria?

  Just making sure.

• 1:01:17Bob Novella?

  And who knows? Who knows how the, the bones that we have were actually cleaned. But let's go through some of the possibilities, shall we? There's the, the tried and true burial method. That's old school graveyard method. Put it in the ground. If you want it done in a reasonable time, you put it in contact with dirt, the, you know, the, the specimen in, you know, not in a coffin, not embalmed, which of course applies mainly to people, but in the ground. So this is slow. It could take potentially months or longer. And then, and then, you know, you could lose the bone. It could be damaged. So it's, it's not great, like for museums to use this method. There's also another technique involving enzymatic digestion. In this case, they use proteolytic enzymes that break down the proteins.

• 1:02:01Bob Novella?

  And this can preserve delicate bone structures, like, like bird skulls have many delicate structures that can preserve it. It actually smells less offensive than, than other methods, but it can be expensive and it can take a while. There's also chemical treatments that they're kind of popular. They can be very fast. And this method can be good for large scale processing of, you know, if you've got a lot of skeleton that you need to deal with or bodies to deal with. Chemical treatments might be your, your go-to method to do a lot, but bone damage can occur using this method. And there's also chemical hazards. These are, you know, this is a chemical treatment. So you'd have to deal with chemicals. It's hazardous to people. You have to deal with waste disposable, waste disposal, which, so this isn't a very popular one for like, say museums.

• 1:02:43Bob Novella?

  But the one that is popular and the preferred method for, for museums is using the dermisted beetle and larval colonies. The beetle doesn't do a lot of the heavy lifting. In this case, it's really the, the larval form of it. Does really have the heavy lifting in terms of actually eating the flesh, the flesh. It's extremely effective at cleaning intricate skeletons, which is one of the reasons why museums love this. It's pretty fast. It could take hours to days to remove the flesh, say on, you know, some, a small animals. It's, it can, like I said, it can preserve these delicate bone structures. So these beetles are, are really, are really popular. Smithsonian and London's Natural History Museum use dermisted beetles, but there's a problem.

• 1:03:27Bob Novella?

  What do you guys think some of the problems, big, you know, big problems, worst problems about using these, these beetles and their larvae as a method?

• 1:03:37Speaker 01

  Because of the economy, they all want a pay raise.

• 1:03:39Bob Novella?

  Yes.

• 1:03:40Cara Santa Maria?

  My guess is that if, if you're not very careful with your colony and it's among a collection, that it could be damaging to, you know, taxidermied collections or other collections where flesh is still in existence.

• 1:03:52Bob Novella?

  Yeah, that's spot on. That's one of the, the biggest problems because this is, it's a huge colony and they can, you know, they can, they can escape. You know, it's kind of very hard to, to keep the, you know, the, the mature beetles from, from escaping. And they can infest other, other museum specimens and damage them because they, they eat not only fret, flesh, but of course, you know, dried skin, feathers and hair. Imagine, you know, you have these amazing collections and you find that beetles have gotten into your, you know, your preserved feathers and hair and dried skin. Oh my God. That would be horrible. So that's the biggest downside to that. It's managing the colonies of these beetles is, is tough. And this is one area where the super worms are much better because when you have these super worms in crowded conditions, a bunch of them together,

• 1:04:37Bob Novella?

  they tend to remain larvae rather than developing into adult beetles. So, so that's a huge, huge plus. So the testing itself that these authors used, they, they tested on mice, bats, birds, fish, a wildcat. And the biggest animal was a gray wolf. They found that the, these super worms, these larvae efficiently removed a lot of the remaining, the remaining flesh that was on the bones, including very importantly, deep, you know, deep tissue, you know, tissue that's deep inside, say the skulls, the skull or other difficult to reach cavities. So it was very, very good at that. One example that I came across was that they cleaned a crow in just 12 hours.

• 1:05:19Bob Novella?

  Took 12 hours, which is pretty good, I think, for, for, for a small bird like that. One unexpected finding they had in their research that the super worms, if it ate a lot of flesh, it interfered with molting and it also decreased the lifespan. So if a museum was going to use these, you'd have to be aware of that. So what they do is they recommend that after you have a cleaning session with a colony of, of super worms, they recommend giving them vegetables because they, they don't need flesh to live. They could just survive on various vegetables. And they don't even need the meat. They just happen to, if you make them hungry, they're going to, they're going to eat meat and they're going to enjoy it.

• 1:05:56Speaker 04

  You're saying too much meat is bad, bad for these worms as well as for humans?

• 1:05:59Bob Novella?

  Yes, it is. It is. And, but it just struck me as funny that these flesh-eating horrors need their veggies. Make sure they have their veggies. So the sweet spot, they found that the sweet spot seems to be about 10 to 15 individual larvae per gram of prepared specimen. That is, that's the sweet spot.

• 1:06:18Speaker 01

  That's a lot.

• 1:06:19Bob Novella?

  Yeah, it can be a lot. But yeah, you generally would have, you know, a colony of potentially thousands of these. That sweet spot represents a minimization of the cleaning time. So it was fast. It was relatively fast, but it also had little to no bone damage. And this was especially good when they used this sweet spot, you know, 10 to 15 per gram. It was really good for the delicate skeletal structures in bird skulls. There was no damage. But if you use too many of these, it can, it can definitely damage the bones. So you have to be careful. And there was one very important qualification here about these animals in the test. What do you think? What do you think about the animals before the super worms got to them?

• 1:07:02Bob Novella?

  What do you think the condition they were generally in or had to be in before?

• 1:07:06Speaker 01

  They had to be rotting.

• 1:07:07Bob Novella?

  Well, they had to be dead. Yep, that's kind of a prerequisite here. These creatures are dead and rotting at some level. But the thing is, they had to be prepared. You're not going to just throw a crow, a dead crow that just died and say, here, have at it. They basically skin it and they have much of their tissue removed. So internal organs, you know, big meaty, you know, you, you know, big meaty pieces of meat would be gone. Like for the wolf, I'm sure they, all the internal organs were gone. It was skinned and also, you know, big chunks of the meat would be gone before. So that's kind of a, it would just take a lot longer if you, it was, if it was just a newly dead specimen without any of this pre-treatment. So the authors stated, they said that our study shows that protein-rich super worms,

• 1:07:50Bob Novella?

  a common pet food that's easy to maintain in colonies, can safely and efficiently clean skeletons for museum specimens. Unlike traditional chemical methods or dermisted beetle colonies, this approach preserves delicate bones, is environmentally friendly, safer for museum collections by minimizing the risk of pest infestation, and makes colony maintenance much easier for museums. So it seems, definitely seems like this is something that museums will at least be wanting to study more or want to try out. It seems to have some very interesting advantages over the conventional dermisted beetles. Now, I know what you guys are thinking. Could these things?

• 1:08:25Cara Santa Maria?

  Help Bob with his Halloween stuff?

• 1:08:27Bob Novella?

  Not a bad guess, not a bad guess. But I know you're thinking, could these things turn an unprepared human corpse into a skeleton? Well, could they do that? Sure. But I gotta say, this was not tested. Nobody tested that. And these, and remember, so these animals were all skinned and partially defleshed. So we don't know how well this would work on an intact human body that you just wanted to skeletonize. We don't know. But if you had to guess, if it was unprepared, it could take probably weeks to probably, you know, potentially months of activity for these super worms to turn an intact, fresh corpse into a skeleton. If the body's prepared, so if you took out the, all the organs and big chunks of meat here and there,

• 1:09:10Bob Novella?

  it could potentially take days to weeks, which is pretty damn fast. So in closing, I'll say that these super worms would make any zombie very proud. Not only can they strip the flesh right off the bones, they can even clean out the inside of a skull without cracking it open. And that's kind of like a zombie's dream come true. So this is a, I think they would make fun parties. Because if you think about how zombies leave bodies, you know, they're munching on the brains, of course, but also the muscle and the tissue. It's like the zombies were preparing the corpses for the super worms to finish the job and really make them, you know, super, super clean. So just interesting. I want to see a movie with zombies and super worms working together.

• 1:09:51Speaker 01

  So Bob, you didn't mention the most effective way of cleaning meat off of bones.

• 1:09:58Bob Novella?

  Well, you'd have to have that ray gun from that Martian movie. That would be, the skeleton would become green.

• 1:10:03Speaker 01

  Now, that would heat damage the skeleton.

• 1:10:05Bob Novella?

  Yeah, but it looks green. And I bought a green skeleton a couple of weeks ago at Target and it's one of my, it's now one of my top five skeletons.

• 1:10:11Speaker 01

  Even better than Bob. This method can skeletonize a fully unprepared, like, human body in seconds.

• 1:10:20Bob Novella?

  Well, it happens in Piranhas and Piranhas in the movies.

• 1:10:23Speaker 01

  You don't want little fish chewing on those bones. No, no. The best method is the Vashtanirata. Alice, you know about this, of course.

• 1:10:32Speaker 04

  Yes, yes, the Doctor Who, um, baddie-ish.

• 1:10:35Speaker 01

  Yeah, the shadows that melt the flesh, the Vashtanirata. So yeah, they would, they would completely turn you into a skeleton in a second, basically.

• 1:10:44Bob Novella?

  Okay, what is this from?

• 1:10:46Speaker 01

  Doctor Who.

• 1:10:46Bob Novella?

  Okay. Oh, I didn't see those episodes or that episode, apparently.

• 1:10:50Jay Novella?

  Why not boiling? What's the matter with boiling?

• 1:10:52Bob Novella?

  No, yeah, boiling is another method that will help the process. I didn't, I had so many other examples, I didn't need, I didn't feel like I needed to go into detail about that one. But yeah, I think it's called maceration. And you see that method used in a movie that I'm watching 28 years later, the second one, the second sequel to that.

• 1:11:10Speaker 01

  Apparently, though, the boiling is not good because it boils the fat into the bone.

• 1:11:15Bob Novella?

  Yeah.

• 1:11:16Speaker 01

  Which then causes it to yellow and could also cause it to rot.

• 1:11:19Cara Santa Maria?

  Yeah, but I think that they, I think that some preparators boil in certain, like with specific chemicals that prevent that from happening and that kind of bleach the bones to make them more.

• 1:11:28Speaker 01

  You could, you could do simmering, which is just sub-boiling, and that's a little bit better. But it's still not as good as, in terms of the bone itself.

• 1:11:36Bob Novella?

  Right. It is a method that you can use, but museums generally won't do that method. The beetles are just better for lots of reasons.

• 1:11:45Speaker 01

  I prefer the Vashtanirata. Okay. Kara, tell us about the Leap Second. What's going on with the poor little Leap Second?

• 1:11:51Cara Santa Maria?

  I was so surprised when I sent in what stories looked interesting to me this week that nobody else claimed to the story. I was like, Bob, aren't you gonna cover this?

• 1:12:00Bob Novella?

  I gotta say, I would have grabbed it if I didn't have this Halloween one ready to go.

• 1:12:06Cara Santa Maria?

  So, okay, the Leap Second. I guess first and foremost, before we talk about what's going to happen to it, anybody want to take a stab, Bob, at what the Leap Second actually is?

• 1:12:17Bob Novella?

  Yeah, it's a way to reconcile our timekeeping devices with the rotation of the earth because they get out of sync. So they're trying to get them back more into sync. So that's why they will add the Leap Second from time to time.

• 1:12:31Cara Santa Maria?

  Right, so the rotation of the earth is equivalent to generally, how much time?

• 1:12:37Bob Novella?

  Well, generally, 24 hours, 23.56 minutes and whatever.

• 1:12:44Cara Santa Maria?

  Generally, the earth rotates within a day. And early timekeeping methods were based on the sun, right? That's how we kind of knew what time it was during the day based on where the sun was in the sky and what time of year we knew that we were in. And then over time, those things became more and more refined. Solar time is the actual rotation of the earth mapped to a clock. But of course, what is the sort of standard right now that we use for keeping time?

• 1:13:19Bob Novella?

  Atomic.

• 1:13:20Cara Santa Maria?

  Atomic time, right? So atomic clocks are ultra-precise. They do not drift. They are not subject to sort of any real interference because what we're actually looking at are, you know, the vibrations of electrons within atoms. And those things, specifically, we often use CCM-133 atoms. And those things are very standard, right? Whereas mechanical clocks and quartz crystals are subject to like temperature changes, humidity changes, warping and aging. Every CCM-133 atom is the same.

• 1:14:04Cara Santa Maria?

  And so, you know, they don't change, they don't age, they're immune to wear and tear. So we know exactly how much time there is based on our atomic clocks. And what happens is that the atomic clock and the solar clock are sometimes out of sync and not in a purely predictable way because the earth is dynamic. And, you know, mass redistributes. The earth sometimes spins unevenly. And so we end up with these drifting scales and they have to be adjusted. So just like we have a leap year, which sort of reconciles the orbit around the sun

• 1:14:47Cara Santa Maria?

  with a 365 calendar, it's really 365 and one quarter. So every four years, we have to add an extra day. The Leap Second is weirder, though, because we can't predict when we're gonna need it. So what ends up happening usually is that over the course of many, many years, as the difference between the earth's rotation and the atomic time moves closer and closer to a second, we then will reconcile if necessary, and it often happens on like two specific days of the year, but that's just by convention. So that's what we've, we've kind of done. And since

• 1:15:30Bob Novella?

  Couple of things, Cara.

• 1:15:31Cara Santa Maria?

  Yeah.

• 1:15:32Bob Novella?

  You said it's 365, what, point 25?

• 1:15:36Cara Santa Maria?

  I said, and a quarter.

• 1:15:37Bob Novella?

  Yeah, and a quarter, but it's also, it's also obviously not a precise quarter. It's like point 25 and then 2424, something like that. So that means so every century, they've got, the leap year needs to be changed. And, and depending on, you know, what, what century it is and stuff. So, so there, so there's that, which is interesting.

• 1:15:55Cara Santa Maria?

  Perfect. We're, we're trying to put arbitrary human divisions on top of these like physical standards.

• 1:16:03Bob Novella?

  One reason why leap seconds would be added is as, say, there's a major earthquake somewhere on the world and it essentially redistributes the mass of, of the earth in a, in a way like conservation of angular momentum, where you're going to spin faster the tighter, the tighter you get. So it actually will change the, you know, the rotation of the earth to a detectable degree.

• 1:16:23Cara Santa Maria?

  Yeah.

• 1:16:23Bob Novella?

  That's, that's another interest, very interesting reason why we'd have a leap second.

• 1:16:27Cara Santa Maria?

  Yeah, yeah, yeah. Which I did mention, but not to that detail. So, um, so can you guess how many leap seconds have been added since the introduction of leap seconds in 1972?

• 1:16:37Bob Novella?

  It's like, um, three?

• 1:16:38Speaker 01

  Like 26 or 27, something?

• 1:16:41Cara Santa Maria?

  27.

• 1:16:41Bob Novella?

  Good job, Bob.

• 1:16:44Cara Santa Maria?

  Yeah, I, I'm guessing that wasn't a guess, that was a memory.

• 1:16:46Bob Novella?

  Yeah, yeah.

• 1:16:47Cara Santa Maria?

  Yeah, yeah. So what is the new bit? Well, the, on May 20th, 2027, the, at the General Conference on Waits and Measures, the International Timekeeping Authority, God, this totally sounds like a Dr. Who episode.

• 1:17:03Bob Novella?

  Right? Don't you love it? I work for the International Timekeeping Authority.

• 1:17:06Cara Santa Maria?

  Yeah. They officially voted to discontinue the leap second. And they have, uh, reasons why. They are really, really concerned that our critical digital infrastructure could be threatened if something very specific were to happen. And it seems increasingly likely that thing, that that thing would happen. Now, we mentioned 27 leap seconds have been added to our clocks since 1972. What has never happened, but may soon need to happen.

• 1:17:41Speaker 01

  Subtracting a second.

• 1:17:42Cara Santa Maria?

  Subtracting a second. And apparently some platforms are not equipped for that.

• 1:17:48Bob Novella?

  Yep.

• 1:17:48Cara Santa Maria?

  So we don't know what would happen if we had to subtract a leap second. Interestingly, there have been some approaches that get around the concept of adding a leap second. One of them is called leap smearing. And this is something that some different large organizations use, like Google and Meta, but there's no standard in leaps smearing. And they use different methods to do it. Um, and just to, as like a quick and dirty, I won't get too in the weeds on it. But in leaps smearing, these tech companies gradually slow down their clocks over several hours instead of injecting like a one second jump. So they sort of slow them down until they're caught up and then they, they go back into

• 1:18:33Cara Santa Maria?

  speed. But there's no standardized way to do that. So what you end up with is actually slightly different times all over. And you would think that wouldn't matter, but that really, really matters when we're trying to have a global standard that a lot of critical infrastructure depends on. So, okay, if we needed a negative leap second or the subtraction of a leap second, uh, well, A, why would we need it? Well, we know that Earth's rotation has, um, slowed down over the long term.

• 1:19:06Bob Novella?

  Oh, yeah.

• 1:19:06Cara Santa Maria?

  But we've also seen that Earth has sped up in short terms. So you mentioned before, these shifts and things like, uh, its core or like the melting of the, the polar ice caps or changes in ocean currents.

• 1:19:20Bob Novella?

  Also, Cara, the slowing down is a general thing that's been happening for millions of years and it's tidal breaking because of the interaction with the moon.

• 1:19:26Cara Santa Maria?

  Right. And the slowing down is more predictable, right? And that's why we would be adding, but sometimes Earth's rotation speeds up. And that's the point, right? If the Earth's rotation speeds up and it speeds up enough that it changes, that it speeds up to more than a second, we would have to remove that second to, to link back to our atomic clocks. And so that negative leap second could be needed relatively soon. And software is not optimized to handle it. According to the different publications by these groups, software is poorly optimized to handle an extra second. So some do it better than others.

• 1:20:05Cara Santa Maria?

  Nobody does it perfectly, but almost no global operating systems are coded to handle a skipped second. So of course there's like a Y2K style fear here. These professionals put their heads together and said, what do we do about this? And the general consensus was, let's just stop doing leap seconds altogether so that we don't have to fear this risk of satellite navigation crashing or being interrupted, space agencies having potential catastrophic effects. But okay, that doesn't solve the problem. We can't just not do it and say, okay, problem solved, because we know that there will still be drift. So what did they come up with?

• 1:20:49Cara Santa Maria?

  They decided that the way that they're going to keep those atomic clocks and astronomical time, uh, in lockstep is they're gonna wait until there's a whole hour of drift.

• 1:21:04Bob Novella?

  Oh.

• 1:21:05Cara Santa Maria?

  And then they'll add that leap hour, which would probably be like a permanent shift in daylight saving time. Now, how long do you think that that would happen?

• 1:21:16Bob Novella?

  Oh, my God, decades, thousands of years.

• 1:21:18Speaker 04

  If we've done, if we've done 26 seconds since the seventies.

• 1:21:21Cara Santa Maria?

  Yeah, they're estimating over a thousand years.

• 1:21:23Bob Novella?

  A millennia, wow.

• 1:21:24Cara Santa Maria?

  So we're making that somebody else's problem.

• 1:21:26Speaker 01

  So basically, so Cara, you said that they, they couldn't decide to simply not do it, but they in fact did. That is the saying, saying this is not going to happen for a thousand years means they are punting this so far into the future that it's, as you say, it's not our problem anymore.

• 1:21:43Cara Santa Maria?

  Right.

• 1:21:44Speaker 01

  Right? So they basically did decide to simply not do it.

• 1:21:47Bob Novella?

  Steve, Steve, all they did, Steve, all they did was boot up their SEP field, the somebody else's problem field.

• 1:21:54Speaker 01

  Somebody else's problem. Cause they could have done two other things, which I'm not, one was just not do the negative second and just count that against a future positive second. Or they could have decided, we're gonna do it only when there's a, a minute, which would still be like every hundred years or so. But they went for a full hour, which means they basically punted so far into the future that it's not even a problem.

• 1:22:17Bob Novella?

  Wow, man. I'm surprised they didn't go for the minute.

• 1:22:19Speaker 01

  Yeah.

• 1:22:19Cara Santa Maria?

  But here's the interesting thing. What, what they're saying is that while digital systems do struggle with leap seconds because they're instant and they happen at the same moment worldwide. So it forces this like 61 second minute all at one time. And computers don't like irregular minutes. They can handle hour long shifts, no problem.

• 1:22:39Bob Novella?

  Oh, daylight savings.

• 1:22:41Cara Santa Maria?

  Yeah. So waiting and letting it naturally shift up to an hour sounds more dramatic, but it's actually easier on all of our systems. We can handle a slow hour long shift, whether it's the computer, whether it's our circadian cycle, a lot easier than we can handle a, a very quick, small shift.

• 1:23:00Bob Novella?

  Like daylight savings is going to mean anything to anyone in a thousand years. Give me a break.

• 1:23:07Cara Santa Maria?

  And, and the funny thing is really high precision industries that require perfect synchronization, like astronomers with their deep space telescopes or like satellite operators for the military, they don't use UTC anyway. They use pure atomic time anyway.

• 1:23:25Bob Novella?

  Right.

• 1:23:25Speaker 01

  Yeah.

• 1:23:26Cara Santa Maria?

  Right? So they already bypassed this altogether.

• 1:23:29Speaker 01

  All right.

• 1:23:29Cara Santa Maria?

  And maybe in a thousand years, we'll all just be atomic and it won't really matter.

• 1:23:32Speaker 01

  Yeah, whatever.

• 1:23:33Cara Santa Maria?

  Yeah.

• 1:23:34Bob Novella?

  Yeah.

• 1:23:35Speaker 01

  All right, Alice, you, you, one of the areas that you focus on is the wellness industry, which I appreciate. You're going to talk to us about that and this thing of hyper optimization. What is that?

• 1:23:46Speaker 04

  Yeah. So, um, I've been looking at the wellness industry for about 12 years now. And it's really interesting to see certain develops, certain trends kind of develop and evolve over that time. And I know 12 years isn't a massive amount of time, but in the wellness industry, it is incredibly, uh, long amount of time because things are changing so, so, so, so rapidly. Um, and one of the most interesting things that I wanted to talk about is this idea of this really extreme optimization. So it's a trend that comes, actually, we could go all the way back to 1988 to start talking about it. Um, when the term biohacking was first used in a Washington Post article. And this was actually an article that was predicting biohacking.

• 1:24:29Speaker 04

  It, it wasn't, uh, reporting on something that was actually happening. Um, but they were predicting that biohacking would happen. Um, or maybe we could go back to Dave Asprey, who, um, invented bulletproof coffee in 2009.

• 1:24:44Cara Santa Maria?

  Didn't he just put butter in coffee?

• 1:24:47Speaker 04

  Yeah, yeah, basically.

• 1:24:48Cara Santa Maria?

  Invented.

• 1:24:51Speaker 04

  But importantly, he, he did that after he went on a Tibetan excursion and, uh, learned about yak's butter coffee.

• 1:25:01Cara Santa Maria?

  So he just stole bulletproof coffee. He appropriated bulletproof coffee. Yeah.

• 1:25:07Speaker 04

  Or maybe we could start with the rise of a fitness tracker as our historic starting point. So, um, the very first pedometer, uh, was developed in 1965, but Fitbit launched their first tracker in 2009. Um, so around the same time as Dave Asprey's bulletproof coffee, actually also around the same time that Goop was launched. Goop's, um, first newsletter launched in 2009 from Gwyneth Paltrow. So maybe 2009 is a nice starting point for the wellness industry really starting to kick off. And obviously, you know, Fitbit trackers are tracking kind of, um, steps, but also calories and various other, every year, there's something new added on to the things that the various fitness trackers are tracking.

• 1:25:48Bob Novella?

  I love my Fitbit.

• 1:25:51Bob Novella?

  I'm so, I'm so, somebody said, welcome to 2007, Bob. Okay.

• 1:25:57Speaker 04

  So when I talk about the wellness and wellness industry, sometimes I, I kind of see it as this quite feminine thing. It's often targeting women in a very particular way. And, um, sometimes I like to say that we're finally seeing it target men more recently. But I actually think it's, it's just become more accessible in the mainstream for men more recently, because those kind of early examples of the, the kind of biohacking ideas are, are really coming out of masculinized spaces, especially when we're thinking about health data collection and hacking, um, especially, you know, biohacking in particular springs straight out of Silicon Valley. It is absolutely from that tech bro culture.

• 1:26:38Speaker 04

  So it's no wonder then that we're seeing it ramp up considerably in the age of the all powerful tech bro, that suddenly, you know, once you're tracking a few health markers, it's ramping up and people are becoming quite obsessed over certain things. So first it's step count. Now we've seen a new understanding that people are experiencing real difficulties with sleep. They're calling it orthosomnia, where people are obsessing over their sleep scores from their trackers.

• 1:27:09Speaker 01

  [laughing]

• 1:27:10Speaker 04

  Yeah, so much so that it is stopping them sleeping because they are so obsessed with making sure that they absolutely optimize.

• 1:27:16Speaker 01

  Oh, the irony.

• 1:27:17Speaker 04

  When they go to bed, when they wake up, all of those things.

• 1:27:18Speaker 01

  Wow.

• 1:27:19Speaker 04

  Suddenly, every minor niggel or negative experience could be tweaked to avoid or to enhance and improve. And we're seeing people who have been recommended a supplement early on, maybe because they're initially tired all the time and they think, okay, I'm gonna, I'm gonna take this supplement. I've, I've looked at the wellness industry. The wellness industry has told me that this is my issue with, with my sleep. This is the reason I'm not very focused, is that I'm not sleeping very well. But it's, it's, it's great because the wellness industry have told me that I've got this problem, have told me that my inability to focus on stuff is an issue. And they've told me what's causing it, even if it's not accurate that that's what, what is causing it, and that it's my, my issue with sleep or whatever invented, there's plenty of invented conditions in

• 1:28:03Speaker 04

  the wellness industry that will pump you in a particular direction. But it's great because they've got the solution. All I need to do is buy this supplement, take this supplement, and then I will, then I will feel better. And suddenly, a minor niggel becomes a deficiency that requires a medication.

• 1:28:17Speaker 01

  So what you're saying is, they're doing exactly what they're accusing the pharmaceutical industry of doing. But they're actually doing it.

• 1:28:24Cara Santa Maria?

  They're actually doing it, and with no regulation.

• 1:28:26Speaker 01

  Yeah, inventing disorders.

• 1:28:28Speaker 04

  With absolutely no regulation.

• 1:28:29Speaker 01

  Marketing the solution, and then turning it in, in medicalizing just whatever, normal everyday life.

• 1:28:34Cara Santa Maria?

  Mm-hmm.

• 1:28:35Speaker 04

  But selling it under the auspices of empowerment, that you can be empowered. You don't need to go and see a doctor for the thing that you're struggling with. You can come to us and we will empower you to do something for yourself. Or maybe you don't even need to come to us, you can just buy our product.

• 1:28:51Cara Santa Maria?

  Which, by the way, insurance won't cover.

• 1:28:53Speaker 01

  Yeah.

• 1:28:54Cara Santa Maria?

  Whereas your doctor's visit will be.

• 1:28:55Speaker 04

  Of course, once you're on one supplement, you end up on a stack of supplements, and then the supplements become injectable peptides, and suddenly it's an entire protocol of procedures and interventions. And all of that makes sense. So one of the things I'm really interested in at the moment is this idea of autonomy. The wellness influencers will sell you that you have autonomy. It can be quite difficult. And I think you've, you've touched on it already today, Steve, that when you go and see a doctor, it can feel like your autonomy is taken away from you, especially if you've got a serious condition, is you suddenly end up on a route of, maybe you get a diagnosis, maybe you get a serious diagnosis, like a cancer diagnosis, and suddenly you're on this pathway, very rapidly moving in a direction

• 1:29:39Speaker 04

  of a, a protocol that is suggested to you by your clinician, and you lose your control.

• 1:29:45Speaker 01

  Hmm.

• 1:29:46Speaker 04

  The wellness industry offers you the ability to take some of that control into your own hands, to make decisions for yourself. They might tell you that the, that the medical industry is problematic, and tell you that you can trust them, and they can make as many seductive claims as they would like to make, because they're not, as you say, Cara, they're not regulated. And so suddenly, you're kind of in a position where you take control. But the flip side of that control is it puts all the responsibility then on to the person who's having a difficulty, that suddenly, if the protocol, if the supplement, if the, the thing that the wellness industry has sold to you doesn't work for you, well, you're just not doing it right. You're, you need to be stacking it with this additional

• 1:30:28Speaker 04

  thing. And okay, it's working a little bit, so you can trust us that it will help. But here, we can just sell you this additional thing to layer on top of it. And now, you're taking 50 supplements or different, stacking different things together, actually. On one of our episodes of Skeptics with a K, I talked about the Nutmaxers.

• 1:30:47Cara Santa Maria?

  Nutmaxers?

• 1:30:49Speaker 04

  Uh-huh. Do you want to take a guess at what a Nutmaxer is?

• 1:30:51Cara Santa Maria?

  They're making their, they're eating nuts to make themselves hotter, or they're making their, their nuts maximally nutty.

• 1:31:00Speaker 04

  They are making their nuts maximally nutty.

• 1:31:04Cara Santa Maria?

  No!

• 1:31:05Speaker 04

  They are looking to enhance and improve their semen thickness, quality, and volume through supplement stacking.

• 1:31:15Speaker 01

  Wait, does this work?

• 1:31:16Speaker 04

  No!

• 1:31:17Cara Santa Maria?

  Have you been listening?

• 1:31:20Speaker 04

  There is an entire Reddit thread dedicated to this, and there are men who are taking, one, one chap was taking 11 different supplements to enhance his semen quality, thickness, volume.

• 1:31:35Speaker 01

  Oh, wait, is he, in the, in, you know, in the adult business, I mean, who would be concerned with that except somebody who was like, you know, on camera a lot?

• 1:31:46Cara Santa Maria?

  Except every man ever.

• 1:31:48Speaker 04

  There are some people like that, but also, yeah, there's, there's definitely a fetish element to it as well, that, that some men just think it is. Describe it as artistic.

• 1:31:57Speaker 01

  Artistic, oh my god.

• 1:31:58Cara Santa Maria?

  That's what like the Maxers do, right?

• 1:32:00Speaker 01

  Yeah, like lux maxing.

• 1:32:01Cara Santa Maria?

  Yeah.

• 1:32:02Speaker 01

  It's the dumbest word in the English language.

• 1:32:03Speaker 04

  Well, we can, maybe we can come on to some of the lux maxers. So I think this, we're seeing this particularly in the masculine spaces of when you're kind of optimizing your health, you'll start to see these small improvements. And maybe, you know, it's something like you're gaining a bit of muscle because you're working out daily, you, you feel a bit more energetic because you're practicing better sleep and hygiene. But suddenly, I think it gets into people's heads, especially when they're sitting in certain communities. So you see this in the incel culture, and particularly masculinized communities, where we do know that loneliness is maybe a bit of an issue, and people are looking for somebody they can connect with. They find this community of people who are all doing these very bizarre things, and suddenly you're getting very paranoid about anything that might negatively

• 1:32:48Speaker 04

  affect your life, such as Stephen Bartlett complaining to 20 million subscribers on his podcast that two glasses of wine ruined three days of his life.

• 1:32:58Speaker 01

  Wow.

• 1:32:59Speaker 04

  Because he's so paranoid about what he's taking into his body.

• 1:33:02Speaker 01

  It's also predatory, and just really so harmful.

• 1:33:06Speaker 04

  So one of the most, you know, clear examples of the damage this can do is in the lux maxing community is clavicular. So clavicular, obviously, is, I mean, I think it seems clear to me from a distance, without wanting to diagnose somebody who, I don't know, or don't know any of his medical details, but he seems to have some quite dysmorphic thinking around certain things. In particular, in a New York Times interview, the introductory paragraph about clavicular said that clavicular is six foot two, weighs 180 pounds, and has a 31 inch waist. His biorchromial width, the span of the clavicle from which the 20 year old streamer gets his name, is 19.5 inches. He has a mid-face ratio, which is derived by dividing the distance from the pupil to the mouth by the distance between

• 1:33:51Speaker 04

  the pupils of 1.07. His chin to philtrum ratio is 2.6.

• 1:33:56Cara Santa Maria?

  Wow.

• 1:33:57Speaker 04

  So he is kind of measuring himself to the absolute extreme. He started taking testosterone aged 14.

• 1:34:05Speaker 01

  Oh.

• 1:34:06Speaker 04

  And he believes himself to be sterile, sterile because of taking testosterone and using steroids. He has what he calls his penta stack. He takes Adderall, DXM, Ketamine, BDO, and Progabalin. A lot of these are actually to help him socialize with people. He really struggles, he describes himself as struggling to have social interactions, and so he takes a lot of these medications to help him socialize. But he also takes lots of other medications, classic in the lux maxing genre, including melanotan, which is used to make your skin look more tanned.

• 1:34:40Speaker 01

  Hmm. Melanotan, hmm.

• 1:34:43Speaker 04

  But this was taken to such an extreme that on April 15th this year, clavicular was hospitalized due to an overdose of the various medications that he takes, which happened live on stream.

• 1:34:57Cara Santa Maria?

  Oh, god.

• 1:34:58Speaker 04

  He was rushed, rushed to hospital. His, his friend switched off the stream as he dropped into unconsciousness. He was rushed to hospital and later released.

• 1:35:06Speaker 01

  I bet he got a lot of clips that day.

• 1:35:08Cara Santa Maria?

  Jeez, yeah.

• 1:35:09Speaker 04

  He's obviously been in and out of all sorts of trouble, and last month, he was arrested for an allegation of rape.

• 1:35:15Speaker 01

  Oh, jeez.

• 1:35:16Speaker 04

  But I think that he's, he's a real example of where this extreme dysmorphic type of thinking can be incredibly dangerous. I think it, it's clear that in some extreme cases, it can be all consuming, and people are thinking about it all of the time. You also see this with peptides. So peptides are becoming increasingly popular. With Joe Rogan telling Matt Damon and Ben Affleck on the Joe Rogan Experience that he recommends the Wolverine Stack. So these are two peptides called BP157 and TB500. He says, I don't know if you ever get injured. If you ever get injured, get immediately on BP157 and TB500.

• 1:35:56Speaker 04

  So these are two synthetic peptides that are originally derived from peptides that are made naturally in the body, but they're much shortened versions. Your body would never actually see this version of the peptide. They're not regulated at all. People are buying and injecting into their bodies these peptides that are research grade, not medical grade, and that are not in any way regulated and are not being tested to see that they have what they say they have.

• 1:36:23Cara Santa Maria?

  Yeah, we talked about peptides a few weeks ago on the show. And unfortunately, our government is all about it. They're on the bandwagon.

• 1:36:33Speaker 04

  Yes. And I think this is an interesting part of the trend because we've had this hyper-optimization and we're starting to see more of a backlash towards the over-optimization. I think people are starting to realize it's not healthy to be over-analyzing every aspect of your health, wellness, food intake, exercise, all of these things so obsessively that it leads you to this really dysmorphic thinking. Even the wellness industry is starting to realize this is an issue. The Global Wellness Institute said that they, they're a warning of the over-optimization backlash and saying that they, they think that wellness is becoming psychologically demanding.

• 1:37:15Speaker 04

  But I think, you know, when you've got an industry that is worth $6.8 trillion, you can very quickly go from, okay, we're starting to see an issue with over-optimization. So now let's think about recovery and relaxation and being present. And now you're optimizing those things and feeling guilty if you're not doing the, the perfect things to recover in the perfect way.

• 1:37:37Bob Novella?

  Oh, man.

• 1:37:38Speaker 01

  Yeah, it's all crazy. It's, it's also, to me, feels very much like an extension of eating disorders, right? It's just different ways of manifesting the same underlying psychological pathology that drives eating disorders, which has always existed in men. It's just men manifest differently. You know, like the hyper-exercises or whatever. This is just, clearly seems like an extension of that.

• 1:38:01Bob Novella?

  The, the body dysmorphia that I have been seeing a lot is, and it's because of the algorithms on Facebook that I'm seeing these, is that, is these guys all over the world that inject oil into their muscles to have instant big muscles. And I just feel, and a lot of people make fun of them and the comments are full of that, but I just feel so bad for these guys that they think that this, this, this shortcut to this look is, is so, it's so terrible. And they think, and the dysmorphia is so strong that they think, the way they're flexing, you're like, they think this is awesome and it's, it's cartoonish. And of course, the end result is dramatically horrible with, with, you know, with amputations

• 1:38:44Bob Novella?

  in worst case scenario, but also wicked scars all over their body because they have to remove the, the muscle that is just destroyed. It's horrible.

• 1:38:52Speaker 04

  And I, I find it really interesting that people are moving towards these injectables so readily because it's often people who are, it's often anti-vaxxers, right?

• 1:39:04Cara Santa Maria?

  People are like, I would never put that in my body.

• 1:39:06Speaker 01

  Yeah. Oh, there's no internal consistency in their philosophy. All right. Thanks, Alice. Jay, it's Who's That Noisy time, but before you give your noisy, I have a noisy for you guys. Shoot.

• 1:39:32Cara Santa Maria?

  It's the coyotes.

• 1:39:33Bob Novella?

  Yeah, the coyotes outside your house. You finally got them. Recorded, anyway.

• 1:39:39Speaker 04

  That's impressively loud.

• 1:39:41Bob Novella?

  What a party they're having.

• 1:39:43Speaker 01

  This is like, for the last few weeks, this has been almost every night in my backyard.

• 1:39:47Bob Novella?

  Oh, jeez.

• 1:39:48Jay Novella?

  What time are they doing it?

• 1:39:49Speaker 01

  Like midnight, 11, 1:00 in the morning, right around there, you know, shortly after we go to bed, turn all the lights off. So I looked it up and it sounds like it's a family of coyote. It's probably the parents summoning the, the younger coyotes. And if you listen carefully, I think you can hear that there are some pups in there, like there's some higher pitched.

• 1:40:07Bob Novella?

  Oh.

• 1:40:08Speaker 01

  And so I'm, so I go, why every night are they having a power in my backyard? And so my hypothesis is that they're doing this right under my apple tree and they're just feasting on the apples under the tree. And yes, coyotes do eat apples. They like apples. They're opportunistic omnivores. Anyway, I don't know that that's the case, but that's why, I don't know why they would be gathering there almost every night, you know?

• 1:40:32Jay Novella?

  Well, can't you tell if they're eating apples?

• 1:40:35Speaker 01

  There's, there's hundreds of apples on the ground under my tree and yes, a lot of them have been eaten, but I don't.

• 1:40:40Cara Santa Maria?

  Yeah, it's hard to know by whom. And you know what? If not there, where? Like, why not?

• 1:40:45Speaker 01

  Yeah, I don't know.

• 1:40:46Cara Santa Maria?

  It's just an easy meeting place and it's near where they sleep. Who knows?

• 1:40:49Speaker 01

  Who knows? But that's, it probably sounds like a lot more than it actually is. It could be just four or five different coyotes.

• 1:40:56Cara Santa Maria?

  Maybe, but I mean, they're pack animals, right?

• 1:40:58Speaker 01

  Yeah, they're a pack animal, but it sounds like a lot more. All right, Jay.

• 1:41:02Jay Novella?

  Yeah.

• 1:41:03Speaker 01

  Give us last week's Who's That Noisy?

• 1:41:04Jay Novella?

  All right, guys. Last week I played this noisy.

• 1:41:25Bob Novella?

  I know what that is.

• 1:41:26Jay Novella?

  What?

• 1:41:27Bob Novella?

  That's the earth slowing down due to tidal breaking.

• 1:41:29Cara Santa Maria?

  If that's not already been sampled by a DJ. So musical.

• 1:41:37Jay Novella?

  Very, very repetitive, right? I had some great guesses, but I want to play you something. So my friend, Adam Russell, you guys know Adam. He is my brother in everything Star Wars. So he wrote in and said this. He said, I don't know what's making this week's noisy, but wherever it is, it has a bad motivator. Don't buy it. Don't let those Jawas push anything on you. Okay, so that said, this is what he's talking about in case you don't know.

• 1:42:07Jay Novella?

  This one's got a bad motivator.

• 1:42:08Speaker 01

  I don't know why that, that scene, I just love it every time I see it.

• 1:42:12Bob Novella?

  I love the theory that R2 is the one that sabotaged that poor robot so that he would be selected.

• 1:42:18Jay Novella?

  Yeah, like, once you told me that, Bob, I'm like, that's my reality now.

• 1:42:21Bob Novella?

  That's your headcanon.

• 1:42:23Jay Novella?

  So I got, I got a guess from Peter Ritter and he said, this week's noisy sounds like a didgeridoo, the musical wind instrument developed by Aboriginal people in Australia. They usually played more expressively than here. It's accompanied by what sounds like someone playing a dried, scored gourd with a stick. I thought this was a great guess.

• 1:42:42Bob Novella?

  Yeah.

• 1:42:43Jay Novella?

  If you listen to the beginning of this noisy, you know, you can kind of hear the sound of a didgeridoo a little bit.

• 1:42:51Jay Novella?

  I mean, it has like that breath sound.

• 1:42:53Speaker 01

  You could probably reproduce that sound with a didgeridoo pretty well.

• 1:42:56Jay Novella?

  Yep. So Peter, you're not correct, but I love the guess. Listener named Bill Bishop wrote in, said, long time, first time, sounds like Pink Floyd Run Like Hell opening, the opening guitar riff slowed way down. So if you guys know this song?

• 1:43:10Bob Novella?

  Maybe.

• 1:43:11Jay Novella?

  Well, those of you who know Pink Floyd well. It does a little bit. It has a little bit of that going on there, but you know, you can't really explain the rest of the sound there. But I did listen to the song in the beginning and it's, yeah, there's a little bit going on, so that, not a horrible guess. And then I have my closest guess of the week, and this came from Torsten Peel, and he said, sounds like a small sterling engine.

• 1:43:33Bob Novella?

  Oh.

• 1:43:34Jay Novella?

  This is not a small sterling engine. In fact, this is a enormous engine. This is, this engine is giant. I think if I had to guess, it was probably about 12 feet high and about 20 feet across. I could be wrong because I'm just, you know, looking at a picture and trying to figure it out. I did not have a winner this week, but the, the person who sent in the noisy, Chris I'mhoff, said that this is a diesel engine, massive Fairbanks Morse Model 32 stationary engine. And this is a massive, slow-revving, two-stroke stationary diesel engine that was built between the mid 1920s through the 1940s. So first of all, I don't know what they use this engine for, but the thing is massive and it's a diesel engine, so I would imagine it's got a lot of power.

• 1:44:19Bob Novella?

  Mm-hmm.

• 1:44:20Jay Novella?

  Anyway, I thought it was really cool. I was looking for other videos of this and I did find a couple, but it wasn't as good as the original. But if you're interested, just take a look. You can find, I'm sure you can find a video on that.

• 1:44:31Speaker 01

  But Jay, when diesel engines were first developed, they were specifically made to be huge. That's kind of the point of a diesel engine. They were made for boats and ships and stationary power generators, things like that.

• 1:44:43Jay Novella?

  Okay, that makes sense.

• 1:44:44Speaker 01

  Yeah.

• 1:44:45Jay Novella?

  All right, guys, I have a new noisy for you this week. This noisy was sent in by a listener named Justin. And this one could be a little harsh, but.

• 1:44:53Speaker 01

  It's a little harsh.

• 1:44:54Jay Novella?

  Be prepared.

• 1:44:55Speaker 01

  Yeah, here it is.

• 1:44:56Jay Novella?

  [snoring]

• 1:45:14Jay Novella?

  I imagine that the coyotes had this going on, right, Steve?

• 1:45:18Cara Santa Maria?

  Yikes.

• 1:45:19Jay Novella?

  All right. So Steve, I'm going to say this to you particularly.

• 1:45:22Speaker 01

  Yeah.

• 1:45:23Jay Novella?

  Which is a clue.

• 1:45:25Speaker 01

  It's a bird.

• 1:45:26Jay Novella?

  Here's my clue. You're not going to believe what this is.

• 1:45:28Speaker 01

  Okay.

• 1:45:30Jay Novella?

  I was shocked when it was sent to me. I'm like, that can't be what the person says it is, but I know it is and I'll tell you next week.

• 1:45:36Speaker 01

  All right.

• 1:45:37Jay Novella?

  If you guys think you know this week's noisy, or you heard something cool that you want to send me, you can do both of those at [email protected]. Steve, we are coming up on the holiday season for a lot of people in the world. That's Thanksgiving and Christmas to us. I know, Bob, you don't want to hear it. Halloween isn't even here yet.

• 1:45:57Speaker 01

  It's still October. Don't say that word.

• 1:45:58Jay Novella?

  You walk into Home Depot with Bob, and if they have anything but Halloween decorations up, he freaks out. Like, he can't stand it.

• 1:46:07Speaker 01

  First off, I wouldn't, I wouldn't describe it as freaking out, but, but seeing Halloween, Christmas decorations like the first week of October is, should be against the law. Just saying.

• 1:46:17Cara Santa Maria?

  Not freaking out, just want to throw them in prison.

• 1:46:21Jay Novella?

  Anyway, thanks, Steve. That's it.

• 1:46:22Speaker 01

  All right. Thanks, Jay. All right, guys, let's go on with science or fiction.

• 1:46:30Speaker 00

  It's time for Science or Fiction?

• 1:46:39Speaker 01

  Each week I come up with three science news items or facts, two real and one fake. And then I challenge my panel of skeptics to tell me which one is the fake. We have no theme this week, just three regular news items. Are you guys ready?

• 1:46:55Jay Novella?

  Let's do it.

• 1:46:56Cara Santa Maria?

  Yep.

• 1:46:56Speaker 01

  Here we go. Item number one, researchers find that face specialists are able to correctly identify faces with over 90% accuracy with only one or two facial features revealed. All right, number two, a new study finds that preschoolers on average were rated as more creative than adults on a variety of creative tasks. And item number three, a new extensive review of whole genome sequencing finds that on average, people have about 5 million genetic variants, including 13,000 protein changes, 229 of which cause loss of function. Kara, it's your turn to go first.

• 1:47:36Cara Santa Maria?

  Ah, gosh, I thought, I thought Alice was going to go first.

• 1:47:39Speaker 01

  Yeah, me too.

• 1:47:39Cara Santa Maria?

  Okay, let's see. So face specialists are able to correctly, you're talking like people?

• 1:47:46Speaker 01

  These are people, these are human beings who are like forensic space, face specialists.

• 1:47:50Cara Santa Maria?

  Okay, yeah. They're able to correctly identify faces with over 90% accuracy with only one or two features revealed. Yeah, that doesn't surprise me. I don't think you need that many features. And this is almost like the opposite of somebody with prosopagnosia. It's like hyperpagnosia.

• 1:48:06Speaker 01

  Yeah.

• 1:48:06Cara Santa Maria?

  And so, yeah, I could see that being, being science. So I guess it's between the next two. I hate when you do this, Steve. Item number two is the most vague with zero detail.

• 1:48:21Speaker 01

  Well, you're going first. I'll answer any reasonable questions. This is obviously, any kind of study, this is going to have some kind of paradigm.

• 1:48:27Cara Santa Maria?

  Of course. But that's not even the issue. My, my issue is when I read something like, "A new study finds that preschoolers on average were rated as more creative than adults on a variety of..." That could be either way. A new study could definitely have shown one based on their operational definition, or the opposite, based on their operational definition. Because creativity, by definition, is very hard to study. It is very hard to agree on what it means to be creative.

• 1:48:53Speaker 01

  You are correct, but in this, in this study, I'll just tell you what they did.

• 1:48:57Cara Santa Maria?

  Okay.

• 1:48:57Speaker 01

  They, you know, had a specific number of tasks, like invent an animal and draw it, or just, you know, whatever. And then they had people who were apparently professionals blindly evaluate the outcome and rate them on many different types of creativity to generate a number, you know? And so at least they had, they had a process, it was blinded, there were people who knew what they were doing, evaluate this on specific aspects of the creativity.

• 1:49:26Cara Santa Maria?

  They were blinded. Okay.

• 1:49:27Speaker 01

  Yeah.

• 1:49:28Cara Santa Maria?

  Because my longstanding belief when it comes to creativity is that, you know, I think people mislabel the creativity of young children for imaginative play, because I think that creativity requires constraint. It is not creative when you give people, you know, a paper clip and a piece of paper, and you say, "What can you make of this?" And a preschooler sticks the paper clip through the piece of paper and goes, "It's a boat." Like, how is that a boat? That's not creative. You're just imagining that it's a boat. Whereas an adult might build something that is either functional or semi-functional. And to me, that is, that's actual creative play, as opposed to just make believe.

• 1:50:10Cara Santa Maria?

  So if, if we were using my definition, I think this would be the fiction, but it depends on how the raiders raided. And then the other one, "An extensive review of whole genome sequencing finds that on average, people have about 5 million genetic variants." You mean genetic vari- what do you mean by genetic variants? You mean the people are genetic variants, or there are 5 million genes that are variable amongst people?

• 1:50:34Speaker 01

  It's not necessarily genes. It's just, it's a whole genome, right? So in other words, you have like the average human genome. Any individual person will have 5 million variants from that. 13,000 of them would actually cause a change in the amino acid sequence of a protein. And 229 of those would actually cause a loss of function of that protein.

• 1:50:59Cara Santa Maria?

  Okay.

• 1:50:59Speaker 01

  And loss of function doesn't mean complete loss necessarily. It's like, there's gain of function and loss of function. This would be just, it would make it function less well than what the typical protein is. And maybe even unnoticedable, right, Steve? It would have to be measurable in some way, right? Do you have to be identifiable as a loss of function?

• 1:51:17Cara Santa Maria?

  Yeah, yeah, that doesn't surprise me. I mean, there are a lot of disease states out there that aggregate in individuals that probably have a deep genetic basis. There are a lot of, yeah, there's just so much variation. I think it's probably, the numbers are probably hard to comprehend. So I don't know. I don't know if this would be surprising to somebody because they think it's too much. I almost think like, yeah, those numbers seem reasonable to me. I don't know. So I guess I got to go with the preschooler one.

• 1:51:47Speaker 01

  Okay, Bob? Okay, so this first one here with the face specialist, 90% accuracy with just one or two facial features. To me, that's just like an app 100% no brainer. Well, of course. And, you know, I'm decent. I mean, I guess I'm above average at recognizing faces. Steve, you, you, I think you and I are similar in that regard, and I know other people that are exceptional at recognizing faces. And a lot of them key in on specific features of the face. Like, for me, mouths are like a fingerprint. I mean, I could just look at a mouth of a kid and be like, "Oh, my God, that's that actor." And he's actually, you know, 40 years old now. I mean, they're so, they're so diagnostic for, for me, anyway. So that, to me, that makes perfect sense. I'd be shocked if that, if that wasn't true.

• 1:52:30Speaker 01

  See, the second one, yeah, I agree with a lot of what Kara said about that. It is, it's just like, can go in so many different ways, depending on definitions and things. And the, and the third one with the genome, that sounds right, too. The variation between people is huge. It's much more dramatic than, than people would, would, you know, realize, I think. So, I mean, it really just leaves this, you know, kind of weirdly ambiguous second one here with the preschoolers and creativity. I'll just have to say that's fiction as well.

• 1:52:57Jay Novella?

  Okay, Jay. The first one, I definitely think that someone who, you know, is a face specialist, I mean, again, I don't know exactly what, what they're doing with their specialty, but I think it's perfectly prominent that they could be that accurate with only seeing a part of a person's face. Okay, the, I'll jump to the third one. The review about the whole genome sequencing, 5 million genetic variants, including 13,000 protein changes, which is 229 of which cause a loss of function. I got to be honest with you, Steve, you could have basically written down any collection of numbers there, and I would have believed it. I can't sink my teeth into that one. And look, of course, most of us can't, right?

• 1:53:40Jay Novella?

  I mean, you know, this is for people who are biologists. But I will talk about the second one. So when you first read it, I'm like, okay, yeah, because look at what they're drawing, and they're free, and blah, blah, blah. And then I thought about it, and I'm like, wait a second. I know adults who are so unbelievably creative, and I've, I've talked to many of, of the creatives in my life, because I'm, I'm semi-fascinated with where they get their creativity from. And I, I've asked people simple questions like, "Are you more creative when you're sad or when you're happy?" And you would be shocked at the different answers that you get. But that's a whole conversation right there. But in that, in that curiosity that I've had for a very long time, I found out that

• 1:54:21Jay Novella?

  the creatives that I know have developed their skills. You're not just born great, because so few people are born with amazing, you know, they have amazing talent, but you have to develop skills as well. And when you, when you spend a decade or two decades developing skills, you are phenomenally better than the earlier versions of you. So I would definitely say that number two is the fiction.

• 1:54:45Speaker 01

  Okay, and Alice?

• 1:54:46Speaker 04

  So I'm interested in the face one, what we mean by identifying faces. So I guess, I can't remember who said it now, but somebody said something about like familiar faces, recognizing particular celebrities from small components. But that's a familiar face? I wonder what the difference is if it's not a face that you're familiar with. Are they being asked to identify faces that they've seen just a snapshot of? Have they got faces to compare to?

• 1:55:12Speaker 01

  They were shown, you know, pictures of two different people, and then they were shown a hidden face with just one feature revealed. And they had to see, say, which one of those two people is that picture. Is the, you know what I mean?

• 1:55:27Speaker 04

  While still being able to see the two, the two reference images?

• 1:55:32Speaker 01

  No.

• 1:55:33Speaker 04

  So they see the two reference?

• 1:55:34Speaker 01

  They're given the two reference pictures.

• 1:55:35Speaker 04

  Take them away.

• 1:55:36Speaker 01

  Then they have to match the unknown picture. And then sometimes they could choose the feature that was revealed. Sometimes it was randomized. And then they could say, "I don't know, reveal, reveal another feature." And then it's like, how many features had to be revealed before they would take a guess? And they were able to, most of the time with a single feature, but with just one or two features, they were able to get to 90% accuracy.

• 1:56:00Speaker 04

  Yeah. So that one, I think, well, for a face specialist, maybe 90% with one or two is probably, probably about right. But certainly for, for a non-face specialist, I think that number's going to be actually really, really low under those specific conditions. So. I think that one's probably true, but I'm a little bit unsure on that. I agree with kind of everybody else's thoughts on the preschoolers compared to adults. I think preschoolers are maybe slightly less restrained, which depending on the measurement of creative task and creativity, might increase their chances on creativity. But I think if we're thinking about real, developed creativity and that those definitions,

• 1:56:42Speaker 04

  then maybe, maybe that's, that's a good candidate for being the fiction. Item three for me, as somebody who's done a cancer cell biology training is, feels like complete truth to me, that there will be an awful lot of genetic variance, especially in that kind of non-coding DNA. And I wouldn't be surprised if there's such a large number of protein changes, including quite a lot with loss of function, because our bodies just kind of figure their way around it. So I think I'm leaning towards two as the fiction.

• 1:57:15Speaker 01

  Okay, we gotta make a choice?

• 1:57:16Speaker 04

  I'll go for two. I'll go for the preschoolers and creativity.

• 1:57:21Speaker 01

  All right, well, let's take these in order then. We'll start with number one. Researchers find that face specialists are able to correctly identify faces with over 90% accuracy with only one or two facial features revealed. You guys are all pretty confident that this one is science. And this one is science. This is science. So yeah, I already described the, the method that they used. What do you think was the feature that was the most helpful in allowing them to correctly identify the target face?

• 1:57:54Bob Novella?

  I'll say mouth.

• 1:57:55Cara Santa Maria?

  I would say eyes as well.

• 1:57:57Jay Novella?

  You know, between the mouth and the eyes, I don't know. I'm going to go with Bob and say the mouth.

• 1:58:02Speaker 01

  You're all incorrect. The ears.

• 1:58:04Cara Santa Maria?

  Oh, wow. No, that's really, you could have gotten us on the fiction with that.

• 1:58:09Speaker 01

  The ears were the most, by far, and again, these are face specialists, so they know that ears are fingerprints. They are extremely distinctive.

• 1:58:18Bob Novella?

  They really are.

• 1:58:19Cara Santa Maria?

  But our brains are so attuned to eyes. That's so crazy.

• 1:58:23Speaker 01

  What was the second most?

• 1:58:24Bob Novella?

  Mouth.

• 1:58:25Cara Santa Maria?

  Eyes.

• 1:58:26Speaker 01

  The second most helpful feature was the forehead.

• 1:58:31Jay Novella?

  The forehead, I knew it.

• 1:58:32Bob Novella?

  You gotta be kidding me. Wow.

• 1:58:34Speaker 01

  Jay, the chin and the neck were the least helpful.

• 1:58:37Jay Novella?

  Well, that's, that's the people you know.

• 1:58:40Cara Santa Maria?

  Okay, but the, the important question is eyes or mouth? What was more helpful?

• 1:58:43Speaker 01

  They were in the middle. I don't know. I don't know. All right. They said the most and the least.

• 1:58:48Bob Novella?

  I'll say this, Steve, that using the ears, though, would not be helpful to find, to look at a kid's picture and say, who is this that you know as a grown up? Because ears continue growing and never, and never stop, actually, so.

• 1:59:00Cara Santa Maria?

  Yeah, but that fingerprint, like the, the shape might not change. It might just get larger.

• 1:59:05Bob Novella?

  Yeah, oh, well, I don't know, man.

• 1:59:08Speaker 01

  Mouths were more helpful than eyes.

• 1:59:10Bob Novella?

  Yes.

• 1:59:10Cara Santa Maria?

  Damn it. That's so crazy.

• 1:59:12Bob Novella?

  They're so much more distinctive. The shape of the lip, the, the teeth, everything, and the way the mouth moves.

• 1:59:18Cara Santa Maria?

  We have so much more neural architecture dedicated to like, reading and looking at eyes, that we recognize tinier changes in the eyes.

• 1:59:25Speaker 01

  The other thing they found, though, because again, these are forensic face specialists. This is their job. They were very adaptable, so they would change their choice based upon how distinctive they were in the specific reference images.

• 1:59:36Cara Santa Maria?

  Oh, that's smart. They're hacking the, yeah.

• 1:59:39Speaker 01

  Like, oh, that's a distinctive nose. I want to see the nose.

• 1:59:41Cara Santa Maria?

  That dude has generic ears.

• 1:59:43Speaker 01

  But, but more often than other, any other feature, ears were the most effective. Okay, let's go on to number two. A new study finds that preschoolers, on average, were rated as more creative than adults on a variety of creative tasks. You guys all think this one is the fiction. And this one is the fiction. You guys got me.

• 2:00:01Bob Novella?

  Yeah, baby.

• 2:00:02Speaker 01

  And Kara, you pretty much nailed it. So the, the part of the reason why they did this study is because that there is a prevailing assumption that children are more creative than adults.

• 2:00:12Cara Santa Maria?

  Yes, but people don't, they're not thinking about what creativity actually is.

• 2:00:16Speaker 01

  Yeah, but, but, but they tried to as objectively as possible score the, the output on these multiple tasks. And the adults were, were generally rated higher than the children for all the reasons that you guys discussed, right? In terms of genuine creativity. However, there was a significant difference on something else. Why, why might children be perceived as more creative? I think Kara, you're sort of correct.

• 2:00:42Bob Novella?

  Because they're wacky.

• 2:00:44Speaker 01

  Well, because they are really confident. They're much more confident than the adults. Adults were very.

• 2:00:51Cara Santa Maria?

  They're not hedging.

• 2:00:52Speaker 01

  They were very anxious and, and, you know, and cautious and, you know, oh, I don't know if this is any good, where kids are like, this is awesome, you know?

• 2:01:01Cara Santa Maria?

  Yeah, kids are just like walking egos. They're just like, everything I say is brilliant.

• 2:01:07Speaker 01

  Exactly. So that was the big, big advantage in the kids, but yeah, the adults were way more creative. Which means that a new extensive review of whole genome sequencing finds that on average, people have about 5 million genetic variants, including 13,000 protein changes, 229 of which cause a loss of function, is science. There's a lot more data in there as well, of course, but those were the highlights. So yeah, it's a, there's a lot of genetic variance. And yeah, Alice, you're correct. I mean, you, you realize that it's the whole genome, so that includes all the non-coding sequences. That's huge.

• 2:01:39Bob Novella?

  Oh, yeah, yeah.

• 2:01:40Speaker 01

  And of course, they're variable, because a lot of it, they don't code for anything. But the 13,000 protein changes was, that was the interesting one to me. That is, that is quite a bit.

• 2:01:50Bob Novella?

  Well, the 229 loss of function, that's what got me.

• 2:01:53Speaker 01

  That's a lot of, but I think Alice is correct that most of this is, even though there is a loss of function, the, the body's pretty resilient. Otherwise, we couldn't survive, right? I mean, the, the other thing they found was that, that children on average, or people on average, had seven to eight de novo mutations that they did not inherit from their parents.

• 2:02:12Bob Novella?

  Whoa.

• 2:02:13Cara Santa Maria?

  That's interesting, yeah.

• 2:02:14Bob Novella?

  Thank you, Cosmic Grace.

• 2:02:15Speaker 01

  Yeah. Which I, which is, squares with what I learned, you know, in medical school about that number. They also found that, you know, most people have two to three rare, disease-causing genetic mutations. But of course, most of those are going to be recessive, right? So they won't manifest.

• 2:02:34Bob Novella?

  Okay. Some people, some people have muscles that other people don't have. That blows me away. Now, granted, they're small, but you know, but there's probably something that our ancestors had, but didn't really, really need anymore. But imagine that, I've got a muscle over here that nobody else, that very few people have, it's really cool.

• 2:02:53Speaker 01

  There's so much variation, which like, what I would teach, like my students and fellows, et cetera, because we, we're, you know, we do nerve conduction studies, which is one of the things that I, that I'm certified in. The, you looking at a book that shows you the anatomy of whatever, the anatomy of nerves or arteries or whatever.

• 2:03:11Bob Novella?

  Oh, man.

• 2:03:11Speaker 01

  That's just an average. That's not the anatomy. That's a good rule of thumbs, like maybe that's 60%, but most people have variations, right? They're, they don't have the textbook anatomy that they're supposed to have. People are varied in, in so many, in pretty much every way that they can be, right?

• 2:03:32Bob Novella?

  Yeah, that's why it's, you know, like surgical interns and stuff, that you got to do surgery, man. You got to expose yourself to this variety, to, to appreciate it, not freak out when you, when you operate on, operate on somebody.

• 2:03:42Speaker 01

  You got to cut open bodies, absolutely. All right, Bob, give us a quote.

• 2:03:47Bob Novella?

  This quote is from Rachel Carson, marine biologist. "The more clearly we can focus our attention on the wonders and realities of the universe about us, the less taste we have for the destruction of our race. Wonder and humility are wholesome emotions, and they do not exist side to side with a lust for destruction." So as I said, Rachel Carson, marine biologist. She was, she was an American, world-renowned marine biologist, an author and conservationist. Her, her probably most famous book, Silence Spring, is credited with advancing global environmental movement. So this quote is from the 50, 1952, I believe. I really liked how Carson reframes the sentiment on environmentalism and conservation.

• 2:04:28Bob Novella?

  You know, she didn't use classic techniques like using guilt or panic, but she argues that our destructive tendencies, right, that our natural destructive tendencies stem from this, this disconnect with curiosity and even an appreciation of science that, that seems to go away in a lot of people as, as they get older. And that deepening, you know, deepening our genuine curiosity comes, you know, cures that destructive impulse. So this is, it definitely had a, I was reading a lot of quotes, saying this one really had a, I had a real reaction to, and that's why I, I'm use it today.

• 2:05:02Speaker 01

  Yeah, but I will, I have to say that some of the things she concludes in her book, Silence Spring.

• 2:05:08Bob Novella?

  Oh, I didn't read it. Okay.

• 2:05:09Speaker 01

  No, so classy, really overstated the risks of DDT and of pesticide, et cetera. She was responsible for a lot of, you know, regulation changes and, you know, I think good things. And, you know, her overall approach was fine, but it was a little, you know, looking back, I think is generally considered to be a little bit of an alarmism, you know?

• 2:05:34Cara Santa Maria?

  Yeah, you have to remember the context.

• 2:05:36Speaker 01

  Yeah.

• 2:05:37Cara Santa Maria?

  There wasn't an alarm being wrong.

• 2:05:39Speaker 01

  Yeah, I hear you.

• 2:05:39Cara Santa Maria?

  You're like, so.

• 2:05:40Speaker 01

  It's more, it's complicated.

• 2:05:42Cara Santa Maria?

  It is, and it's like, you, you do what you can with the evidence that you have at the time, and then it changes. So we can't hold her to a standard of, of evidence that she didn't have.

• 2:05:52Speaker 01

  No, but just, because you know, you know, our audience, there are valid scientific criticisms of the conclusions she draws in that book. We just want, we don't want to not say that.

• 2:06:02Bob Novella?

  It's good, it's good to point that out, but I love this, this stress.

• 2:06:04Speaker 01

  This is a great quote.

• 2:06:05Bob Novella?

  Yeah, it is. I love the stress on wonder and humility. There is just not enough of that. And we talk about it. How could people not be fascinated by this or that or whatever? And it's just like, that wonder and the humility is just like, not there for, for a lot, for a lot of these people. And it's, it just seems sad from, from our, you know, from our point of view, anyway.

• 2:06:24Speaker 01

  I agree. Well, Alice, thank you for joining us on the show. It's been a lot of fun having you.

• 2:06:29Speaker 04

  Thanks so much for having me. It's been great fun. Thanks.

• 2:06:31Speaker 01

  And guys, thank you all for joining me.

• 2:06:33Bob Novella?

  Anytime, brother.

• 2:06:33Jay Novella?

  Thanks, Dave.

• 2:06:34Speaker 01

  And until next week, this is your Skeptic's Guide to the Universe.

• 2:06:41Speaker 01

  Skeptic's Guide to the Universe is produced by SGU Productions, dedicated to promoting science and critical thinking. For more information, visit us at theskepticsguide.org. Send your questions to [email protected]. And if you would like to support the show and all the work that we do, go to patreon.com/skepticsguide and consider becoming a patron and becoming part of the SGU community. Our listeners and supporters are what make SGU possible.